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APPLICATILA FOR CONSTRUCT .JN PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 ,259-8810 Evr�vErr <br /> DEMOLITION I COMBINATION rT BUILDING fA-MECHANICAL fPLUMBING SIGN <br /> PROJECT ADDRESS �ZOy <br /> 58PLgck SCU. ,cIJEKErr <br /> OWNER , -(�i4.S11. <br /> MAIL ADDRESS CmIIP <br /> / //�� c/ / PIIONF. <br /> TEEN IllN 22 7/!)7N/Ik SE //OM)cf,/�/Lt4 9�i290 l <br /> MAIL ADDRFSB CITY 1 �7 352e <br /> IIP PIgNE <br /> ARCMTECT OR DESgNER MAIL AGGRESS CITY <br /> 71P PHONE N / 7 C <br /> Sf- oucrtucrr N Tye, dd12 7 rnDR a <br /> GENERAL CONTRACT L �,� SDn.A AIC Yy�/A 9&29e C2�)337 3sza <br /> CITY IIP PIgNE STATE LICENSE-0 <br /> - <br /> MECHANICAL CONTRACTOR MAILADDRESS C,tt <br /> ZIP PHONE STATE LICENSE 1 <br /> PIUMBiNO CONTRACTg1 MAIL ADDRESS CITY• <br /> 21P PIgNE STATE LICENSE� <br /> CONTRACT PRICE OF WORK <br /> 8(D 3 HEATING SYSTEM: 114GAS f 1 ELECTRIC n <br /> DESCRIBE WORK AND SWARE FOOTAGE INVOLVED <br /> Ng Lu 5 4r R <br /> CONTACT PERSON AND PHONE NO <br /> C <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PIK)PDSED USE OF BUILINNG APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> 2 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY(SLIOWN BELOW ORALTACH TWO COPIES) WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT- _S6 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> BLOCK of ILC G GEA; 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 I COMPLY WITH THE STATE <br /> PNACEL TAX I D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> ' A' <br /> C-OINSTRUCTION LOAN LENDER.ADDRESS,TELEPIgNE NUMBER <br /> LV X <br /> to f 1� JJU iiWWNVVy O <br /> --11" <br /> SIGN A DATE <br /> fltt RUSINFSS t ICFNSF.NO <br /> PLUMBING <br /> NO. MECHANICAL <br /> TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 2 WATER CLOSET(TOILET) , AIC—AMNDLGUNITS—H.P. <br /> z BATHTUB <br /> ' FORCED AIR SYSTEMS—B.T.U. <br /> 2 LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER ' UNIiHEATERS—B.T.U. M , <br /> / KITCHEN SINK 6 DISP ; / CLOTHES DRYERS <br /> / DISHWASHER , VENTILATION FAN <br /> _ LAUNDRY TRAY ' <br /> CLOTHES WASHER RANGE/ WATER HEA ER <br /> URINAL ' WOOD STOVE , <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) <br /> FLOOR DRAIN ' <br /> ' FIREPLACE INSERT(WOOD BURNING) , <br /> BACKFLOW PREVENTERS ( GAS FIREPLACE , <br /> SINK(SERVICE—BAR,ETC.) I GAS RANGE <br /> ' GAS PIPING , <br /> EXHAUST FAN <br /> 1 ' <br /> SUB TOTAL E ' SUB TOTAL E <br /> PERMIT E , PERMIT E 1 <br /> TOTAL FEE E ' TOTAL FEE E I <br /> FOR OFFICE USE ONLY: <br /> IRONY SETBACK FEAR SETBACK BIDE BETBAC� PIAN CIIEC�A'/E FE . RECEIO- <br /> ZOYE <br /> usE"go C'Jp"/ LOTARE,L_ VACANT FEES VALUATION / FEE / <br /> /�'� L <br /> IT Yes n No BUKDINa <br /> HEIGHT LIMITATION/ NOITOF DWELLING SIZE PE t7 <br /> ( Ls <br /> G-4,`E PLUMBING <br /> OCCUPANCY <br /> NO OF STORIES OCCUPANTLOAD BASEMENT <br /> J MECHANICAL <br /> U nYfS <br /> FIRE ALARM REGO REASON ADDITIONAL PLAN CHECK <br /> L <br /> FIRE SPRINKLER REOD REASON OTHER <br /> .0 STATE BUILDING SURCHARGE O <br /> TYPE OF WST PLANS APPROVED BY <br /> J L� CITY OF EVERETT Pusuc VroRKs <br /> v LOCAL SALES — <br /> .1L"fV DATE 3 ZI/ICs TAX CODE IS 3105 1 TOTAL <br />