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� APPLI�ATILnI F'OR Ct'�1STRUCI .ON PEi;MIT <br /> r CITY OF FVERETT • BUILDING DIVISION <br />� 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> f 1 DEMOLITION �l COMBINATION fl BUILDING rl MECHANICAL f l PLUMBING rl SIGN <br /> °ROJECT ADDRESS <br /> �/> , <br /> i � I� ��i ����� f�-'L �{% <br /> ow a, iu,t,r,aess , cirv zm rnoHe <br /> l� ,� P� �l� , � , . , � � -- <br /> �% ,� �1�.La��L� /Z�ll ,��� �1/c��'���.t/" �����`/ > � � �r;c� <br />( I.NFNT MNLADpqE55 CItV 71P PHONE <br />/ PPCHRECTOR�ESIGNEIi 61pILMORF55 CITY )iA PHONF <br />� <br /> G ER4L CONTRAC MAII.A�DRESS CITY ]IP PHONE SiATE LICGIJSE x <br /> ( � <br />� ����I�,(%I I ti'7'y'C.'J �'L�� <br /> MEC��LCONTR4CTOR MAILAD�f1E55 CITY ZIP PI104[ STPTEUCENSE� <br /> PLUTABINGCONiRACTOR h1FILF�DRE55 GIN 21P PHONE SiATELICENSE• <br /> CONTRACT PRICE OF WORK <br /> , f i 'i HEATING SYSTEM: I�GAS I-I ELECTRIC Cl <br />� DES RIDE LYOPK N�oOUARE FOOTAGE INVOtVE� CUY.TA T f[RSON ANO PHONE Np� <br /> s"�' Sr i � �±� f/'9 :� � /'.G <br /> 5" � 3 — ��1 � <br /> I /�� � �/^�, I HEREI3V CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> I -4/dPd �� C/ APPLICATIOP�AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PF SED USE OF BUILDING <br />� �� PROVISIONS OF LAWS AND ORDINANCcS GOVERNING THIS TYPE OF <br /> ����L WORK WILI BE COMPLIED WITH WHETHER SPEGFIED HEREIN OR <br /> LGGALDESCRIP710NOFPPOPERTY(SHOWNBElOYlOP�TiACH7VJOCOPIE51 NOT. THE GRANTING OF A PERMIT DOES �OT PRESUME TO GIVE <br /> iot�_o�ocK or AUTHORITY TO VIOLATE OR CANCEL THE P!70VISION OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> - �� �t I � �� � � � � �-�!� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ON/NER CF THIS PROPERTY TO PEFFORM fHE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX I.D.NI161BER CON�i AC70R5 LA 27 RCW AND �200 WAC. <br /> r� -C�Gc.!� ��`'/,,�- I��. / <br /> CONSTRUCTIONLOAN�[NDCR.F�DBESS,TELEPHONENUMBER x �/,�,� ����j�,yA/,t/v ���Z�7J <br /> SIGI:Pil1RE~� � �ATE <br /> CITV BUS W E55 LICENSE N0. <br /> PLUMBIdG MECHANICAL <br /> NO. TYPE OF FIXTURE OR I7EM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AlHNDLG UNITS—H.P. � <br /> BATHiUB ; FORCEC f�IR SYSTEMS—B.T.U. M E.A. ; <br /> � LAVATORY(WASH BASIN) � HEPT PI.iMP � <br /> SHOWER ' UNITH6�TER5—B.T.U. M I <br /> KITCHEN SINK R DISP i CLOTHES DRYERS i <br /> --� <br /> DISHWASHFR �� VENTILATION FAN � � <br /> LAUNDRY TRAY ; j RANGE HOOD � i <br /> CLOTHES WASHER � � WATER HEATER � <br /> URINAL ' WOOD STOVE ; <br /> DRINKING FOUNTAIN i METAL FIR[PLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPIACE INSERT(WOOU BURNING � <br /> �ACKFLOW PREVENTERS � GAS F .7EPLAGE � <br /> - T <br /> SINK(SERVICE—BAR, ETC.) GAS RANGE � <br /> ; GAS PIPING ' <br /> � ? EXHAUSTFAN � <br /> , — i <br /> � � <br /> � -- ----— <br /> � � <br /> SUB TOTAL S ; S1�5 TOTP,L 3 ' _ <br /> � <br /> PERMIT S PERA^IT S � <br /> TOTAL FEE S � TOTAL FEE 5 � ' <br /> FOR OFFICE USE ONLY: <br /> FROtlTSET�AGK � �'�y R[ARSFT[14CN SIDESETf1f�.CK � PLANCIIECHNIIMOER —FE FECGIPTNO. <br /> 1� S�' ' � �'� t �o ��(n 7,� � <�� �///C'[') <br /> u�,ezoNE �ornnen vnenrvrsiTr PEES JALUATIQN FEE <br /> 2�f1 S 7�� r!�Es n r.o ouaowc •�2,3�; �- <br /> HEIG:ITL1lAITATION NOO�DWELLWG SIZEOFpL�Q�TI. - i <br /> Z�� uNirs ' / '79 Sf y vi.iuomc ,�L/' <br /> �r.:i S 4Art .—{ <br /> OGWP4NCI NOOFSi0P:F5 OCGUPAIJTLO�� BAS[NEN� MEGIIANICAL ��CIj <br /> GNOUP <br /> �.3 Z nI�/1 ❑YES 0 i <br /> FIREALARMREO'� REASON ADOITIONALPl4NC11GCN __i <br /> � OiHER / ) � <br /> FlRESPRINKIERR�O'� RF.�SON ' i <br /> � STATEDUILOINGSUfiCH�RGE ,L �J� <br /> TVPEOFCONSi PLANS�PPROVEDOY CITYOFEVERETT PU�LICWORKS ��� � <br /> J LOCALSALES -- � <br /> �'/J onte Z6 $ TAX CODE IS 3105 7o7AL /i�/ ��� <br /> J� <br />