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,-. <br />APPLICATIO� FOR CONSTRIJCT�ON PERMIT <br />CITY OF EVERETT • BUILDING DIV�SION <br />3200 CEQAR STREET • EVERETT, WA 98201 • 259-88'0 <br />f] DEMOLITION (-I COMBINATION fl BUILDING C] MECHANICAL �-i PLUMBING �( SIGN <br />cm zir <br />2�/O <br />IEN�N� MAII.ADDRESS CIN IIF PMONE <br />�srn� �,n�,x� v-�3�x aab�5 s.�7�R£i-r .�s 98203 zob 3s �330 <br />ARCNI7ECT OR DESIGNER MRIL ADDRESS CITY ZIP PHONE <br />/�'i�vf2 sa�N co. i�sy r��G9s. ,r�u�-r.�,�_�A ��a�3 36a-�J�f-13ar <br />GENERAICONTRACTOR MAIIAD�RE55 GITY JIP P110NE STr17ELICENSE� <br />MECXANICALCONTRRCTOR MAILADDRESS CIN ZIP PHOUE S7A7ElICEN°E/ <br />PWMBINGCONTR�CTOR M�IlA0DRE55 CITY ZIP PHONE ST�TEUCENSL� <br />i(o.Oa <br />�NO SMIARE FOOT�GE <br />OF <br />iar <br />BLOCK <br />BELOW OR ATfACN <br />CONSTRUCTION LO�N LENDER. A�ORE55, TELlPHONE NUMBER <br />PLUMBINO <br />N�— <br />WATER CLOSET <br />BATHTUB <br />KITCHEN SINK E DISP <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. E7 <br />FEE <br />SUB TOTAL $ <br />PERMIT $ <br />I TOTALFEE�— <br />FOR OFFICE USE ONLY: <br />FRONT SET04CK RERR SETBALK SIDE SETBRCK <br />� ' 6��1 ' <br />USEZONE AqEA�y 1 VACRNi51TE <br />C � � .�/.Sw �IVES fjrNO <br />HEIGNTLIMITATION NO.OFUWEILING SIZEOFBLOG�fI. <br />� � UN17S � <br />Li <br />OCCUPANCV NO O�SIOP�ES OCCUPANTLOAD BASEMENT <br />SPRINNIER REO'0 <br />IIYES fl NO <br />HEATING SYSTEM: �l GAS f� ELECTRIC fl <br />I HEREBY CERTIFY THAT I HAVE REA� AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <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 PFOVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATIN(i CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY 1'NE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1. W AND 296200 WAC. <br />% �l..l�/L---- /O �j5'r <br />SIGNATUFE DATE <br />_ ��l7� L <br />CITY Bl ;I �55 LICENSE NO. <br />MECHANh:AL <br />NO. <br />A/C — FVHNDLG UNITS — H.P. <br />FORCED AIR SVSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILAT�O�� FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METALFIREPLACE(WOODI <br />FIREPLACE INSEF`T (WOOD <br />GAS FIREPLACE <br />GAS RANGE <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />PIAN CII ���� I FEE I RE�/T �� �� <br />euaowc <br />PLUMOING <br />MEC11nNICAL <br />AODIilON4L PLAN G��CCK <br />OTNEF <br />STATE OUILDIHG SURf,HnRGE / � �y , <br />PL�NSAPP�ppVEOBY CITY OF EVERETT �1IB11f, WOf1K5 <br />�d � r LOCAL SALES - <br />onTe 11- �-S � TAX CODE IS 3105 TOTAL <br />