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r.. ^ <br /> APPLICATIOA FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION �iCNr�� <br /> . 3200 CEDAR STREE7•EVERETT, WA 98201 •259•8810 � <br /> ❑ DEMOUTION ❑ COMBINATION O 6UILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS:1�L� nL `� A I� _�J��v��_�� <br /> �o»+rta /�� uui�ooness I/� �7 atr <br /> /� dl'-1�'1 L �� I I � }{ �/,l,,}(([��-y1 A1 I7 rvm)I ri�a+t r/ <br /> TENI1Mt uMi i1fIPK55 " �++-+_—Ll]!_"�il�i[�'N� d� � 1 ��� <br /> f,t1Y lll' fuOt�l -- <br /> 11(�1L(MTCCi Oq p[SIGNFII M�tl MIlqE55 Glh. )p..---- <br /> ./_�(L� h�/����Ga l�_ n�oar - <br /> "' � " �������5�_�iqy �� - �� � <br /> GENE1UlfANiR�CtOt1 M�IlAOORE CtlY <br /> �ML ;�� ,��E «,,«<����. <br /> �aur�rxca+m�cTon M�n�ooaEss ' _ /�n277�rAJ/-�/n�� <br /> rm 7m �iroNc s e u�u`sE: <br /> �(Vl l <br /> au.or+ecor�Ta�croa r�n�ooness urv nn------- ri+or�c <br /> S1AfE LILENSE� <br /> CONiMLTPIMCEOFW0f1k / ________ <br /> � � f1EATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> ��M�Mf��A SOUIIRE FOOT�GE MVOlVEO r,�ri��r,r rrnsor�uw>r��ov[rq <br /> � __�i:l� Mc1,�� <br /> C �. — ZKZ '��e� <br /> I HEREBY CERTIFV TH�T I HAVE READ AND E%AMINED THIS <br /> vnoroseo use ov euionq APPLICATION AND KNOW tF;E SI1ME TO BE TRUE AND CAqRECT ALL <br /> PROVISIONS OF LAWS AND OADINANCES GOVERNING THIS TYPE OF <br /> ����tiMa�IOPEpn'ISNDWNSElOWO!7AR11�NTWOCOPIES� WORK WILL BE COMPUED WITH WHETHEH SPECIFIED HEFEIN OR <br /> NOT. THE GHANTINp pF A PERMIT DpES NOT PRESUME TO GIVE <br /> �or_ e�;,cx a AUTHORITY TO VIOLATE OR CANCEI TNE PROVISION OF ANY <br /> OTNE(i SiATE OR LOCAI.LAW qEGUUT1Np(bNSTRUCTION OR TME <br /> ___ ('ERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO P FORM THE VYOqK Fpq yyH�CH <br /> APPLICATION IS COMPLV WITH THE STIITE <br /> nwCel7eR i.D.ruueEn — -- CONTRAGTORS 1 I 200 WAC. /-� <br /> CON5TiN1G1�ONlON1LEN0ER.dODqE55.TE1CIMIQVEM11d�R �� / / � � . <br /> x f�� / <br /> S�CH�iU �T� <br /> CIIY pU51NE551 ICCNSC NO <br /> ��d MECHANICAI <br /> NO. T1TE OF fll(TIlRE Oq ITEM �_ N0- --_ n•pE OF EOIMMEN� FEE <br /> WATER CLOSET(701LET) � A/C—AMNDL�UNfTS -T -;— <br /> ��� � FORCED AIR�YSTEMS � <br /> LAVATOFiV(WASN BASIN) � liEAi PUMP � <br /> S��p ' UNIT HEATERS � <br /> KITCHEN SINK 6 DISP ; CLOTHES DRYENS � <br /> DISHWASHER � RANGE HOOD � <br /> UVNDRY TR�Y � WAlER HEATER � <br /> CIOTNES WASHER � WOOD STOVE —�— <br /> URINQ � METAL FIREPIACE(WOOD BURN�NG) � <br /> DRINKIN6 FOUNTA�N i fIREPLACE INSERT(WppD BURNING) <br /> FLOOR DRAIN � GAS FIRFPLACE � <br /> BAqCFLOW PREVENTERS ; GAS RANGE � <br /> SINK(SERVICE—BAR,ETC.) i GAS PIPING ��'— <br /> � <br /> - f-XHAUST FAN � <br /> — ' i <br /> i <br /> � <br /> � <br /> � i <br /> � <br /> SUB TOTAL f � SUB TOTAL f ' <br /> PERMIT f � PERMIT S <br /> _ TOTAIFEE f � TOTALFEE S � <br /> FOR OFFICE USE nNLY: <br /> ��T�Tp�K PEAR5F7BI1CN SIOESETBACk PI�NCIIC�%II�� f[P I1ff.fIPfNO <br /> USEZONE �orenee V�C�Nt51tE FE[5 VALUATION FEE <br /> ❑YES ❑ NO T <br /> � 0114 pIN6 <br /> NEIGHT�IMIT�TIqI NO Of UW[lUN6 512E Ot BIpG/fl � <br /> UNiit — � <br /> vi uunn�c <br /> GC��MCY Np p St(WIFS OCCUAANi LO�O B�SEI.�Nf --__----- - --�-- <br /> MfC11�NILM <br /> ❑Yf5 ❑NO --- - - ___ <br /> FIRESPflINKLE!IREO'D RF�SpN �pOIIIOrUI.PIIUlGlff.k �- - — _- <br /> �- <br /> omrn <br /> FIRE�IAqMREO'0 RE�SpH ' <br /> 5111 f Illlq f1111R SII�if.110f16( � <br /> fYPEOFCONST n��N$IPPnOVEftBY —'—' — <br /> CITY OF EVERETT �unur wonr.s <br /> LOCAL SALES ----- — <br /> o„E TAX CODE IS J105 iOta� <br />