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APPLICATION FOR CONSTRUC? �ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />DEMOLITION fl COMBINATION rl BUILDING CI MECHANICAL rl PLUMBING fl SIGN <br />PROJECT ADDRESS � ��Et'-C�2E�/U I/U � �U� �� �� / �ZG� <br />OWNER MaILAOD GSS LITY ZIP PNONE <br />S�P-g Irirni 1�7+ ��'�n�.'sA�(� Po �. (�(�4 I�e'�r�eu�l(e , 02 9��-S� <br />TENANT M�ILADDPE55 T CITV 21P PIIONE /_B <br />li-k �'1�12G(ia.�N�•cJ �1c0/ (o`�" /iv� So • ,SPu i�f.e � G�✓� 3 ", <br />ARCHITEGTORDESIGNE9 MMLADOFE55 Gltt lIP PHONE <br />N�a <br />GFNERAI CONTftACTOii MAILRODBE55 CITY ZIP PNON[ STATE I.ICENSE � <br />MECHANICALCONlR�CTO MAILADORE55 CIN 21P P��ONE STAiEUCENSE� <br />PLUMB�/ � TRACTOR MAIL A�ORESS CI7Y ZIP PHONE S7A7E LIGENSE • <br />NIA- <br />CONTH'tAp% P,RICE OF WORN — <br />�7 HEATING SYSTEM: f 1 GAS fl ELECTRIC rl <br />DESCRIBE WORN ANO SOUARE FOOTAGE INVOWED � � �� � CONTACT PERSON r1ND PNONE N0. <br />LOT BLOCK <br />PARCELTAXI.O.NUMBER <br />i��8���-oas-000 <br />CONSTRUCTION IOAN LEN�ER. ADURESS.IELEPHONE NUI <br />� <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILETI <br />LAVATORY <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR DRAIY <br />BACKFLOW PREVEN' <br />AINK ICFGVICF _ RA <br />SUB TOTAL 3 <br />PERMIT 5 <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSF.TPACK PEAR SETBACR <br />USE 20NE <br />IfEIG11T LIMITATION <br />LOi AilEA <br />NO.OF DWF�LING <br />UNITS <br />On7E <br />OY <br />GOPIES) <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE 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 LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWPIER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COM ITH THE STATE <br />CONTRACToae �"�^� �827 RCW ANDs29 200 W9 � <br />BUSINESS UCENSE N0. <br />FEE I N0. <br />DATE <br />- - A/HNDLG UNRS — H.P. <br />ICED AIR SYSTEMS — B.T.U. M E.A. <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOODSTOV� <br />METAL FIREPLACE <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />SIOESETBACN IP�ANCIIECKNOMOER <br />VnCANISRE YttS <br />f1YE5 f1N0 BUILDING <br />SRE OF BLDG/f.l <br />PWMIiING <br />PASEMENT MECNlNICPL <br />f1YE5 fl NO <br />ADDIiION�L PL/N CHf.GK <br />OTIIER <br />$TNE BUIIDiN[ SUfiCHORGE <br />CITY OF EVERETT ruour, vronKs <br />LOCALSALES ' <br />TAX CODE IS 3105 TOTAL <br />SU8 TOTAL S <br />PERMIT S <br />TOTALFEE $ <br />FE[ j .'.L:.oPT NO. <br />FEE <br />