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APPl.ICATIOrI �`OR CONSTRUCT�ON PEFtMI f <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 9820t •259-E1810 <br /> ❑ DEMOLITION CUMBINATION I� BUILDING C] MECHANICAL t� PLUMBING fl SIGN <br /> PROJECT ADDRESS � �,� C <br /> 5� i 11j' I��P . �1�. � ��J_e.VC:I-1� <br /> OY/NE�"S�.71.�1'�L�l�] .�_ i RI�ADOIO�/I� �I1 )LlI 'C�ViVQ11 IA.U,I.t ��J�"Vll� l/ I(l�.�l�f`HO/�l+U''��lL " Ll���'I <br /> l. <br /> TENANT � MAILADDRE55 CITY 21P PHONE <br /> ARCHITECTOR�ESIGHER MAILAOOfiE55 ;Itt ZIP PHONE , � <br /> GENERRLCONiMCTOR p� MqILqO�fiESS CIIY ZIP p11pNE SiAiELIf,ENSE/ � <br /> ��5�:��1"1C . _�l��l(,C-1!)1�C� . .. , • - . . <br /> MECH�NICAI CONTR�CTOA MAIL ADOFE55 Cltt 21P PHONE STqTE LICENSE� <br /> Z�ae-ti- N�r,-\ivn � o �nX ?��ln 1 riD� � `��e�le��s �PaSS� 3 tf �i'!ll P�,��z�la.yy �,zlk� <br /> PLUMB GCOMf1AC70R MAILADDRE55 CITV IIP PHONr_ STATEIICEN5E1 <br /> °-4� U� r '� 3� '� : , � e.v � `��'a�� - �',�5 luA L i S►� 51�;�,� <br /> CONTRACT PRICE OF WCRK <br /> HEATING SYSTEM: -1 Gp,S fl ELECTRIC I l <br /> OESCRIBE WORK A 0 SOUARE FOOT�GE INVOLVED LONTACi PEHSONAND PI�JNE Nb. <br /> �l.)b��r���� , � � � ' <br /> � <br /> l�".t�l( � I`T8 la� (;1�(r I , -I. 3 <br /> � ' ' � - I HEREBY -CER7IFY 7HAT I HAVE READ AND �EXAMINED THI: <br /> PROP D�ISEOFBVIL�INO APPUCATION AND KNOW THE SAME TO BE TRUE AND CORFECT.AI . � <br /> �� ' ,�_� (,_ � PROVISIONS OF LAWS AND ORDINANCE5 GOVERNI�IG THIu TYPE Cr <br /> � WORK WILL BE COMPLIED WITH WHE'(HER SPECIFIED HEREIN �JR <br /> LEGALDESCRIPTIONOFPROPERTY�SHONMBELOW.ORATTA �itwocoviEs) � NOL THE GRANTIIJ� OF A PERMIT DOES NOT PRESUN' TO GIVE <br /> LOT"�BLOCK r OF � \ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY I <br /> � t � p OTHER STATE OR LOCAL LAW REGULATING CONSTNUCTION OR THE <br /> 61.L1i Q C , .CC. � � 8f,j c.� (,1,�, �� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTF'ORIZED BY THE I <br /> I OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> --�1,1,Q �(�(,Q�' �( � APPUCATION IS MADE AND I COMPLY WITH THE STATE II <br /> PARCELT/JI I.D.NUMBER CONTRACTORS LAW 10.27 RCW AND 296200 WAC. <br /> �L(aU ' �U(� -1,'�(d�- �O(bZ / n '� <br /> CONSTROCTION LOAN LENUER.ADORE55.TELEPHONE NUMBEA SIGNAI �� ^` v ��L � / I <br /> OATE � <br /> CITY BUSINE55 LICENSE N0. ' <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF FIXTURE UR�TEM FEE NO. 7YPE OF E�UIPMENT FEE <br /> WATER CLOSET(fOILET) � A/C—A/HNDLG UNITS—H.P. � � <br /> BATHTUB � FORGEDAIRSYSTEMS—B.T.U. M E.A. ; <br /> LAVATOFiY(WA3H BASIN) � HEAT PUMP —�— <br />� SHOWER � � i ' <br /> UNIT HEATEPS—B.T.U. M � <br /> KITCHEN SINK&DISP i CLOTHES DRYERS � � <br /> DISHWASHER � y VENTILATION FAN � <br /> LAUNDRY TRAY . � � j ' � RANGE HOOD ' � <br /> \ CLOTHES WASHER � WATER HEATER � � <br /> UPINAL � WOOD STOVE � � <br /> ORINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR ORAIN � FIREPIACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ; � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING <br /> i ! EYHAUST FAN i � <br /> i " i <br /> i � <br /> � <br /> — i i <br /> SUB TOTAL $ � SUB TOTAL� $ � � <br /> PERMIT 5 , PERMIT $ � � <br /> TOTAIFEE $ � TOTALFEE $ � � <br /> FOR OFFICE USE ONLY: <br /> FRONTSLiBACN REAASETB4CN SIDESETBnCN P�A1lCu[CNNUMBER FEF RECEIPTNO. <br /> � �' .S3O7 ^ �.�� l,J �l� '�;.- <br /> use2owe iornnen vncnNrSirE FEES VALUATION FEE <br /> "- � �6 a '�3' �s n Ho ouuoiNc 17 0? �t�0 <br /> IIEIGH7 LIMIUTION NO OF DYIELLIIIG SIZE OF OLOG/CI ' <br /> � UNIiS � IQiLI S.F, llvw�:a t i . <br /> 3 S f GA2A4� �'wn+oir+c �/ � OD <br /> OCCUPANCY NO(1f SIOPIES OGCUPANi i0A0 dASEMENi MECHnNICAL � <br /> cnou ��,� ,�,� <br /> R•3 2 nves � — -- <br /> . � <br /> FIPEdLARMREOD REp$ON A0�1710NA�PLANCHFCK i <br /> OTHER � <br /> FIRESPRINKIERREO'D REASON i . <br /> � STATEOUILDRlGSURCHARGE � . <br /> i S� <br /> TVPE OP f,ONST P�ANS APFP V�0 BY � .`1 � <br /> �i_ CIT�OF EVERETT Pueur.wonKs a�7 � G.b - I <br /> LO�.AL SALES 1 <br /> �— OAtE �D 7 tn TAX CaDE IS 3105 TOTAL C� l' ;3� <br />