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APPLICATIO�1 FOR CONSTRUC'T �ON PERMIT <br />CITY OF EVERETT • BUIL6ING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />� n���n� �r�nu n trnuwiNeTloN fl BUILDING f-1 MECHANICAL dl PLUMBING fl SIGN <br />OP N1OR � _� HEATING SYSTEM: f1�GAS rl ELECTRIC f-1 <br />�ND SOUARE FOOT E IN LVED CONTRCT PEHSONAND P ONE NO. <br />, , i ���:A�;��n..-.,v� Ai��ff GC�F _r__ %�eNo�� �S ���cs 4 <br />BELOW <br />LOT' BtOCK <br />PARCELTA%I.D.NUMBEH <br />�O�n - �C�G - <br />CONSTPIiCT�ON LOAN LENDER.IIODRESS. TEIEPHONE NUMBEH <br />NO. <br />WATER <br />SHOWER <br />KITCHEN SINK E DISP <br />CLOTHES WASHER <br />FLOOR <br />— BAR, <br />FOR OFFICE USE ONLY: <br />FRONT SETP�LK REAR SETBACN <br />USE20NE <br />HEIGHT LIMITATION <br />PEOD <br />CONST <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE S <br />LOT AREA <br />NO OF DWEILING <br />UNIiS <br />OCCUP�NTLORD <br />DATE <br />I HEREBY CERTIFY THAT I HAVE REAO 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 OFi <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 BV THE <br />OWNER OF THIS PROP T RFORM THE WORK FOR WHICH <br />APPLICATION I ADE D I MPLY WITH THE STATE <br />CONTRACTO AW 1 D 200 WAC. �� � <br />X DATE <br />SIGNATURE <br />CITY BUSINESS IICENSE NO. <br />FEE NO. TYPE OF EGUIPMENT <br />� A/C—A/HNDLGUNITS—H.P. <br />� FORCED AIR SYSTEMS — B.T.U. M E.A. <br />, HEAT PUMP <br />� UNIT HEATERS — B.T.U. M <br />� CLOTHES DRYERS <br />i VENTILATION FAN <br />� RANGEHOOD <br />, WATER HEATER <br />� WOOD STOVE <br />� METAL FIREPLACE (WOOD BURNING) <br />� FIREPLACE INSERT (WOOD BURNING) <br />� GAS FIREPLACE <br />� GAS RANGE <br />� GAS PIPIN6 <br />� EXHAUST FAN <br />SIDE SETB�CK PLAN CHEC NUM tr+ <br />90� <br />VACANT $ITE FEES <br />f1VE5 !7 NO Bllll[11NG <br />S�ZE OF BLDG/TI <br />Pll/M01NG <br />B/SEMENT MEC11nNIClI <br />fIYES II NO <br />ApDI11ANM. PLAN CHf:CN <br />OIIIER <br />SiAIE flWIDINC SURCHMGE <br />CITYOFEVERETT �'��A��r.wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TO7AL <br />SUB TOTAL $ <br />PERMIT S <br />TOTALFEE $ <br />FEE � I RECEIPTNO. <br />