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APPLICATIO'_i FOR CONSTRUCT. JN PERMrT(* <br /> CITY OF EVERETT r BUILDING DIVISION <br /> 3200 GZDAR STREET• EVERETT, WA 98201 IF 259.8810 <br /> ❑ DEMOLITICN ❑ COMBINATION V�iRUILDING ❑ MECHANICA1 ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: / Fe47 <br /> OWMETI '4A4 ADIXI_C�SS CITY ZIP PNoit <br /> "4" <br /> N 7uY/ Z3 7 n y�e�z,,., , t rs VeAe <br /> IENANI MAIL A Air Sr n.IIY rip PIIONr <br /> ARpCH�ITE�CT DROES.GNFn MAIL A..dnESS CITY 711, PHONF <br /> _LrI / T __ _ <br /> GENERAL CONTRACTOR MAII ADOnF ss CITY lIP r1IDNF SIAIE IICFNSE r <br /> LK �e�•//c,e /tl 7s�' bW �yevl.�'6.�Asjt/ PXM7AOZ 21J yycuVV <br /> MECHANICAL CONTnACTOn MAIL ADDnFSS CITY lip PILONI STATF IICENSC r <br /> PLJMB:NGCONIRACYM MAIL ADDRESS CITY ZIP PHONF STATE LICENSE <br /> _2A�CV/CG.J 1'1401864'17. g - — <br /> CONTRACT NOCE a Monl< <br /> HEATING SYSTEM: 1111GAS El ELECTRIC ❑ _ <br /> LiE5CL11BE ViOnK AND SQUARE FOOTAGE INVOiWGj CONTACT PERSON AND PHONE NO <br /> 1A'ebgt -- <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAM:TO BE TRUE AND CORRECT ALL <br /> Pn01 FeO USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> I EGALDESCRIPTION OF PRorEn"SHOWN BELOW CRA"ACO TWO COPIES) NOT, TP- GRANTING OF A PERMIT LOES NOT PRESUME TO GIVE <br /> LOT �—BLOCK__ or a exp_ AUTHOP TY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> JI HER -TATE OR LOCAL LAW REGULATI1IG CONSTRUCTION OR THE <br /> R'ERI'ORMANCE OF CONSTRUFTION.THAI I AM AUTHORIZED BY THE <br /> O MNIIR OF THIS PROPERTY 10 PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PARCEL RUT I0.rNMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCCT�e- <br /> ION LOAN LENGTH.ADDRESS.TFLEPHONE NUMBER - <br /> S NOtfUnE DAIF <br /> CITY LugNE SS L K;CNSE NO <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEC NO. TYPE OF EQUIPMENT FEE <br /> -'T <br /> WATER CLOSET(TOILET) I IVC-A/HNDLG UNITS <br /> BATHTUB FORCFD AIR SYSTEMS <br /> ! LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS L_ <br /> KITCHEN SINK 6 DISP ; CLOTHES DRYERS <br /> _ ( DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER ) <br /> T� <br /> CLOTHES WASHER I WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> _ DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> i— <br /> FLOOR DRAIN GAS FIREPLACE _ <br /> BACKFLOW PREVENTERS ; GAS RANGE <br /> SINK(SERVICE-BAR,ETC.) i- GAS PIPING I _ <br /> EXHAUST FAN <br /> I <br /> SUB TOTAL f SUB TOTAL f <br /> PERMIT f I PERMIT f ,I <br /> TOTALFEE f ' TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> FnONT SFTBACK PFAR SFTBACK SIDE SETBACK PI AN CHECK NIIMnfn Ir `j ,tin nFCFIPr No <br /> Zo ' 2c)' S a i� S2/C�! <br /> USE ZONE ...... <br /> OI AREA VACANT SIIF FEE VALUATION FEE <br /> �- / L� ( 7$ f2YFs ❑NI) mnIDINr, 91 S-0 -- A <br /> PCCUP LIMINCY I ION NO U DWELLING S'jE OF SEMEN) <br /> r� UNITS I I S.F. Lwu.Jo +r PI UMDING <br /> Gna.A(... <br /> OCCUPANCY Iq M SI(KbTS OCCUPANT LOAD BASEMENT FM'1 MfCIIANICAI �Q ) <br /> GROW I <br /> 3 v-F _Z ❑YTS ADDITIONAL Pl AN GR CA I <br /> FIRE SPRINKLER REO'D IIF ASON <br /> ouirn <br /> FIRE ALARM FIED'D REASON I /� <br /> STATE DUILOING SIIRCIIAnnE <br /> TYPE OF CONST PIANSAPPROV( DY �Cj iL <br /> 1 CITY OF EVERETT ruflnc wonnS <br /> IT LOCAL SALES — - — - — <br /> DATE 7Z9 /)6 TAX CODE IS 3105- TOTAL Y2) I�67 <br />