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APPLICAT14.i FOR CON�TRUC7 .JN PERMIT <br /> CiTY OF EVERETT• BUILDING DiVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> (I DEMOLI710N fl COMBINATION I}d BUILDING (,� MECHANICAL � PLUMBING f-1 SIGN <br /> PROJECT ADDRESS <br /> :��1// '/G�h .L�L Gc�� <br /> OWNER IdAILADDRESS Cltt 71P PMONE <br /> J�/�C�IS/t�z/ ��t's �iuc 7nZ3 -Z3%'� �L: St=. /.���P// ��S'OZ/- yb'3/D6S <br /> TEN�NT MML �OFE55 CITY ZIP i'iIONE <br /> ARCHRECTOR�ESIGNER MMLAOORE55 GIIY ZIP �YONE <br /> /�PS,�a,�s �,��;j,�,� .� ��z- zs�a <br /> GENER��CiO� MAILA^�RESS CITV 71P �'��OHE STFTELICENSEn <br /> f�PCC�5��u1 li�rrmrs T�c 7., z3- Z3y� i�L �,� /.�oT�// `/$FJZ/ �/'P�i/<lD�/GE <br /> MECHANICALCONTR4CTOR M�ILADORESS CIiV ZIP P��ONE SIATLI.ICENSEx <br /> —��rPf- /�.en,�c, 3�5 /'S�/I / <br /> PLUMBI CONiRACTOR AILAODRESS CITY ZIP PHONE STATEUCEHSE/ <br /> L _ <br /> C NiRACT PRICE OF WORN i <br /> S � ' � HEATING SYSTEM: [4f GAS fl ELECTRIC ❑ <br /> OESCRIBF WORK A. �SOUARE FOOTAGE INVOLVE� CONTA i PERSON ANO PNONE NO. <br /> ��1Cel S.r� /SY 5 � ��h�r.�-- : _ - <br /> d <br /> .,o, .;,>>. ��-C�.at',� G.n-.a� c �•�,� e �,�'3�-lu �d- <br /> S. _ ��� I HEREBY CERT� Y THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPCSED USE OF BVILOING PROVISIONS QF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> L'cGALL1E5CflIPTIONOFPROPERtt�SHOWNBELOWORATTACHPNOCOPIES� NOT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or '� / BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF AIJY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TI'.E <br /> PERFORMANCE OF CONSTRUCTiON.THAT I AM AUTHORIZED BY Tfii� <br /> 'l �. / n n� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � JL'1' APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELLI%I.D.NUM9ER <br /> �� � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTF�CTION LOAN LEN�EIl.!AOOBESS.TELEPHONE NOMBER X /�q,��R �/�Y/ �� <br /> _�flMJk// /��U SIGNATURE AT� <br /> CITV BUSWE55 LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM11 FEE <br /> T <br /> ' WATER CLOSET(TOILET) �// � A/C—AlHNDLG UNITS—H.P. � <br /> BATHTUB �� ; ( FORCEDAIRSYSTEMS—B.T.U. M E.A. -- ; <br /> ?j LA4ATORY(WASH BASIN) J � HEAT PUMP � <br /> SHOWER � UNIT FiEATEPS—B.T.U. PA ' _ <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS � � <br /> DISHWAS!�IER � VENTILATION FAN ' <br /> LAUNDRY THAY ' ( RANGE HOOD " I <br /> / CLOTHES WASHER � � ( WATER HEATER — ' <br /> URINAL ' WOJDSTOVE '-- <br /> DRINKING FOUNTAIN � ME.TAL FIREPLA(;E(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLAi.E INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) � GAS RAhGE <br /> � 3 GAS PIPING � <br /> � <br /> ; EXHAUST FAN � � <br /> — i <br /> � <br /> — i ' <br /> SUB TOTAL 5 ; SUB TOTP.L S ; <br /> PERMIT 5 i PERMIT S � <br /> TOTAL FEE 5 � TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSEIOFCN REFRSET04CN SI�ESET[1ACK PVNCNECKNUM�ER F[E FECEIPTNO <br /> I 5 t�' Zo' S � y�,� �� 3��� . �� ll�o�`' <br /> usezo�'�� �oTaee� 5 vnenNrsi e FEES VALUATION FEE <br /> 70 es n No om�oiNc ,�•�r'�• ��yT� ��r " <br /> HEIGHTLIMITATION NO.OFOWELLING SiZE0F8LDGRl �7 � <br /> � UNITS Iy�7 SF� LlV/�U� PLUlApING f I ' / / �� <br /> � .�� �y/JR.QG�. �,/'7 <br /> OCQIPANCV NO OFSi0FIE5 OGCUPANTLGAD � – EMENT ''/ MECM4NICAL �.(/ i <br /> GROU ��YES ynVO <br /> �-3 Z N ' <br /> FIRE ALARM REO'D �E�SON AD�I710NAL PLAN CHECK � ��� <br /> i <br /> Q �� OTMEfi -�/ � �J i <br /> FIRE SPPINKLER REO'D REASON � /� � <br /> r STATE DUILDING SURGHAFGE L � � <br /> TYPEOF ONST PIANSAPPROVED�V CITYOFEVERETT PUBLICWORKS �(�i — <br /> �//—r LOCAL SALES <br /> �f� r TAX CODE IS 3105 TOTAL / � ' � <br /> 1L-/J DATE � ]S _ <br />