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APPLICATI&I FOR CONSTRUC"MON PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, VIA 98201 A 257-8610 <br />i - DEMOLITION " 1 COMBINATION * BUILDING ❑ MECHANICAL PLUMING SIGN <br />[PROJECT ADDRESS 'IZ y, <br />E,•-12 Avc_uLNa . �?tea 14109 <br />STAGE <br />M1gNE STATE LICENSE• <br />R,UAXA iiC RACTCR OApAWNE55 LNv IiP r+•orrt STATE LICENSE <br />cw.AGI TRICE OE WOIIK 45 <br />000 IHEATING <br />SYSTEM: Fl GAS - ELECTRIC Fl <br />DESRm[ WOn4 6g1.RE wm —, , Ct4r <br />IONTAci Pyi:oy.' <br />IVE3gL _{�J`�iE�_T1�L1 <br />C,.1i cy <br />OW10 � <br />4 <br />8 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. At I <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LCCAL 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 />CONTRACTORS LAW I B 27 RCW AND 296 200 WAC. <br />% <br />,ROwSEO usE Dr BuIL0RK3 <br />LEG.4IXscnRTCNa PaovEPTV ISHONNe¢ow oR An•cH rvrocoaPrEas E, <br />LOT 1'1•tB PocB �y o• (,�GTFj fTYT� <br />•� �•��'�'� <br />E <br />PARCEL TAXI O. IRA 1A •O'O <br />IXXISiRM7"LOANLENCER. A➢DRESS. TUET'I N SURIER <br />$GNATVUF DATE <br />CITY BU5ML5S LICENSE W <br />PLUMBING <br />MECHANICAL. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A'HNDLG UNITS <br />BATHTUB <br />D AIR SISTEMS <br />! <br />LAVATORY (WASH BASIN) <br />UMP <br />SHOWER <br />EATERS <br />!WA�TER <br />KITCHEN SINK A DISP <br />ES DRYERS <br />DISHWASHER <br />HOOD <br />LAUNDRY TRAY <br />HEATER <br />CLOTHES WASHER <br />STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />! <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />_ <br />I <br />I <br />SUBTOTAL S <br />I <br />SUBTOTAL S <br />I <br />PERMIT $ <br />PERMIT S <br />TOTAL FEE S <br />IOTALFEE $ <br />cnn PSCCIE•C I IQC nNI V. <br />.RF N SETBAC. <br />PEAR SETBACK <br />61CO SETBACK <br />RA CN[Cx NJMBER <br />f <br />PECLI rq <br />USE 20"E <br />LOT AREA <br />vACAHt SnE <br />[]YFS ❑ NO <br />FEES <br />VALUATION <br />FEE <br />PURDIWi <br />KGW LMIT.TXM <br />AOA'OF Um <br />OIt <br />SIZE M BI ' TI <br />ttLARI'm <br />OL{1pANCY rq R STORES <br />m <br />OCCUPANT LOAD <br />Q <br />PASEu Il <br />YES RO <br />MECHANICALnPo <br />AWITp 4PLANCHECK <br />f IPEB MKICP REDO <br />NO <br />MASON <br />Iv'i- <br />orHER <br />FOEAIAPMMOD <br />n <br />PEASON p.v AI <br />(/NG�5 ;157 J•� <br />n.rE Buzomn suPCH4+oE <br />wBLCvnx+Ks <br />TYPE OF coNST <br />/'D <br />J• ,III�� <br />PLANo'k, Eoev <br />�� <br />DATE /OZ .�! <br />CITY OF EVERETT <br />LOCAL IS 31 <br />TAX CODE IS J705 <br />-- <br />TOTAL <br />7 <br />O <br />