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,� <br /> APPLICATION FOR CONSTRUCTrON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ri DEMOLITION fl COMBINATION �l BUILDING I� MECHANICAL r l PLUMBING f l SIGN <br /> PROJECT ADDRESS <br /> pWNER MaILADDFESS Cltt ZIP PMONE <br /> '��3 l,� i�1C-,�.C�I S�ZS' - IS}" c� c.� iG�l� �i�2v�l 3���- So�i � <br /> TENANT MNLAOORF55 GTY 21P FMONE <br /> ARCMITECTORDESIGNER MAILAD�RE55 CITY ZIP PNONE , <br /> GENEMLCONiRACTOR MAILADORE55 GtY 71P P�IONF: STAIELICENSE� <br /> � MECIIANICALCONTR4CTOR MAIL�D�RESS fl �Zr`1 � LIN ZIP P110NE STATE UCENSE� <br /> Gr�� �t l� �St✓��.i tiµL. ��flsri 1�1� �,� }-� (ait-1- `182L3 y3S 4qD`�, C�Z'-�1-1i �zL��vn <br /> PLUMBINGGONTRAGTOR MAILADORE55 Cli� � ZIP PHONE STATELICENSE� <br /> WNTRACT PRIGF.OP WO�N <br /> �3pD - <br /> HEATING SYSTEM: I l GAS �I ELECTRIC f I <br /> OESCRIBE WORN ANO SOU�RE FpOTAGE INVOLVED CONTPGT PERSON AND P''.JNE NO. <br /> ,�,��J �r ��',�-�f�'Y�E_ <br /> I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> — APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT ALL <br /> PPOPOSED USE OF OUII.DING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF � <br /> ���5 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGALOESCFIPT10NOfPROPEFTVISHOWN6ELOWORATfACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE <br /> �aT 9LOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHFR STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFiIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAeCEL Tnz I.D.NUMBER CONT S LAW . 7 RCW AND 2�C. <br /> CONSTFIICTION LOAN LEN�ER.P�DRE55.IELEPNONE NUMBEP x — —v` � <br /> SIG TUR OATE <br /> CITV OUSINESS LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. _ ' <br /> BATHTUB ; I FORCEDAIRSYSTEMS—B.T.U.(�oM E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ' RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREFLACE(WOOD BURNING) � , <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS � <br /> GAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE '_ <br /> � <br /> � Z GAS PIPING � <br /> ; EKHAUST FAN <br /> � <br /> ' � <br /> SUB TOTAL S � SUB TOTAL 5 � i <br /> PERMIT 3 i PERMIT S / � <br /> TOTAL FEE S ' TOTAL FEE 5 7 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETPACK PEAR SF.TOACN SIDE SETBALN PLn1!CIIECK NUMFIFR �EF RFCEIPT NO <br /> usezoNe iarnaea vncnr�rsire S FEE� VALUATION FEE <br /> IIYES il h0 � <br /> pUILDM[ � <br /> HEIGIIT UMITATION NO OF pWELLING S2E OF 9L�G/(I �— <br /> llNif$ P�IIM�ING � <br /> — T <br /> � <br /> OCGl1PANCV HO Of 5�0�iES OCCUPANi 104� BASEMENT MECN4NICFL � <br /> Gf10UP — --- <br /> IIYE$ I1 NO <br /> AOUIIION�L PI�N G���f,N <br /> FIREALARMPEO'0 Rf450N �— <br /> i <br /> O111ER � <br /> i <br /> FIqF.SPRINKI[RREO�D RE�SQN � <br /> SiNE DUIIDMG SURGI�RGE <br /> rrPeorr,ovsr vinNsanvnovEnov CITYOFEVERETT runur,wonKs <br /> IOCAL SALES <br /> ��A,E TAX CODE IS 3105 70TA� <br />