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- -� <br />' APPLICATItirl FOR CONSTRUC?.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f-1 DEMOUTION �l COMBINATION fl BUILDING f� MECHANICAL fl PLUMBING �l SIGN <br />PROJECT ADDRESS <br />1802 DULL PLACE LVERF.TT, IdA 987.01 <br />OWNER MAl1,ADDRE55 <br />��tt Z�� PHONE <br />JACK HF.NRY 1802 DULL PLACE �VERETT 98201 252-2830 <br />IENANT MNLAOORF.SS GTY ZIP PIIONE <br />ARCHITFCT OR DESIGNER MAII AD�RE55 GITY ZIP PHONE <br />GENERAICONitinpTOR MAILAODRESS C11V 21P <br />EVERGTT IILDRS. INC. 19010 51st AVr NC ll3 - ARi.TNr,Tnn� qR2 <br />cm �i� <br />PHOIJ[ STAiE LICGNSE � <br />435-7667 EVGRGB*301PH <br />s�nir uctrvst • <br />PWMBINGCON7RPCTOR MAILPDDPESS Cltt ZIP PHpNE SiA1ELICENSE� <br />GUNINPGTPRICE Of WORN <br />$18,533.00 <br />DESCRIBE WORN AND SOUARE FOOTRGE �NVOLVED <br />�R � S"v75 � 1�� o,.,.,.w_r., naa:. <br />PNOPOSED VSE OF BUILDING <br />Residential <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW /O�R' <br />V�f� 1& Z BLOCK 4 OF� <br />CONSTPUCTION LOAN LENDER. ADDPE55. TELEPNONE NUMBER <br />TYPE OF <br />WATER CLOSET <br />LAVATORY <br />KITCHEN SINK 8 OISP <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />I SUB TOTAL 5 <br />I PERMIT 5 <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SFTl1ACN � P@M SF.TIfACN SIDE SEiB�CK <br />Z� zd� 5�d- <br />USE20NE IOTAi1EA VACpNtSITE <br />_ `I BZS� f1VE5 <br />IIfiIG11T LINI7ATION NO OF DWELLING SIZE OI' ALDG?t <br />2C� � UNIfS I '� ICi S�� <br />U <br />2 <br />0 f1EASON <br />aE0'D RFAFON <br />FI�NSAPP <br />`I <br />onre '7 / <br />FEE <br />/ <br />1IYES 11�i0 <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />HEATING SYSTEM: f l GAS �l ELECTRIC f 1 <br />CONTACT PERSON AN� PIIONE NO. <br />I lieREBY CERTIFY THAT I HAVE READ AND E%AMINED : HIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT ALL <br />PROVIS�ONS 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 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 />APPLICAT IS MADE AND I COMPLY WITH THE STATE <br />CONTRA T PS LAW 7827 RCW AND 296200 WAC. <br />GZi u1 G - Z8- .5- <br />I NAIUPE D�TE <br />BUSME55 LICENS[ NO <br />NO. TYPE OF E�UIPMENT <br />A/C — AMNDLG UNITS — H,P. <br />FORCED AIR SYSTEMS — B.T,U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRVERS <br />WATER HEATER <br />WOODSTOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS PIPING <br />EXHAUSTFAN <br />OUIl01N6 <br />PLUMOING <br />MECN�NICAL <br />ADDI710N�L PIM1N C��(:CK <br />O1NER <br />STA7E OIIILDING SUPCIIAfiGE <br />ruai ir, wor+Ks <br />TOTAL <br />SUB TOTAL $ �j ', <br />PERMIT 5 � <br />TOTALFEE $ �_ <br />fEG RECEIPTNO. <br />'% /,/ � <br />