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APPLICATILA FOR CONSTRUCI .ON PERMIT <br /> r' CITY OF EVERETT R BUILDING DIVISION <br /> AI 3200 CEDAR STREET A EVERETT, WA 98201 A 259-8010 <br /> I I DEMOLITION COMBINATION I I BUILDING I1 MECHANICAL 11 PLUMBING I1 SIGN <br /> PROJECT ADDRESS ` <br /> �'�n ► ?��� �t,)(-) \,J E u ere. - <br /> OWNER 1 MAIL ADDRESS OILY IIP PIIMlE <br /> ca jaffit�_l lie Ik51 3 i3o�ItPII- C-CefP-�� l�uwJ7S � g UWA Sko11 /�nJa�316 ��bl <br /> TENANT MAID ADDRESS CITY IIP PHONE <br /> ARCHITECT On DESIGNER MAIIADORESS CITY IIP PHONE <br /> �rch��e cEs <br /> GENERAL CONTRACTOR MMI AOf1RE55 fli . <br /> IIP • PUCNE STATE IICENSE A <br /> 11AP1 cn E� "t- SAMc- _ MET -nC 943 K4- <br /> MECHI ZAt CONTRACTOR MAIL A IORESS CITY IIP PHONE STATE IICENSE R <br /> V�Ia Plu rYlhlnp9+a G� V(? 04 K lk cS MR G?ntc) �3fi lu4sr� <br /> WALTsP!Sb RP <br /> PLUMBING CONTRACTOR MAIL AODPESS� CITY IIP PINNIE l STATE LICENSER <br /> LCILOV 1�]�C�l� ,a �tla -- 11 Pl1GETh4a�ySi1� <br /> CONTIT PRICE OF WCTnK <br /> _ 223' '220-0 HEATING SYSTEM: >QGAS Fl ELECTRIC n <br /> DESCRIBE WpiK AND SQUARE FOOTAGE INVOLVED CO TACT PERSON ANO PI IONE PAD <br /> Arg(AU, c L (11L�(' rrtr of 1V1; (u;���n9C <br /> �unre Faa_�- Ist FI • nA1 - � <br /> I HEREBY CERTIFY TI4AT I HAVE READ AND EXAMINED THIS <br /> �ASetnlLn� (rxT�R n APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> ism <br /> E of eIMaNO PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> O•I(��- WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IPTION OF PROPERTY ISUOWN BELOW On ATTACH TWO COPIEsI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> 9_BLOCK OF - AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � mPf PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> 59 Pla S C APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> D NUMBER CONTRACTORS LAW 18.27 RCW AND 290.200 WAC. <br /> CONSTRUCIIONIOANIENDEII ADDRESS.TEIEPHONENUMOER [i�/ // ( i�L(�(.G/� <br /> SIPAIATURE / DATE <br /> 1UP- _nr. 043K <br /> CITY BUSINESS IICENSE NO <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. _TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) ' AIC—A/HNDLGUNITS—H.P. ' <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) 1 HEAT PUMP 1 <br /> SHOWER ' UNIT HEATERS-B.T.U. M ' <br /> KITCHEN SINK&DISP CLOTHES DRYERS 1 <br /> DISHWASHER ' VENTILATION FAN ' <br /> LAUNDRY TRAY RANGE HOOD i <br /> CLOTHES WASHER 1 WATER HEATER <br /> URINAL WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) 1 <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ! <br /> BACKFLOW PREVENTERS GAS FIREPLACE i <br /> SINK(SERVICE-BAR,ETC.) 1 _ GAS RANGE ' <br /> ' GAS PIPING ' <br /> 1 EXHAUSTFAN I <br /> 1 ' <br /> 1 ' <br /> T <br /> 1 ' <br /> SUB TOTAL $ ' SUB TOTAL S }_ <br /> PERMIT $ 1 PERMIT f _ <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: — <br /> FRONTSFTRACK REAR SETBACK SIDE SETBACK rl AN CIIBCK NIIMBFO n FEE RECEIPT NO <br /> 30 //7704 <br /> USE ZONE IOT AREA VACANT SITE FEES VALUATION FEE <br /> I IYES I I NO BINDING <br /> IIE1611T LIMITATION NNII�I1WCllINO SIIy�IXT75 �� <br /> 1,3 Lap ,* 1`IIIMORG ,�� � �8 <br /> S � we <br /> OCCUPANCY NO IK SBVNS OCCUPANT LOAD BASEMENT 770 MECUANICM <br /> F3 u. 'L I IIVES 14R0 <br /> FIRFALARMREOD REASON ADIANNIAI P1 AN CHECK <br /> OTIIEn <br /> FRE SrnINKI ER RED 0 REASON <br /> STATE DTIII OIIR SIRLIIARGE <br /> TYPE OFraHST rlAnsArPZv3,.. <br /> ,�r CITY OF EVERETT ruBIN: WK, TKS <br /> LOCAL SALES <br /> Z-1i DATE -TAXCODE IS 3105 TOTAL <br />