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a�``� !.l�2 , -� - c <br /> APPLICATIt�N OR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION fl COMBINATION �l BUILDING fl MECHANICAL f� PLUMBING fl SIGN <br /> PROJECT ADDRESS �� �I ` �//J <br /> v c_ <br /> OWN MFILADURE55 CITY 21P PHONF <br /> u.� � '��2 3 zol �- �� <br /> TENA T � MAILADDRESS CITV ZIP PIONE <br /> AFCHR[CTOROESIGNER MAILAO�RE55 CITV 21P PNONE <br /> GV��NTRaf�JQR`r� MAIL�Y//� //�/~ Nb(J��� ��'�z�33S�.�zz SUGLIC�/���� <br /> MECNANICALCO iRACTOR MAILADDRE55 CITV 21P PIIONE STRELICENSE� <br /> PLUMBINGCONTRRCTOR MAILADDPESS CIiY ZIP PHONE STATELICENSE• <br /> CONTRACT PRICE OF WORN <br /> '� ��1D HEATING SYSTEM: ❑ GAS ❑ELECTRIC ❑ <br /> DESCRIBE WdRK AND SOUARE FpOTAGE�NVOLVED CONTACT PERSON AND FHONE N0. <br /> !� <br /> � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Pnoroseo u F aua Nc / PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> <- L!/�(. WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR . <br /> LEGRLDESCRIPTIONOFPROPERTV(SHOWNBE WORATfACNTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK_ 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 PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICA IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TNf I.D.NUMBER CONT CTOR L I B.Z�R AND 296200 WAC. <br /> CONSiRUCTION LO�N LENDER.AOURE55 TELEPMONE NUMBER x / ' <br /> SIGNAiURE DAiE <br /> CITV BUSINE55 UCENSE NO. <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF flXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK&DISP i CLOTHES DRYERS � <br /> OISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY � RANGE HOOD i <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLP.CE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE i <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE ' <br /> GAS PIPING � <br /> � E%HAUSTFAN � <br /> � <br /> i <br /> � ' <br /> � ' <br /> � ' <br /> SUB TOTAL 5 ; SUB TOTAL 5 ; <br /> PERMIT S PERMIT $ � <br /> TOTAI FEE S ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SRBACN AEAR SEIOALK SIUE SETBACN PLAN CIIECN NUMA(3�� FEE RFLEIPT NO. <br /> a <br /> usezone LOTAREA VACRNiSITE FEES VALUATION FEE <br /> � <br /> f7YE5 fl NO OUILOING Q i � <br /> HEIGNT LIMITATION ��0.OF DWELIING SIZE OF OLDG.41 � <br /> UNITS PLUMpING � <br /> OCCUPANCY NO O�S70PIE5 OCCUPANTLOAD BASEMENT MEGIIANICAL I <br /> GROUP <br /> ❑VES Il NO � <br /> FIREAURM(i[O'D �EASON AO�ITIONPLPIANCHECK � <br /> i <br /> i <br /> OTIIER i <br /> FIRE SPRINKLER REO'D REASON i )� <br /> STR7E OWLDING SURGHARGE � �/ <br /> TYPEOFCONST. PLANSPPPf10VEDE7Y CITYOFEVERETT �'U�UCWORNS � <br /> LOCAL SALES � <br /> OATE TAX CODE IS 3105 TOTAL ' <br />