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APPLICATICA FOR CONSTRUCTON PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •257.8810 00L <br />DEMOLITION COMBINATION iX BUILDING I I MECHANICAL PLUMBING SIGN <br />PTCT ADDRESS <br />Oo:VU, •.A'I DDPESS orr <br />nnAru <br />uAn AOwlEss <br />cnr <br />rua¢ <br />_/I,� <br />4- 77Y 6 <br />S� <br />/� <br />� � L /J S! <br />Az�mr <br />H ipll' — <br />An�IRI[CI"I OE$GM:R <br />YA0. AgNlC$$ <br />CITY <br />!n <br />_ <br />IY1016 <br />1. <br />GLIEMLCONTAACTO11 <br />MAR AUMESSI <br />CITY <br />!n <br />mlow STATE LICENSE <br />aE��S��G�I���NC�'LN <br />LiAI�UQ("/ <br />l L0C <br />1 g7�Olf <br />"LCIM ICALCOrrtRACTd1 <br />MAIL E55 <br />CITY <br />!n <br />RKXK STATE LCEIISE 0 <br />I'WMURq CONTRACIM MMLAGd1ES CITY In Nfi SIAIELICENSE- <br />CJIITRACI <br />(Y Y <br />HEATING SYSTEM: ?(GAS 17 ELECTRIC f 1 _ <br />UE$CRRE NURI(ANU SQUARE EOOrAGE Ir1VOLY[O <br />_ - <br />CONTACT PERS&I MITI IYglrt W <br />vzs_— 3-IL-7 - 40 14 <br />s r - <br />r2�= I� vs c <br />L�'y 6INF �AF S r. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296 200 WAC. <br />����r /+/�/ <br />X�L^wd, :?p. o <br />PTlpos$DusEa euaOINO <br />— <br />LEGAL OESCIInTKXI IX KIOPERTY (SITOi SEEM OR AJTT lT6VCOPIESI <br />LOT BLOCK ClAUTHORITY <br />PARCEL TAK Io Nuuu R <br />5 0o as o0 <br />COTSTFOCt" LOMI LENDER A tSS. TELEPNpAE WLASER <br />AGNATURE GATE <br />CITY WSTIESS LICEISE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC—AMNOLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />j <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />! <br />GAS FIREPLACE <br />DACKFLOW PREVENTERS <br />GAS RANGE <br />i <br />SINK (SERVICE — BAR, ETC) <br />I <br />GAS PIPING <br />I <br />EXHAUSTFAN <br />i <br />/ <br />I <br />I <br />I <br />I <br />_ <br />SUBTOTAL S <br />I <br />SUBTOTAL S <br />i <br />_ <br />PERMIT S <br />j <br />PERMIT S <br />TOTALFEE S <br />I <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />ERCNI$ETBACK <br />REAJISCI ACK <br />Zo <br />SIDE SETBACK jAW./ <br />KC0R <br />00!3) <br />EEE <br />L) <br />RECEnTTA <br />ul ZONE <br />tot MEA <br />z }q ZQ <br />vACANT snE h'� <br />IT <br />FEES <br />VALUATION <br />FEE <br />WILOAKI <br />NEA:Nr uunAT10N� <br />rw GE owtuonI <br />WEaoL �I <br />79 .'.L S <br />LIM <br />KUMBMq <br />OCCIIPMICr I IOU STgYS <br />Ngu <br />�•3 0-1 2 <br />OCCUPANT LOAD LMLNI <br />nres No <br />MnYM1ACA1. <br />ATKKt1ONLLKAIICIIECK <br />En SPRKnLERRCOU <br />REASON <br />OMER <br />FATEALARM11E00 <br />REASON <br />STATE BUEDKAG SIMCIWIOE <br />trKacorrsT <br />--J <br />1L <br />PI.AN$APPROVLuuY <br />DATE /01 <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />nnLIC WGNKS <br />O <br />TOTAL <br />