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APPLICATIOh FOF6 CONSiRUCTIul�1 PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />32Cp CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: �H(x7 �.��Q����L_ �Q� _ <br />l� r� � i . — I ' i . � G_. � n . _ c� ,. +... _ '+a �0 _ . _. � i . <br />^ � � � � v r_ k,.,.. ��. ._ . ..,,..., � a� ��. �,_ <br />TENANt IA/.IlA0DPE5$ � CIiY M' P�IONE <br />C�..��c ��:� �S,c.� '�i s V��c,._.���� 2nl^ 2�'�,�2Fr,s� <br />AqGHITECTOR0E51GNER M�ILADOfiE55 GIfY 711' PIIONE <br />�.�,,� : c�..� . '��, �� �.,� �, I� w. S�w�,�_ _ �9.�,. � �,� �--. ?,/, [�- � zq� (�.(p ��- <br />GENEMLCONTRAGTIX7 MAIIAD�f1ES5 CIiV /ll' PIIUN[ SfNELICFNSE� <br />MECHANICALCONTRACiOR MAILRDORE55 f,l7Y 7iP CIIONE STALEUCENSE• <br />PIUUflINGCONTR�CTOR MAILAO�RE55 Lltt ZIP <br />YfORK AND SOUAPE FOOTAGE <br />PROPOSEDUSE <br />LOT � BIOLNGa� O-GO <br />PMCE4 TAX I.D. NlIMOER U <br />��'+,3�-d06-C <br />CONSTRVCTION LOAN lENOER. ADORE55. <br />PLUMBING <br />NO. TYPE OF <br />WATER CLOSET� <br />BATHTUB <br />LAVATORY(WASI <br />8 <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINA� <br />DRINKING FOUNTAIN <br />FLOOR DFlAIN <br />BACKFLOW PREVENTERS <br />tiINN (SERVICE - BAR, El <br />dOC��+G <br />JNE NUoEfi <br />OR ITEM <br />FEc <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />Ff10NT5ETBALN REFfI5ET9RGK <br />O G <br />USEZONE <br />__� <br />MEIGMT LIM� j}QN <br />O <br />OGGUPANCY NO 0� SIOFiFi <br />V-v <br />� . ...�,_-..�.--....�-��.� <br />t07 <br />NO.OF OWELLING <br />UNIIS <br />�� n,, <br />OATE % � <br />SI�E SETBACN <br />iv <br />����NT S�T� <br />0 <br />PIIONE STATE UGENSE � <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />coN�r.r rrnsori nNo m�or+e r+o ��, 2�_ �_� <br />" i _ — <br />' v�n�b;l� d�- ��(D-�17 <br />I HERE�Y CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br />PIIOVISIONS OF LAWS AND OaDINANCES GOVEFiNING THIS TYPC- OF <br />WORK WILI DE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTI�IORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW flEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEFiFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT^RACTORS 18.27 RCW AND 296.200 WAC. <br />C ,\1 � —�.'�—�'i,�l <br />X —" `�l� <br />SIGNAIURE � OAIE <br />l:l1Y IIUSINESB LICENSE K0. <br />MECt1ANICAL <br />NO. 7YPE OF EOUIPMENT FEE <br />—T— <br />NC - MiNOLG UNRS ' <br />FORCED AIR SYSTEMS � <br />HEAT PUMP � <br />UNIT HEATERS ' <br />CLOTHES DRYERS � <br />--� <br />RANGE HOOD ' <br />WATER HEATER � <br />WOODSTOVE ' <br />MGTAL FIREPLACE (WOOD BURNING) ' <br />FIREPLACE INSERT (WOOD BURNING) i _ <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />; SUB TOTAL S � <br />PERMIT S � <br />�- TOTAL FEE S <br />>`��� � ,1 <br />PIANCII[CNNl11A0Ef1 � FEE RECEIPTNO <br />-S:� 7 � �/�-_�� — <br />❑YES ❑ NO nw�nir�c /�� a ? /. <br />UC � �' ' <br />512E OF OLOGRI <br />S riuuniNc <br />BASEMF.NT MECIIRNIf.AI <br />❑YES MO <br />AOOIIIONM. PI �N G�[GR <br />on�en <br />O _�+ 2 srme nunninr suncimnce <br />I <br />°Y CITYOFEVERETT rumir.wonns <br />�ocn�sa�es <br />R-9 '1 TAX CODE IS 3105 TOTAL <br />� � <br />