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� APPLICATI4rd FOR CONSTRUCT �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 1 3200 CEDAr� STREET• E�lERETT, WA 98201 •259-8810 <br />` f� DEMOLITION fl COMBINATION �l BUILDING 1� MECHANICAL �1 PLUMBING f l SIGN <br /> PROJECT ADDRESS <br /> %'N� /-� ✓c_� lt� - E V c`R E �T �� <br />� yyp�Eq MI1I�AODRE55 Cltt ZiP PHONE <br />� I�I.iK` �.uNah�i �-7i�is� A�el{) Ev��;i 4'�aaa (aab)�sa -�9so <br />' TENANT M LAODPF55 f,ITV lIP PIIONE <br />( ARGHRCCTORDESIGNER MAl1.pODRE55 CIiY ZIP PHONF. <br /> I <br /> GENERALCONIPAGTOfl MAILAppRESS CItY iJP P�IOY[ SfATE�ICFNSF.� <br /> MECHANICALCONTR4CTOR MAILA�DPF55 ,D��OX //V8 ��TY 71� P������ STR[IICFN$E� <br /> �KJl2�'A�C dba{�n� rr LLcCtF Crx1TQ �-�INdI(dUdP 9�0�6-�4o8�aob�6��flio ��ia�l��+t�oe��°t� <br /> ' PLUM9INGCONIFAf.TOR MAllA00RE55 fIIY 21P PNONE SIATELICENSE• <br /> � ' GONTRFCTPRICE Oi WOPK <br /> i;! O.O o <br /> HEATING SYSTEM: � GAS f l ELECTRIC f I <br /> � P.�.<� �'� �ESCRIBE WORK AN�S�U�RE FOOTFGE INVOLVED CON7ACT PFRSON ONO PHONF NO <br /> 'r;' <br /> �I. <br /> , ` ,�nJs� u � as ru N a r > H ul� <br />` ,. � �1 �i I HEAEBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> . (y /}S r� P r,��(t- APPLICATION AND KNOW THE SAME TO BE TFUE AN�CORRECT.ALL <br /> - PROPOSED VSE OF Bl11LDIN'G/ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />� ��,',�:- � �(� ry��t�/ ry o r)'I. cr WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGRLDESGRIPiI OFPROPERTYISHOWNBELOWORARACHTWOCOPIE51 NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> , � �oT e�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTi7UCTION OR THE <br /> - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM 7HE WORK rOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ppRCELTA%ID.NUMBER CON-�S LAW 1827 RCW AND 296200 WAC. <br /> CONSiRUCT10N LOPN LEN�ER.ADOFESS.TEIEPHONE�UMBER x /'����51 <br /> SIGNA G DaTE <br /> CITY 9115MG5S UCENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ' I <br /> BATHTUB ; � FORCEDAIRSYSTEMS—B.T.U. M E.A. ; �, <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK&DISP � CLOTHES DRYERS � <br /> DISHWASHER VENTILATION FAN � <br /> LAUNDRY TRAV ; RANGE HOOD � <br /> CLOTHES WASHER � � WATER HEATER ' <br /> URINAL ' WO00 STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINii) ' <br /> � <br /> BACKFLOW PREVENTERS i GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) GAS RANGE <br /> � GAS PIPING � <br /> ; EXHAUSTFAN ' <br /> � <br /> � SUB TOTAL $ � <br /> SUB TOTAL S � <br /> PERMIT 5 PERMIT S S� <br /> TOTALFEE $ ' 70TALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETPACK REAR$FTBALN SIDE SET�aCN �L�N GIIECH NIIMA[f��, <br /> �EF r+er.Firr No. <br /> �<� 7 <br /> USEZONE IOiRREA VnCANfSItF <br /> FEES VALUATION FEE <br /> IIVES I1 NO 1 <br /> pUILf11NG � <br /> HEIGHi LIMITATION NO OF UWEILING SIZE 0���OGRI � <br /> i <br /> IINIiS PlU1d�ING _�^__ <br /> OCCIIPANCY N00�51pRi[5 OCCUPFNiLOPD B�SEMEN� M[f,H4NICAL -/` I <br /> GPOUP — f-��"-'-- <br /> IIVES �� NO <br /> �DDt110NN.PI.�N C�If.GN <br /> FIREALPRMREOP PBnSO4 -' <br /> � <br /> OIMER � <br /> i <br /> FIRF.SPPoNNI.F.RREO'D �F�SON � <br /> srmr:nui�ov+c sunr.r+nncc , _ <br /> ivaeorr,oNsr vinNsnrrnovFonv CITYOFEVERETT rumir,wanKs ___,_ <br /> LOCALSALES <br /> unrE TAX CODE IS 3105 TOTAL <br />