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APPLICATICod FOR CONSTRUC7.ON PERMIT <br />CITY OF EVEF'ETT • BUILDING DIVISION <br />3200 CEDAR STRREE-1 A EVERETT, WA 98201 •259-8810 00 m <br />n DEMOLITION Ll COMBINATION M BUILDING I MECHANICAL 1 PLUMBING I SIGN <br />PROJECT ADDRESS <br />5365 c As r -1>p �y e� rr c,kjA <br />OWNER MAIL ADDRESS CITY. <br />21P PHONE <br />ikkooRA--- ll0C121 NF lk�ItiP`L7DL%DLr1JIL1k q& —.)- <br />F� _ ( 20�) <br />TENANT MAIL ADDRESS L11Y TIP PHONE <br />AR ITECT OR DESIGNER MAR A DRESS CITY ]IP <br />p PIIONf. <br />�� IiESIbN 121�38 1-�� 14 �� (2ot�) $27 -6 �1� - <br />RALC.ONiRACiOR MAIL A011RESS ❑TY ZIP PHONE $LAIC IICFNSE• <br />�LSurJ C»r`►��r1l,SrS ,��1 �CITou�,N(',� % �u a8olz 2e�- Cr,iZ�L <br />NECHANICAA ITR^TpR MAIL ADDRESS <br />CITY ZIP PHONE STRf IIfFNSF � <br />M wmHAGItNV MAIL ADDRESS <br />To V I7ECLl1PJ LNr�LL <br />CONTRACT PRICE OF WORK <br />-T%Mc- FL Ll C av aA o L.N [ <br />ZIP PHONE STATE LICENSE <br />(. '-In n.N WCSTIWG eVeTeu. -.,&' <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED jj j <br />5 <br />CONTACT <br />PERSON AND PHONE NO <br />wl Z cA�}L Gwlz.wc�6 <br />Zt�(:• - 17b-(oC-��.1 <br />7 hs <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL. <br />PROPOSED USE OF BUILDING <br />Res io `t a 1= S% L 1104 <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN On <br />LEGAL DESCRIPTION OF PROPERTY ISHpWN BELOW OR ATTACH TWO COPIES <br />NOT. THE GRAN', ;NG OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />as R." IJe C) 9 3 <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE-TRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF HIS PROPER O PERFORM THE WORK FOR WHICH <br />Aa o FLL E F-T « qZ-0 615Op 2p <br />APPLICAT N is MADE AN 1 OMPLY WITH THE STATE <br />CONTRA ORS LAW 18.27 RCW A 96.2J0 WAC. <br />PARCEL TAX I D. NUMBER / <br />4l -U0o -O l3^GCp 1 lr kacp uP,pL <br />CONSTAUCRLIN LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />G R C <br />77 <br />9GNATURE <br />DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />, <br />---- <br />A/C — A/11NDLG UNITS — H.P. , <br />i <br />BAl'HTUB <br />- <br />FORCED AIR SYSTEM:: — B.T.0 M E.A. <br />LAVATORY (WASH BASIN) // <br />, <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />; <br />j <br />CLOTHES DRYERS <br />DISHbVASHER_ <br />, <br />VENTILATION FAN <br />, <br />LAUNDRY TRAY , <br />' <br />I <br />RANGE HOOD <br />I <br />CLOTHES WASHER <br />, <br />l <br />WATER HEATER <br />, <br />URINAL <br />' <br />WOOD STOVE <br />, <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />; <br />FLOOR DRAIN <br />( <br />FIREPLACE INSERT (WOOD BURNING) <br />��� <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />I <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />�— <br />GAS PIPING <br />EXHAUSTFAN / <br />) <br />, <br />, <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />PERMIT- $ <br />, <br />PERMIT $ <br />TOTAL FEE $ <br />TOTALFEE $ <br />run U1.1•lut U5t ONLY: 11.4i l/L . / / nL / i/,- fCr <br />FRONT SFTPACK / <br />5� <br />RU n qFTBACK <br />/ <br />/0 <br />PInN CUEf. N�B <br />. �•V <br />fP <br />REC.FIPT NO <br />"/C� <br />USE ZONP <br />IOTAREA <br />VACANT SHE <br />FEES <br />I VALUATION <br />FEE <br />I IYES I' NO <br />BUILDING /] F! <br />GT V <br />�y0 <br />/- <br />(P l <br />NEIGIIT LIMITATID <br />NO OF DWELLING <br />/ <br />( <br />IIMI$ <br />OF <br />SIZE OF BLDCy41 <br />'L,1 32 <br />(-IVuJ6 } <br />40o s F�aTacE <br />PLUMBING <br />inn <br />OCCUPANCY NO 01 $IORLLS <br />GROUP n <br />OCCUPANTIOAD BASEMENT <br />/ <br />VGCHANICAL <br />- _, , <br />3 U. L- <br />F$ „ No <br />ADDITIONAL PLAN CHECK <br />— <br />i <br />FIR ALARgI HEOP <br />Rr ASON <br />7/T <br />pi11ER <br />— — <br />, <br />FIRE. $PRIE71(LF.R RED <br />BEACON <br />No <br />STATE BUIIDING SURCHARGE <br />TYPE OF CONST <br />PIANSAPP ,VFj1 BY CITY OF EVERETT <br />rum IC. WORKS <br />`7 <br />' <br />LOCAL SALES <br />TOTAL <br />I <br />` /� <br />DATE 3/ /7 TAX CODE IS 3105 <br />