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APPLICATI("'"V FOR CONSTRUCT'�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> p" DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: ,�gO•I Fu� mnJ F� Fize 77' <br /> FVfRG77' 60.5Pt� mrssroa P.o. 8ox �3 �✓F.zF"r7— 98ac, I a�.�- �f7�6 <br /> ONRlER M�1LA00{1E55 CITV ZiP PHONE <br /> VAC A nJT <br /> . 7ENANT MA�LADIXIE55 LITY 21P PNOHE <br /> ARLHITECTOROESiGNER MAILAODRE55 CITV ZIP PHONE � <br /> • C�'rY 6F £.vERF'T FiRE '�EPAQ'7'n�e �T <br /> GENEMLCONiRACTOR MIJLAOORE55 CIfY IIP PIIONE $GTELICENSEI <br /> MECHIWICAICONTR�CTOR MI�ILADDRE55 CITY IIP PHONE STATEIICENSE� � <br /> PLUMBINGCONTRACTOR MAiIADOqE55 CITV ZIP PHONE STATEIILENSE� <br /> CONiMCT PPoCE OF WORN <br /> HEATING SYSTEM: 0 GAS ❑ ELECTRIC � ' <br /> OESCIUBE MfORN�NO SOUANE FOOTAOE INVOLVED CONT�CT PERSON AND PMONE NO <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS � <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEG�LDESCRIPTIONOFPROPEP7Y�5lIOWNBELOWOq�TThLNTWOLOPIES) NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> .oT e�ocK oF 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 AUTHORI2ED BV THE <br /> OWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH <br /> 593�. - G S7- 6i4� pnn APPLICATION IS MADE AND I COMPLY WITN THE STATE <br /> PMCEI TiV(I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> _ CONSTRUGTIONLOANlENOER.�DDf1E55.TELEPHONEM/YBER x /Y(Q(lia�.ta�\ d�1� /�'IJJI�IQl� �Z�/9G ' <br /> SIfsNATURE DATE <br /> CITY BOS�NE55 LICENSE N0. <br /> PLUMBIN6 MECMANICAL <br /> �NO. TVPE OF fll(TURE OR ITEM FEE NO. TYPE OF EOUIPMEHT FEE <br /> WATEH CLOSET(TOILET) � NC—NHNDL6 UNffS � <br /> BATHTUB ; FORCED AIR SYSTEMS ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASHER � RANGEHOOD � <br /> UUNDRY TRAY ; WATER HEATER � <br /> CLOTHESWASHER � WOODSTOVE � <br /> UHINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN ' i FIREPLACE INSERT(WOOD BURNING) i <br /> FLOOR DRAIN - � GAS FIREPIACE � <br /> � BACKFLOW PREVENTERS • ; GAS RANGE � <br /> SINK(SERVICE-BAR,ETC.) � GAS PIPING � <br /> . � IXHAUST FAN ' <br /> i � <br /> i ; <br /> SUB TOTAL S ; SUB TOTAL S ; <br /> PERMIT S � PERMIT f � <br /> TOTAIFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> iRONT SETBACK REAR SETBACK SIDE SETBACN PLAN CIIECK NUMBER� FEF AECEIPT NO <br /> �� <br /> � USE ZONE LOT�REA VAC�Ni$ITE FEES VALUAf10N FEE <br /> , OVES ❑ � OUIL�ING � <br /> _ i <br /> NE�GMT UMITATION NO OF DWELUNO SIZE OF BLOG�f.I � <br /> UHITC PlI1M61NC � <br /> � OCCUPANCY 1q O�SIMtlES OCCUPANTLO�D BASEMENT MECNeNIC�I � <br /> 6RWP <br /> OYES O NO � <br /> FIRESPRINNLEflflEO'0 �EASON ADUITION�LPUNLHF.LR i <br /> �T— <br /> OTHER � <br /> i <br /> i <br /> FIREAUflMREO'D RE�SON i <br /> STAE OUIlDIN6 SIIRCM��GE � <br /> -- r— <br /> TYPEOFf.ONST PLANSAPPROVEOBY - CITYOFEVERETT �IIBIIf.W0itN5 � � <br /> LOCAL SALES — —"�— <br /> o�TE TAX CODE IS�105 TOTAL � <br />