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APPI_ICATI N FOR CANSTRUC' OK PEFiW-T <br /> CITY OF EVERETT A BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 7T <br /> r? DEMOLITION COMBINATION I-I BUILDING MECHANICAL i PLUMBING SIGN <br /> PR03�CT ADDRESSP39, QEF 6 <br /> y7i AILADDRESB o cm rm I no•a <br /> 15127 mAcy¢o <br /> TEM41 MAILADDRFSS CITY ZIP TI <br /> NL II(TEr;i OR DE:N:iNrR MAIL ADDRESS CITY ZIP PHONE -- ---- <br /> �tJ E5S <br /> Or�R:RAL TRtI.fON MAIL AODRGS CITY ZIP 1'H04L "TALE LICENSi�I <br /> r p) Vs2n3Q4� — V 5aw'2 bL_3 RA5aA1jro86sz <br /> MECHANICAL CONTRACTOR MAILADDPESs _ CITY ZIP PHOI STATE LICENSE <br /> }��on � u, Alder, +'� i•�3�,>�.1L+� 1, WA y8?ss apicE �E oPa�B <br /> P ' IO C�OtI'R.a.igt/' ` MAB ADDRESS CITY/� l ZIP ,�,�1 P'IO,rt StAT ILENSEA <br /> d 4 l.�S'�'i�M T 1�L/1'>f/li N_ (/ ��2 C'Y/SVA 547 od <br /> TPAC I PPI E or VAWK <br /> �— HEATING SYSTEM: YGA3 11 ELECTRIC Fl— <br /> FOOT <br /> • �� <br /> fl— <br /> GrM CqAC E AND PIKKJE <br /> e swWS71N2 _ <br /> {—'p—�•f— <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINI ') THIS <br /> -- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORE _CT.ALL <br /> P <br /> POSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> X &"41 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ILGAI E. PTIGNorP rERTY1SHOLVNBELMVonArTACHTVrocoPIEsl NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> '01 oF 7 BLOCK or 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 PROF ERTY TO i2RFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX 10 NUMBER, _ CONTRACTORSLAW 18.227/R/�W AND 298.200 WAC.r <br /> CO STRUC110N lOA lE4D-ER,ADDINIESS.TELEP"ENU,,IOEP j4 /[((.�.' <br /> ' / �O Z X <br /> BIWIf ADATE <br /> CITY BUSINESS LICENSE NO. 7 0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) ' AIC—A/HNDLG UNITS—N.P. ' <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> T <br /> LAVATORY(WASH BASIN) , HEAT PUMP I <br /> SHOWER ' UNIT HEATERS-B.T.U. M ' <br /> KITCHEN SINK 8 DISP i ) CLOTHES DRYERS i <br /> DISHWASHER ' VENTILATION FAN ' <br /> LAUNDRY TRAY I RANGE HOOD i <br /> CLOTHES WASHER I WATER HEATER ' <br /> URINAL WOOD VTOVE ' <br /> •� DRINKING FOUNTAIN i METAL FIREF:ACE(WOOD BURNING) I <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ' <br /> .. BACKFLOW PREVENTERS GAS FIREPLACE i <br /> 'SINK(SERVICE—BAR,ETC.) 1 GAS RANGE ' <br /> ' GAS PIPING ' <br /> EXHAUST FAN ' <br /> SUBTOTAL S ' SUB TOTAL S ' <br /> PERMIT $ , PERMIT $ , <br /> TOTALFEE S ' TOTAL FEE E ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK / REAR SETBACK / SIDE SETBACK / PLAN C NUMBER FF' RECEIPT NO. n <br /> C/J�IJ/f y-5- 77 3 JirJ. !O 1a 3 wo <br /> USE�� LOT AREA —4// VACANT SITE FEES VALUATION FEE <br /> n YES n NO <br /> FOLDING Z J <br /> HE1011T LIMITATION UNITS OWELUNO Sit ' BLC f7 �IV,N4r <br /> J(r0 S PLUMBING <br /> (K CUUPANCY NO OF STORES OCCUPANT LOAD BASEMENT MECHANICAL <br /> l7, Z 4 n YES 0710 <br /> FIRE ALARM REO' REASON ADDITIONAL PUN CHECK <br /> Q OTHER <br /> FIRE SPRINKLER REO) RF.AS'VI <br /> STATE BUILDING SURCIURRE n �^ <br /> -rPE OF CONST PLANSA"rr:Ti�,cHH, - CITY OFEVERETT PUBLICWORKF- ------ <br /> :D LOCAL SALES <br /> N DATE 3 55 TAX CODE IS 3105 , TOTAL <br />