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APPLICATI(..J FOR CONSTRUC7 .JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COM8INATION ,� BUILDING p MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT RDDRESS:S-Sd 3 /� t h D� i9/ / <br /> OWNEN M�IL�WRESS �ITY zIP pNONE <br /> f/H��c�s 1���0 sssa 3 �o r ^ v,� rv rvP,-efr PS�ad.� �� �' -z/�9' <br /> TENANT MNLAODPE55 LITY }IP PIIONE <br /> �RCHREGTOqDE51GNER M�ILADOFE55 �ITY 71P PNONE <br /> GENER�ICONTMCiOR M�I�AO�RESS CIiV zl� pI�ONE SUTEIICELSEr <br /> /{er+ro�?e%�'9 tilat � c 99<?� �/s'`�9uc'�'6 � �pfr wi� q8'.208' R .naoMiO�'�/� <br /> AIECHAN�CAL WNTRA ON MAIUDORE55 Cltt pIP Sy�PHONE ST�fE LICENSE r <br /> `J$`fi �� <br /> PLUMBING CONTR�CTOR MRIL ADDRE55 Cltt ZIP PIIONE � STATE LICENSE� <br /> CONiMLTPRICEOF RK <br /> 7�C'l�-� /CG�J HEATING SYSTEM: ❑GAS ❑ ELECTRI� ❑ <br /> OESCRIBE YIO{IK ANO SpUARE FOOTAGE INVO�VEO CONT�CT pER50NAND PMONE NO <br /> 4"X/�! L� .�l�H�r/r c�wB i � 3�s' <br /> , I HEREBY CFRTIFY THAT I HAVE READ AND EXAMINED THiS <br /> Fi10PoSEDUSEOFBUILDING APPLICATIOIJ AND KNOW THE SAME TO BE TRUE AND CJRHECT ALL <br /> PROVIS�ONS OF LAWS AND ORDINANCES GUVEfiNING THIS TYPE OF <br /> WORK WILL BE CUMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lEWLOESCRIPTIONOFPqOPERTY�SHOWNBEIOWORFTT�CHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT�6 e�ocK � oF�e�r'���/�c/ C �/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCA�.LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE I <br /> PAqCELTAX I.D.NUMBER CONTRACTORS LAW 1B.27 RCW AND 296200 WAC. <br /> • - d0 - 6 -,QoO 8' p <br /> CONSTRUGTIONIOANLEN�ER.�ODRE55.lELEPMONEMUMBER X_� L7.w,_,-��j� 3- lv - c� �' <br /> �� f � —1` <br /> SIGNATURE OATE <br /> CITY BUSINESi LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE aF FlXTURE OR ITEM FEE NO. TYPE OF E(]UIPMEHT FEE <br /> WATER CLOSET(TOILET) � A/C—NtiNDLG UNRS � <br /> � BATHTUB ; FORCED AIR SYSTEMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP �— I <br /> SHOWER ' UNITHEATERS � �. <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS ; I <br /> DISHWASHER � RANGE HOOD , �I <br /> LAUNDRYTRAY ; WATER HEATER � ''� <br /> � <br /> CLOTHES WASHER i WOODSTOVE , <br /> URINAL � METAL FIREPLACE�WOOD BURNING) � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT(WOOD BURNING) i <br /> FLOOR Di7AIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS MNGE � <br /> SINK(SERVICE—B.4R,ETC.) � GAS PIPING � <br /> ' EXHAUSTFAN <br /> � ; <br /> � ; <br /> SUB TOTAL ; ; SUB TOTAL S ' <br /> PERMIT S , PFRMIT S <br /> TOTAL FEE S � TOTAL FEE E <br /> FOR OFFICE USE ONLY: <br /> FRONT SETAACN PE�R SETB�CN SIOE SETB�CN PUN C11ECN NUMPFR FEE REf.EIPT NO <br /> � �� C �77 � <br /> USEZONE �pTAqEA yACANT5I�E FEE VALUATION FEE <br /> ❑VES ❑NO OUILOING [1 � <br /> HEICMTLIMIT�TION NO.OFpWELLING SIZEOFBLOGRI � <br /> i— <br /> UNIiS <br /> �-,6 5 F -f- PlI1MdING <br /> OCCOPANCY Np Of5I0NE5 OCCUPANiLO�D BASEMENT —r— <br /> GRWP MECHaNICnL i <br /> �f�� ❑YES ❑ 110 - <br /> FIRE SPfl�NNLER REO'D RERSON ADDIIIONAL Pl\N CH[CN J � �/ <br /> / a <br /> Oi11EP <br /> FIREAIAflMREQ'0 REnSpN <br /> S1RlE8WlDINC511RCHAqGE — '�� <br /> TYPEOFf,ONST PL�NSAPP(�O�DBV CITYOFEVEREIT �1IB11f,WORNS — i <br /> J LOCAL SALES —1— <br /> oarE Z `'/�o TAY, CC.^,c IS 3105 TOTAL ; <br /> w <br />