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13IDG APPLICATI( V FOR CONSTRUC90"ON PERMIT <br /> CITY OF EVERETT E BUILDING DIVISION <br /> 3200 CEDAR STREET E EVERETT, WA 98201 0259.8810 <br /> Cl DEMOLITION fl COMBINATION I BUILDING fl MECHANICAL FI PLUMBING n SIGN <br /> PROJECT ADDRESS <br /> OVMFF L'IILADDRESSCITY IP, PI NE <br /> a u , " g -3 l91)f/ 2'�� <br /> TENANT MAIL A00FIESS CITY ZIP PHONE <br /> _ _ C <br /> W <br /> SIGNER MNLMORE45IIYTIPPHONE PI <br /> ORAD ((E•JTOR MAIL ADDRESS LITY ZIP P110N STATE LICENSEE <br /> PLUMBING CONTRACTOR MAILADORESS CITY ZIP PHONE STATE LICENSEE <br /> CONTRACT PRICE OF WORK <br /> $X yvR�' = 3a0 G iO HEATING SYSTEM: ❑ GAS r-1 ELECTRIC Cl <br /> DESCRIBE WORK AND SGUARE FOOTAGE INV VED CONTACT PER3ON AND PHONE NO. <br /> Y <br /> ("o-aaX77//1✓ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> lO C d421la mej APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPS EDUBE I B DI"�j PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> P.g1�(P/1 j/ WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRIPTION OF PROPERTY'SHOWN BELOW OR ATTACH TWO COPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT BLOCK 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 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> PARCCL TAX I.D.NUMBER <br /> CONSTRUCTION LOAN LE NDB.;0 S,TP110NyEyLNUM�E 67.' <br /> SIGNA URE DATE <br /> ZCITY BUSINESS LICENSE NO <br /> PLUMOIND It MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 2 WATER CLOSET(TOILET) A/C-A/HNDLG UNITS-M.P. <br /> eli BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) ' HEAT PUMP ' <br /> SHOWER ' UNIT:(EATERS-B.T.U. M I <br /> , <br /> KITCHEN SINK&DISP i CLOTHES DRYERS I <br /> DISHWASHER ' VENTILATION FAN <br /> LAUNDRY TRAY RANGE HOOD <br /> CLOTHES WASHER I WATER HEATER ' <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN I METAL FIREPLACE(WOOD BURNING) I <br /> FLOOR DRAIN I FIREPLACE INSERT(WOOD BURNING)) ' <br /> BACKFLOW PREVENTERS GAS FIREPLACE I <br /> SINK(SERVICE-BAR, ETC.) I GASRANGE ' <br /> ' GAS PIPING ' <br /> EXHAUSTFAN ' <br /> I ' <br /> i <br /> I ' <br /> SUB TOTAL E ' SUB TOTAL $ ' <br /> PERMIT S , PERMIT E ' <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK I REAR SETBACK SIDE SETBACK PLAN CHEOK NUMBER FEE RECEIPTNO. <br /> USE ZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> n YF.S n NO BUILDING <br /> NEIGHTUMITATION NO OF CNELUNG SIZE OF BLOGRI I <br /> UNITS .11?z PLUMOING ' <br /> GOCCUPANCYNO OTSTORKS OCCUPANTLOAD BASEMENT MECHANICAL <br /> 3 2 nYES PC NO <br /> FI ALARM EGO REASO/N����j/�� ADOIRONAL PIAN CHECK 1 <br /> OTHER / <br /> FIRE SPRINKLFR REO'D REASON <br /> a,yL STATE BUILDING SURCHARGE 7 I <br /> TYPE OF CONST. PLANS'AFfROVEO BY CITY OF EVERETT PUBLIC WORKS <br /> JM LOCAL SALES <br /> DATE C TAX CODE IS 3105 TOTAL IQ <br />