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APPLICATION FOR CONSTRUC7iON PERMIT <br /> CII Y OF EVERETT• 9UILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 A25&-8810 <br /> 1-1 DEMOLITION I1 COMBINATION I1 BUILDING I I MECHANICAL 11 PLUMBING CI SIGN <br /> PROJECT ADDRESS / YJ' I <br /> OWNER MAIL ADDRESS CITY ZIP PHONE <br /> y,r S'N��/j <br /> TENANT MAILADDRESS CITY ZIP PHONE <br /> ARCIKICCTORDESIGNEn MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MNLADDI7ESS GTI ZIP PHONE STATE LICENSE <br /> }1 <br /> 11 ; -y'd - �9/AAI fie: /))///C`epe wj, >- S/6 33Ns/ MclirV,y�ao- Jy% <br /> MECRANICAL CONTRACTOR MNL ADDRESS CITY ZIP PIK7NE STATE LICENSE <br /> PLUW"G CONTRACTOR MAIL ADDPESS CITY ZIP PHONE STATE LICENSE# <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> DESCRIBE WORK AND SQUARE FOA)W E INVOI VFO CONTACT PERSON AND PHONE NO <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PnOPODED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRIPTION O PROPERTY RSIfOWN BELOW OR TACO TWOCOPIESI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT BLOCK of Ne 1r A AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OT'1ER STATE On LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMAN.;E 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 /> PARCEL TAx TN11MBFR_ CONTRAC1`7 LAW 18.27 RCW AND 296,200 WAC. <br /> CONSTRLJC71ONN LOAN LENDER.ADDRESS.TELEPHONE NUMBERX r,�A /&69 � <br /> 510NAf RE / DATE <br /> CITY BUSINESS rI(CENSE NO <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE _ <br /> WATER CLOSET(TOILET) I AIC—A HNDLG UNITS—H.P. ' <br /> L BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) , NEAT PUMP , <br /> _L SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 6 DISP _CLOTHES DRYERS i <br /> DISHWASHER I VENTILATION FAN ' <br /> LAUNDRY TRAYRANGE HOOD <br /> CLOTHES WASHER , WATER HEATER I <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN , METAL FIREPLACE(WOOD BURNING) I <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) , GAS RANGE ' <br /> ' GAS PIPING ' <br /> EXHAUSTFAN , <br /> I I <br /> I ' <br /> SUB TOTAL S ' SUB TOTAL $ ' <br /> PERMIT S I PERMIT S , <br /> TOTALFEE $ j TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACJL _ _ REABSETBACK SIDE SETBACK PLAN CHECK NUMBER FEF RECEIPT NO. <br /> 04 <br /> USE- // IDT AnE VACANT SITES FES VALUATION FEE <br /> � F1YES 1140 c <br /> WORDING 7J / <br /> HEIGHT LIMN N' LINTS DWELLING SIZ3 rl <br /> / y Iv+V4,i r1uMBINa <br /> OOCUPPANCY NO O510WE5 OCCUPANT LOAD BASEMiNT MECHANICAL <br /> 12 -, Z n/ A IT YES A-9101- <br /> FIRE ALARM AEG D <br /> ✓FOFIREAIARMREO'D REASFN ADDITIONAL PIAN CHECK <br /> 2nIEn <br /> FIRE SPRINKLER REO'D R:ASON �- <br /> -_�ATAIE BUILDING SUDCIIARGE <br /> TYPE OF CONST PIANS MPRov�D qr CITYOFEVERETT IPunitcwoms 42 <br /> LOCAL SALES <br /> DATE '3412 (e TAX CODE IS 3105 TOTAL Jr� <br />