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APPLICATIO�1 �OR CONSTRUC7 �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ;F\ DEMOLITION fl COMB'INATION rl BUILDING fl MECHANICAL �� PLUMBING �l SIGN <br /> PiiOJECT ADDRESS /O� o� � f- /J „ SC <br /> im <br /> OWNER MAILADDRESS CITY IIP pO��U PHONE I.�U��? <br /> (���4cfc P(�Rrr�ERIH�P q`lo0 1�'rN A�� Wrsr K3oY �VFREiT WA 2U6 - 337�_ <br /> iENANT M�ILADORE55 f,IT: ZIP PNONE � <br /> No�E <br /> ARCNITECTORDESIGNEN MMLADORE$S CITY lIP PMONF <br /> [SONE <br /> GENERALCONTR�CTCH MAILADDRE55 CIIV 71P P110NE S�niEIICENSE� <br /> (�aPe <br /> MECHANICALCONTRACTOR M�ILAU08E55 CITV 71C PIIONE STATELICE' i� <br /> (�O�E <br /> PLUMBINGCO �1 R C�T� M�ILADDRESS — CI7Y ZIP PHONE STATELICENSE� � <br /> (�d�� <br /> CONTRACTPMf�FWOfiN <br /> � �� HEATING SYSTEl..I: I I GAS ELECTRIC fl <br /> OESCRIBE WORK AND SOUARE FOOTME INVOLVED CONTACT PERSON AND PHONE N0. <br /> DEMo�.rda (�caf� (3Y c nh-Aa�tE� [{u ia 1 oovJ ob - � a 3_ <br /> � ,/, UT`F OP FU�RET'i` F(Rr DEP'(: <br /> .� ClT'7 €� .0. rr p 4� ,P 2 u N '00 - 5 • _ <br /> C b � V S�.G . I HEREBY CEP.TIFV TH.4T I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AI.L <br /> PROPOSEDUSE OF BUI_ _ �oy� pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> N� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN Oft <br /> LEG�LDESCRIPTION FPROPERTVISXOWN9ELOWORA7TACHTWOCOPIES� NOT. THE GRANTIi4G OF A PERMIT DOES NOT PRESUME TO GIVE <br /> I �oi' e�ocK oF_ AUTHORITY TO 'JIOLATE OR CANCEL THE PROVISION OF ANY <br /> I OTHER STATE O'4 LOCAL LAW REGU TING CONSTRUCTION OR THE <br /> PERFORMAIVCE �F f:DNSTRUCTION HAT I AM AUTHORIZED BY THE <br /> OWNE'"OF THI;� PROPERTY TO P RFORM THE WORK FOR WHICH <br /> • APP T io MADE AND I COMPLY WITH THE STATE <br /> PNiCELhVt I.D.NUMB C T RS LA 1827 RC D 296200 WAC. <br /> CONSTRUCIIONL � R.�DIXiESS.TELEVHONENt1MBER X � � ` J <br /> SIC� ATU E A.(� ORTE <br /> �,�� <br /> CITY BUSME55 LICENSE NO. <br /> PLUMBINa MECHANICAL;� <br /> NO. TYPE OF Fll(TURE OR ITEM FEE NO. j TIPE OF EGUIPMENT FEE <br /> WATERCLOSET(TOILET) � ;fi/C—AIHNDLGUNITS—H.P. ' <br /> BATHTUB ; � FORCED AIR SYSTEMS—B.T.U. M E.A. ;' <br /> LAVATORY(WASH BASIN) � � HEAT PUMP ' ' <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> � <br /> KITCHEN SINK 6 DISP � CLOTHES DRVERS / � <br /> DISHWASHEH � VENTILATION FAN ' <br /> UIUNDRY TRAV i RANGE HOUD � � <br /> —r— <br /> CLOTHES WASHER � WATER HEATER . ; <br /> URINAL ' WOOD STOVE �' ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BU NING} � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOjI'BURNING � ' <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE / � <br /> SINK(SERVICE—BAR,ETC � GAS RANGE ' <br /> � GAS PIPING ' <br /> ; E%HAUSTFA � <br /> , <br /> ; � <br /> SUB TOTAL S ; SUB TOTAL $ ; <br /> PERMIT $ � PERMIT $ � <br /> TOTAL FEE S ' TOTAL FEE $ <br /> FOR O CE USE ONLY: <br /> FRONTSE�PRCN AERRSETBACN SIUESETBRCN �UNCIIECNHUM9F.R �EE AEf.EIPfNO <br /> �/�a os <br /> USEZONE LOTAREA VPCRNi51IE FEES VALUATION FEE �_ <br /> IIYES fi NO i <br /> ounniHc , <br /> HEIGHT UMITATION W-�/����-- .�IF.OF.YlO('dJL---'-"— .. .- - '------. —. � <br /> p���.��: I o a o � 7�,� �vE. s�� • T <br /> occuPer+cr ra a su I <br /> GROUP ' <br /> Tract 18, Broadway Farms No. 2, accordinq to the plat ther�o! ; <br /> FIREAIARMREO'D r�cord�d in volum� 13 0! Plat� <br /> , paq� 93, racords of Snoho�ish �-- <br /> County, f�'�ashinqton. T� p{�Rcc� .#� 3`�70 - poo- f���'- Ocoo � <br /> FIRF.SPRINKtER REO'D � <br /> $TATE flUILDIN6 SURCH�RG[ � <br /> TYPEOPf,ONST PI�NSA�PROVEOBY CITYOFEVERETT 1'IIflIICWORNS <br /> LOCAL SALES <br /> opTE TAX CODE IS 3105 TOiA� <br />