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APPL.ICATIO.. FOR CONSTRUCT►JN PERMIT <br /> CITY OF EVERETT A BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8010 O;ff-rr <br /> ❑ DEMOLITION ❑ COMBINATION ®'"BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: <br /> owNEn MAIL IDgiFSS CITY ZIP PHONE <br /> r-... � -ani �JJfS! � _ t,T.r. •1 ,;-J CJ�i�+- � ' N `�"-�rls/ <br /> �ENANI r MAUI ADDRESS CITY 71P PHONE 1- <br /> ARCHITECT On DESIGNER MAIL ADDRESS cm ZIP PHONF <br /> /ylC ✓- �Am t� y� S .� �i.>uc _ �;,� J •� -�f � � OSs.i D <br /> GENERAL CONITIACIOR MAILADnnESE CITY Ar PIIONr SIM:LICENSE, <br /> MECHANICAL CLN11nAC1011 MAIL ADDRESS CATV ZIP PHONE SINE LICENSE, <br /> PLUMBING CONTRACTOR MAIL ADORE ES CITY ZIP PHONE STATE LICENSE, <br /> CONTRACT PRICE OF IMORK -- <br /> HEATING SYSTEM: 910AS ❑ELECTRIC ❑ <br /> DESCRIBE WORK/NO SWAnE FOOTAGE INVOLVED CONT TPC AND PHONE NO <br /> Tei r ! <br /> I HEREBY CERTIFY THAT 1 hAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> P11orosE0 USE a BUILDINGAPPLICATION <br /> OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGAL T+ APTION OF PROPERTY(SHOWN BELCAVOR ATTACH IWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ,OT_ �' BLOCK__—OFD AUTHOViTY 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 fnMPLY WITH THE STATE <br /> I ARCEI.TAX I D.NUMBER CONTRACTOR LAW10.)27RCWAN.�D2996.2DOWAC. <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEMKNIE NUMBER X <br /> SK7NA E <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A10—AMNDLG UNITS ' <br /> BATHTUB ; FORCED AIR SYSTEMS ; <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS _ <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY i WATER HEATER ' <br /> ( CLOTHES WASHER �— WC/OD STOVE I <br /> URINAL I METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN _ i FIREPLACE INSERT(WOOD BURNING) <br /> _ ) FLOOR DRAIN GAS FIREPLACE <br /> BACKFLOW PREVENTERS ; GASRANGE <br /> SINK(SERVICE--BAR.ETC) —T GAS PIPING <br /> 4- EXHAUST FAN <br /> I I <br /> I I <br /> I <br /> SUBTOTAL S _ i SUBTOTAL $ <br /> PERMIT S PERMIT S _ <br /> TOTAL FEE S I TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FR-NTSFTRACK / REAR SETBACK SIDE St T15 <br /> K PUN CHECK NUMBER FEE HFr.(IPI NO <br /> ZO Za/ ` Z4 -)() 17C) <br /> USE ZONE 101 AREA _7 _ <br /> _ VACANT SITE FEES VALUATION _ FEE <br /> r DYES O NO n101nIN0 �,,[f BS6 ' <br /> HEIGHT UMITATIG NO OF DWELLING SIZE OF BUIOTTI <br /> UN IS / 0_ $.f. GY/VrA/q �- PLUMBING _— \/ i <br /> OCCUPANCY I NO Of STORKS OCCUPANT LOAD BASEMENT <br /> GROUPDYES FFG MFCIIANICAI <br /> Z <br /> TITLE SPRINKLER REO'D REASON AO(NIIONAI PIANpRCM <br /> omm <br /> FIRE AURM REO'0 REASON <br /> SIAL E nIm DING SURCIIAnGE — Z I /, <br /> TYPE or CONST PI ANS APPnovt ,or CITY OF EVERETT FUEL w <br /> C nRKc /'✓—�,[ <br /> N �JI� LOCAL SALES — — --- ---w ) <br /> Dj TAX CODE IS 3105 TOTAL <br />