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^ ^ <br />APPLICATI�.A FOR CONSTRUC7 �ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT WA 98201 • 259-8810 <br />fJ DEMOLITION t�l COMBINATION �BUILDING � MECHANICAL r�p�UMBING f-1 SIGN <br />1�'��,,,i <br />C., �(/�1z�AH Z�3C <br />MMLAL <br />:CTORUESIGNER MR;LAC <br />�� "t ��nfs �9( <br />LCONTIIACTIXi /� MNLAO <br />'L �/I ! 'f � fJ� t/ T 4�s-. <br />N <br />LOT' <br />iO . pCITV / ZIpP U <br />Li„cc% W�i Si.'�c P��r.1nWo..�( L�� G:'7 <br />, <br />/� 4 � f �-s <br />2�ZU G��uti! <br />�, <br />ZuZU G,—�cIK <br />C��-� 24'i2u L�-.cc I+ <br />�J. (/J <br />D 5� UARE Fop TAGE INVOLVED <br />G7/�c T.n %%,�,/�tf <br />yCII f <br />. <br />IUIIDING <br />pu�ii, -�y <br />OF PROPERTY (5 BELOW ORATG <br />_ BLOCN pF � <br />l:ON5Tm1G*ION IW �ENDER,ADOqE55/ <br />�✓v�7. �{/� _�i-- !< <br />�✓ 01� Mk f ( tJ4 <br />PLUMBIN6 <br />NO. TYPE OF FlXTUI <br />� WATER CLOSET ROILEI <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />TELEPHONE NUMBER <br />1Szo 3 <br />z�r <br />.� Qt��y� <br />7S7 - 670 0 <br />3S3—o.s�3 � <br />SiATE LICENSE � <br />�•• / �UOy� ��vnc yTATE UCENSE � <br />��'''�W�"" r� � Z��7&7-67uo <br />C�6c7EU laoH <br />G ZIP y(�UYb PHONE STqTELICENSE� <br />_y�(kWc`.Q �37-67�� .�EL ELiloe <br />HEATING SYSTEM: GAS �l ELECTRIC fl <br />CONTRr,TPERSONANDP��+ONENO. <br />��_� f/raRrYH ( 2U�► 7i'7-(�7ov <br />'/ I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCF.S GOVERNING THIS TYPE Of <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEfiEIN OF <br />esl NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER SiATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTqUCT10N. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATI N IS MADE AND I COMPLV WITH THE STATE <br />— CONTRA RS LAW 18.y7 (�qND 2 200 WAC. <br />/ / j` 'I <br />X K/c �/ f�., �s � / / yY.� <br />SIGNA E OA <br />_O� y�j CITV BUSINE55 LICENSE NO. <br />ITEM FEE NO. TYPE OF ECUIPMENT FEE <br />' A/C—NHNDLCiUNfTS—H.P. <br />; FORCED AIR SYSTEMS — B.T.U. M E.A. <br />� HEAT PUMP <br />' UNIT HEATERS — B.T.U. M <br />i Z• CLOTHES DRYERS <br />' VENTILATION FAN <br />i Z., RANGE HOOD <br />� 'Z WATER HEA7ER <br />' WOODSTOVE <br />i METAL FIREPLACE (WOOD BURNING) <br />' FIREPLACE INSERT (WOOD BURNING) <br />� GAS FIREPLACE <br />� GASRANGE <br />. i n GAS PIPING <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONT SEiBAC �.� / REAR SETB�LK <br />�� L <br />c- <br />USE20NE /�/� LOT�REA <br />/"_ '� Z/ <br />HEIGHTLIMITATION � NOOFDWELLING <br />UNIfS <br />rOCoNU�ANCY NO Oi510FIE5 OCCUPANTLOAD <br />� <br />� SIDE SETBRC� � PLAN CHECK`Nl fi� <br />4 <br />J <br />VRCRNT SITE FEES <br />�IYES ff NO <br />aunowa <br />SIZE OF BLIX1R <br />314b S� �-/V/N[�t PIUMBING <br />003 S' cE <br />6ASEMENT _ / MFGNRNICaL <br />f7YE5 lu.qp <br />FDDI710NAI. PLAN GHF.CK <br />OTIIE(i <br />STATE OUII�ING SpRCHMG[ <br />CITY OF EVERE7T ruaur, wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 7oTAl <br />SUB TOTAL y <br />PERMIT $ <br />TOTALFEE $ <br />— I RECEIPT NO. <br />�� <br />