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APPLICATICA FOR CONSTRUCT .JN PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREET A EVEREI T, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATIONUILDING I I MECHANICAL f7 PLUMBING F1 SIGN <br /> PROJECT ADDRESS: `��!T - 79"" p-1 <br /> OW��.4 MML ADDRESS CITY Im THIONE <br /> IENAN MNL ADDRESS LILY /IP PIIORE <br /> AnCMrECTOn DESIONEn MAI ADDRESS CITY lln INTONE <br /> d l/,, uuC'OA/-Vwp9/I1cT /s'yiF'1y ,/usZ /!fi//C.KeK 9TuiL 3"i� �3t: <br /> NERAL CONIRACIDR MAIL ADM SS CITY III' � Flow SIATEOCENSE• <br /> IIECHANICAL CONTRACTOR MAIL ADDRESS CITY /IP PIIDNE BTA1E LICENSE F <br /> PLUMBING CONTRACTOR MAK ADDRESS CITY lIP F44M STATE LICENSE. <br /> CONTRACT EWE or WTMIK <br /> HEATING SYSTEM: tTGAS J ELECTRIC ❑ <br /> DESCRIBE WORK ANDSOUAIIE FOOTAGE INVOLVED r.DI1fACi "SON AND PHONE.NO <br /> IV <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> -- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PREA'OSED USE OF BUILDING PROVISIONS OF LAWS ANI I ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIEJ WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPT1ONorrnopEn1YI51Kvmt!EtOWOOA I�TTACNnVOCOf9E51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT_ -__BLOCK OF 'c'�AG c , -»`'�T'vs_ 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 /> PARCEL TAX 10 NUMBER CONTRACTOij::LAW 18.27 RCW AND 299.200 WAC. <br /> CONSTRUCTION LOAN LENDER ADDRESS.TFLErNON:NUMBER <br /> sxBl ullr DATE <br /> CRY BUSINESS LICENSE NO <br /> PLUMBING _ MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) AIC—NHNDLG UNITS <br /> 2 BATHTUBFORCED AIR SYSTEMS ; <br /> 3 ----------- <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER i— _ _UNIT HEATERS <br /> KITCHEN SINK 6 DISP CLOTHES DRYERS <br /> DISHWASHER I RANGE HOOD <br /> LAUNDRY TRAY ) WATERHEATER <br /> / CLOTHES WASHER �_ WOOD STOVE <br /> URINAL I METAL FIREPLACE(WOOD BURNING) _ <br /> DRINKING FOUNTAIN I FIREPLACE INSERT(WOOD BURNING) _ <br /> FI GOR DRAIN I GAS FIREPLACE <br /> BACKFLOW PREVENTERS GAS RANGE <br /> _ _SINK (SERVICE—BAR, ETC.) I GAS PIPING <br /> 14 EXHAUSTFAN <br /> 1 ) <br /> - I <br /> I I <br /> _ SUB TOTAL S ' SUB TOTAL S <br /> PERMIT S I PERMIT 5 <br /> TOTALFEE S I TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> rnONISFTRAL;K RrAI15nnACK 511N Sf IBACk / MANCIK.ck MMBrO ru MCFIPT NO <br /> USE ZONE IOT AAf A VACANT SITE F _ _ VALUATION FEE <br /> 13 ND <br /> ... OYES DIXI HIND /J -% YY1[[ LL. <br /> NEIGNT LIMITATION NO OF DWELLING SI�Ea BLDprLI "- '---- I <br /> Z LIN115 174�t SFOITAG + <br /> QRC�ANCY NO DI SIPM(S OCCUPANT LOAD BASEMENT MrCINNICAI <br /> .I Z _ ❑Yrs d' a -- — <br /> FIRE SPRINKLER REOD of AEON AODIIKINAI TSANCIKC.K I <br /> omm _--- I <br /> FIRE ALARM REO'D REASON -- - - I <br /> STATE BURUNG VIR IMME - -- I <br /> TYPE OF CONST PLANSAPPI10 BAY CITY OF EVERETT PIMI W.WEMLKS <br /> I �.I I-- LOCAL SALES �D-'— <br /> N DAVE 6 IZ TAX CODE IS J10S TOTAL - - I <br />