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.�. <br />APPLICA'T14�1 FOR CONSTRUCT�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />O DEMOLITION fl COMBINATION F�tl BUILDING Ll MECHANICAL t�i pLUMBING �l SIGN <br />PROJECT ADDRESS <br />OMRlEF M�IL�DDRE55 ��7y <br />fr�.�ci5�cas r 1J�I�+�C. �l1�ab�.a <br />�F.NANT MAILADDRESS CITY <br />OR OESIGNER <br />1 � 1 .'i <br />PiIOPOSED USE OF <br />LOT' <br />M�IL <br />> - 72� -4'2� - <br />CONSTRIICTION LOMI IENDER.AOdiESS, TELEPHfX1E NUMBER <br />PLUMBINO <br />NO. <br />BATHTUB <br />OF fll(TURE OR ITEM <br />KITCHEN SINK d DISP <br />DISHWASHER <br />URINAI <br />BACKFLOW PREVENTERS <br />SINK ISERVICE — BAR. ET <br />PERMIT $ <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONT SE7B�CK REAR SETBRGK <br />USEIONE LOTAREA <br />HEIGHTIIMIUTION NO.OFDWELLING <br />UNIIS <br />� <br />RF.ASON <br />, <br />Cltt <br />SIDE SETB�CK <br />V�CRNT SItE <br />fIYES fl NO <br />IIP <br />zm <br />zm <br />i� <br />lIP <br />GNONE <br />P O E <br />HEATING SYSTEM: 1-1 GAS fl ELECTRIC I-1 <br />GONTRGT PENSUN PNU YMUNE NO. <br />n <br />I HEREOY CERTIFY THAT I HAVE READ AND EXAMINED TH{S <br />APPUCATION AND KNOW THE SAME TO BE TRUE AND CORFECT. 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 PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTHACTORS LAW iB27 RCW AND 296200 WAC. <br />�� F �OG ii�/ �..F/l7�i� �4�� <br />CITV BUSINESS LICENSE NO. <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />A/C—A/HNDLO UNR'S—H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DR�ERS <br />VENTILATION FAN <br />RANGE HOOU <br />WATER HEATEP <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING <br />FIREPLACE INSERT (WOOD BURNIN( <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN � <br />PLAN <br />BUIl01NG <br />SIZE OF BLDG?I <br />' I PUIMBING <br />BRSEMENT MECHnNIC/L <br />�ES I'I NO - <br />ADDI110NAL PLAN CNF.CK <br />OiNER <br />STAIE BUILDING SIiNCN1'1GF. <br />CITY OF EVERETT ruauc wonKs <br />LOCAL SALES <br />; TAX CODE IS 3105 TOTAL <br />'SUB'fOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />-��'� � <br />FEE RECEIPTNO. <br />Q� <br />