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� <br /> I�` APP�.I�QiT10N FOR CONSTRUCTICIN PEF�MIT <br /> CITY OF EVERE7T• BUILDING DIVISION <br /> II 3200 CEDAR STREET• EVERETT, Wq 98201 •259-8810 <br /> I [-1 DEMOLITION �- COMBINATION f-I BUILDIN� I� MECHANICAL Il PLUMBING fl SIGN <br /> h PROJECT AUDRESS �q� C• f� <br /> i �. I?�,�-1 �' . I� G�J(.V_����1 <br /> OWNER MAILADURESS ��n. � <br /> MLiC.0 1 l_ {I. hf � - �C Q( �t;IZ r�(P'l)�lt� <br /> TENANT �IL AODRESS CIiY ' <br /> z��' t'110NE <br /> MCHITECTORDESIGNER MAILAOORE55 ��TM <br /> 71P PHONE <br /> GENEfUICONTMC70N MFILAODPE55 CIIY 21P PIIUNE $IATF.UCENSEY <br /> �i'�A���`>IYIE� U.-� �IJY1,L � (A.�iU( � « � l�Ll7��� � <br /> MECHM1NICAICONTRpCTOf1 MAI�ADUPE55 CIiV <br /> ZIP PIIONE SiniE LICF.NSE� <br /> R��� !-1,�n.�v�c� �'t� F-���c 331�� ���- � � e�9g��� 3'��{-�/� i i �1 i�t � F rH-���f <br /> PWM�INGCON7RACTpp IAILADOPE55 CIIV ZIP —� PHONE STAIELICENSE� <br /> 1 <br /> � 'ts �l.i,�+�J,;3��1 �ua`�'� S'r. S� . �� r-�:�-I i� c�8� v� 3 - ! y "s UJ lT P� Sln FS I�- <br /> coNrnnct rnicE oc wonK � <br /> HEATING SYSTEM: � <br /> 'GAS f� ELECTRIC rl <br /> OESCRIDE WORK AND SOUARE FO TAG�INVOLVED <br /> i ` CONT q PGRSON l,N P IONF.NO <br /> , <br /> � �� �Q�c, <br /> l�c,t�tc 11`I '� l.f�-I,�IPI cN �lU°I - lr�r5 �C,X� , dl1 <br /> � � (� JIC/�`�S^ 9' ' L LYl � I HEPEBV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PROPOSED U .OF BUI DIN _` p,�u Q` � i '� � - APPLICA710N AND KNOW THE SA�1E TO BE TRUE AND CORR[CT qLL I <br /> ���1C� M Vl � \ PROVISIONS OF LAWS AND ORDINANCES GOVFRNING THIS TYPE OF <br /> LEGALDESCR �TIONpFPqOFERTV�SHOWNBELOWOq nnc Tw coaiEsl�C ���RK WILL [3E COMPLIED WITH WHETHER SPECIFIED HEFiEIN OR <br /> �or f "—" -� NOL THE GFlANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF APlY <br /> �`Q�)�'�"�`�' C��Q-� �njAS'C� '� �[ PERFORMANCE OF pONSTRUCTION.THATG AM AU HORI ED BY THE <br /> L� �—�� � �Ct( �' O PLECAOF�NHI S�'MADET AND PI RCOMPLY EWITH KT ER ST TE <br /> �L_L� <br /> PARCEL TAX I yp,,.,t��uue�q' 1/ V U� '- C � ` U(�(�� CONTRACTURS LAW 7 . 7 RCW AND 296.200 WAC. <br /> \/��� 1 V -u� ? � - <br /> CONSiRUCTI0NLO0.NLENDER.A0DRE55.TELEPMONE NUMBER <br /> SIGN�*URE DAiG <br /> 7 <br /> CIIY OUS�NE55 UCENSG NO. <br /> ` � PLUR181N1; <br /> � MECHANICAL — <br /> . NO. TYPE OF FIXTURE OR ITEM 'EE N0. TVPE OF EOUIPMENT FEE <br /> _ WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. i <br /> BATHTUB ; FORCED AIH SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' <br /> ' UN;T HEATERS—B.T.U. M � <br /> KITGHEN SINK 8 DISP ; CLOTHES DHYERS � <br /> DISHWASHER ' <br /> ' VENTILAT�ON FAN —�— <br /> LAUNDRY TRAY ; RANGE HOOD � <br /> ` CLOTHES WASHEq � <br /> � WATER HEATE(7 � <br /> UqINAL � WOOD STOVE � <br /> DRINKING FOUNTAIN � <br /> - - . i METAL FIREPLACE(WOOD BURNING) ' <br /> FLOOR DRAIN ' <br /> — ' FIREPLACc INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE � � <br /> SINK(SERVi-,'E—BAR, ETQ) ' <br /> GAS RANGE <br /> � <br /> ; GAS PIPING � <br /> � EXHAUST FAN ��— <br /> - � <br /> _ i --�-- <br /> i <br /> � <br /> � � <br /> ' � � <br /> SUB TOTAL $ � SUB TOTAL S � <br /> PERMIT g � ' <br /> PERMI? $ � <br /> TOTALFEE $ � TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FfiONTS[TPACK REMSFiBACK SIDESETBALR PlNlCIIECKIlUAIf1fR fEE RECFIPiHO. <br /> � ' �.'C.�'� s ' c-�y� <br /> usEzoN��(, iornqEn vacaNrsire FEES VALUATION FEE <br /> i ��� �j��? 1.�,YES fl NO T <br /> Ol11lDMG � � ,� Q. <br /> HEIGNTU'MI7FTION NOAFOWEILING 512EOFBLUGR.1 — �:��� �J !� � �.''� <br /> Z UNIIS ` <br /> � 7C�'], I' 7J C . PLUh10WG (�/ :, .. <br /> �- � O J ...� —i_ <br /> OCGUPANCY Np piS�ONES OCCUPAN�LO�� BASB ENi <br /> ❑OI P � � IdECN�NICA� qqq � <br /> '��V'� IIYES IIYNO _�� �.'��-� <br /> FIR p�A�MREOD RF.�SON A�DI710N�I.Pl4NCNF.CN i <br /> 01HEfi � <br /> FIRF.SPBINNLERREO�1) RE�SON '� � � <br /> � <br /> STN E�UII DING SIIRf11AfiGF i <br /> 'PEOFf,ONSt PLANSaPPPOVEDOY <br /> i��._'' <br /> CITYOFEVERETT rueiir,wnnes � <br /> -�7`- 6 ' LOCAL SALES _ ,_��� ���_� <br /> IL_�y nnr[,� 7 TAX CODE IS 3105 TOTAL L__ /b,n�/r, I Ct� <br /> • o� <br />