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APPLICATILA FOR CONSTRUCI .ON PERMIT <br /> CITY OF EERETT•Rl IILDINDIVISION <br /> 3200 CEDAR STREET• EVERETT, WA <br /> 98201 • 259.8810 <br /> i 1 DEMOLITION COMBINATION I i BUILDING 1-1 MECHANICAL PLUMBING I SIGN <br /> PROJECT ADDRESS JA <br /> 20 2 - SO �I. S,W ✓d'�E TTA GC119 <br /> ow,ln3 //MA�ILADURES'I b9y7Cow%C IGraK PA �awr�Sd {} 1- �7 3T <br /> 3ffNcaa., .ALLLc LXCAILo Ce2rl/6wCy rsr tfJl4 4ReSq (019 - 2216 - Mo8E1. <br /> TENANT MAILADDRESS CITY L ZIP PIIgNr <br /> MK;HITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAILADOBESS CITY ZIP PHONE STATE LICENSER <br /> SR"A T3BNCH4-12- 077c S <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICE NSE• <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE IICF.NSER <br /> CONTRACT PRICE OF WORN <br /> HEATING SYSTEM: ''GAS f 1 ELECTRIC f l_ <br /> OESC�9BE WORK ANO SOOABE FOOTAGE INVOV'ED CONTACI PERSON NO PHONE NO <br /> /VE w S.t- �. /y'/5'_ 1,r✓irk c Lss a A.l - _z <br /> 't o A(2- <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PR <br /> GP?u9 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> --K.t:'� i ()e`AJG =• F. WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL OE:CRIPTIp,OF PROPERTY ISHOWN BELOW OR ATTACH TWOCOPIESI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT 9 BLOCK Or ? P't Z O'L '• - 9 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 H <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I D.NUMBER JF 7-6 TF• • CONTRACTORS LAW 18.27 CW AND 296.200 WAC. <br /> _ 313x, 00 0 •- 0 lit — o o a 13 C SIGNATURE )AT F <br /> CONS(RUCTION LOAN LENDER ADDRESS.TELEPHONE NUMSFB X pL 7 •� / J <br /> SIGNATURE ATF <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) I A/C—AMNDLG UNITS—H.P. I <br /> 2. BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> AW LAVATORY(WASH BASIN) I HEAT PUMP I <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK A DISP i CLOTHES DRYERS - <br /> . I DISHWASHER I VENTILATION FAN ' <br /> LAUNDRY TRAY ; 1 RANGE HOOD ) <br /> CLOTHES WASHER I WATER HEATER I -- <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) I <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ) GAS FIREPLACE I <br /> SINK(SERVICE—BAR,ETC.) I GAS RANGE I <br /> ' GAS PIPING ' <br /> I EXHAUST FAN <br /> I I <br /> I I <br /> I T <br /> I I <br /> SUBTOTAL 5 ' SUBTOTAL S ' <br /> PERMIT $ I PERMIT S 1 <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR C.'FICE USE ONLY: <br /> FRONT SETBACK RFAR SFTRACK / SIDE SF.TBACI( D / PLAN CHECK NUMBER � FEE / RECEIPT NO. <br /> USE ZONE LOTAREA VACANT nY SIT/ n No FEES VALUATION FEE <br /> _ BUILDING <br /> HEIGHT LIMITATIgpy- p / NO OF DWELLING SIZE OF PLODgI <br /> L/�! .5V UNITS /5/5 SF e- t PLUMBING <br /> OCCUPANCY 1 '10 0'STORIES OCCUPANT LOAD BASEMENT MECHANICAL D <br /> G0 Z � <br /> Hues <br /> FIRE AIARM REGD REASON ADpRONAL PLAN CHECK <br /> OTHER <br /> FIRE SPRINKLER REG'D PFASON <br /> STATE BUILDING SURCHARGE O <br /> TYPE OF CONST PUNS APPAO LO RY CITY OF EVERETT PUBLIC WORKS I— <br /> z� LOCAL SALES <br /> _:iL t4 DATE 8 8 9S TAX CODE IS 3105 TOTAL . <br />