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� ' <br /> APPLICATIf=N FOR COI�S'4'RtACTlON PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERET"i, WA 98201 • 259-8810 <br /> fl DEMOLITION �l COMBINATION �1 BUILDING I-1 MECHANICAL J�l PLUMBING f l SIGN <br /> PROJECT ADDRESS � � ;, , /�h�'�" �� / � � �— <br /> OWNER MAILA�ORESS CITY ZIP PNON[ <br /> TNhG�� ' � <br /> V� U <br /> IEN��N�/T � 1 .Ap RL55 'CIiV 71P FIIONE <br /> �f��l-P, �.(.YlS4 > <br /> ARCHI fC70�DE51GNER IAAl1.ADDRE55 GITV ]IP PNONE <br /> ,����.l�-��M , �'I�,�, 2�2�eS'�'�,��'������ • <br /> GENrEPPI CONiRAC70R IdAILA0�RE55 CIIY liP PNUN[ S1ATE LIC[NSE� <br /> 11.x_ i.� �� a �.r ! � :a � .7�,: ,J..,i �7:�.,- "-[//� � 'S'��.>' j ,q�y�..G��L�� h,i�rlf /�-s:.i U 9�`f//�`. <br /> MECHANICAI CONTR�CTOF MAI�'�OORE55 Cltt ZIP PIIONE S1ATE LICF.NSE� <br /> PLUMBINGCONTRAf,TOR MAILADDRE55 GIiY 21P PlIONE STATELIGENSE� <br /> CONiHACT PRICE OF WOfiK <br /> HEATING SYSTEM: f l GAS �l ELECTRIC f l <br /> OESCj11BE W0 N ANO S U�RE POOTAGE INVOLVEU , GONiACT PERSON AN�PHONE NO. <br /> 1 .7 <br /> . . �! � r' l.- _ <br /> . \� / i • _ � NL• _ <br /> � /� _7 - rf � � � I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> � -��"�r'> >�`� `"��'' APPLICATION AND KNOW THE SAME TO BE TRUE AND COR4ECT ALL <br /> ' PPOPQSEO USE OF1 Bl11LDING � ' � �� '� pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �tpClCtYY�� _ WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDELGRIPTIONUFPHOPERTY�SHOWNBELOWOFARACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE , <br /> � ior BLOCN oF _ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY �. <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED FY THE <br /> — OWNER OF TH�S PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE . <br /> PARCECTAX I D.NUM9Efl CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. �� <br /> / 72 ���- i 032 -Goa3 ���,� 7 J � <br /> �a � � <br /> CONSTRUCTION LOAN I.ENDER.A�Df1E55.TELEPHONE NUM9ER X �) (/ rLi6Lj+1.� � 7,'f �i <br /> . _ SIGNATURE OATE I <br /> CITV�VSINF.55 LICENSG N0. I <br /> PLUEIBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> . WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. �— I <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M EA. ; ', <br /> �?� LAVATORY(WASH BASIN) � HEAT PUMP � <br /> HOWER � UNITHEATERS—B.T.U. M ' . <br /> KI EN SINK 8 DISP ; CLOTHES DRVERS I � <br /> DISH SHER � VENTILATION FAN � � <br /> LAUNDR AY ; !�ANGE HOOD ; <br /> CLOTHES W ER � WATER HEATER <br /> UFINAL ' WOOD STOVE ' <br /> DRINKING FOUNTA METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLAGE INSERT(WOOD BUfiNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> ; GAS PIPING ; <br /> � EXHAUSTFAN � <br /> � � <br /> SUB TOTAL 5 � SUB TOTAL 5 � <br /> PERMIT S PERMIT 5 i <br /> TOTAL FEE S � TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fRONT^ETAAGK REARSF.TAACN SIOESETBACN PIANCII[CKNUfdOER PEF �Pf.flPTtlO <br /> usezONe iornn�n vncnutsre FEES VALUATION FEE <br /> IIYES I I Np ���� <br /> F3UII OWG � <br /> - i <br /> HEIGNTLIMIiAT10N NOOFDWELLING 52EOFOL�RI i <br /> ❑NI I$ Pl11MBING � <br /> _--�_ <br /> OCGUPANCY NO Oi5I0PIC5 OCCUP�NItOAD BASEMENT i <br /> GROUP MFGNnNIf.aL � <br /> ItV[5 I1 NO <br /> FIREALARMPEO➢ fiEASON �II�iLONnI.PIANCHFCK � <br /> on�en � <br /> � <br /> FIRf.SPRINKIF.R REOT RFA50Y i-/1 <br /> STNE IlUItDING SUqC11AfiGE ;�/ / <br /> J�� <br /> iVPEOff,ONST PIANSAPPROVEDAY CITYOFEVERETT ����IIf,WOnHS <br /> LOCAL SALES --- — -`— <br /> unrE TAX CODE IS 3105 7o7AL J�9 �C�f <br />