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�+► ar�r <br />APPLICATlO�1 FOR CONSTRUCT�OM PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />I-1 DEMOLITION f1 COMBINATION fl BUILDING fl MECHANICAL � PLUMBING fl SIGN <br />PROJECT ADDRESS <br />EL.feN � <br />L <br />doK <br />� ��..rz`ft" i�7A« W l+ y <br />citt zm <br />7oS�4 fe�. ��'�07 <br />CIIY Z�p <br />cm <br />-S.I �-.foo <br />GENER�ICONTR�CTOR MAILAOf]RE55 CILV pIP p110NE SiATELICENSE� <br />l•)E,r B�,n z�iys3 � Ze� q.�E. JE K�Nr 9�uy2_ wE.lQc�C.to99C� <br />MECHANICAL CONTR�CTOR AIAq ADDRE55 CITY ZIP p110NE STATE UCENSE � <br />PL=MBINGCON7RACTOR Me1LADDRE55 Cltt ZIP PHONE STATELICENSE• <br />WOFK AND SOURRE <br />LEGAL DESGRIPTIpN OF PROPI <br />LOT BLOCK <br />PAqCELTA%LU.NUMBER <br />CONSTRVLTIONLO�NLENOER.ADDRESS.7ElEPNONENUMBER <br />PLUMBING <br />TYPE OF flXTURE OR ITEM <br />WATER CLOSET (TOILETI <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAI. <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />!d. r E d d-rv.,af T�i�� <br />SUB TOTAL 5 <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />fRONTSETPACN PEM SFTB�CK <br />USE20NE <br />HEIGNT LIMITATION <br />OCCUPANCY NU( <br />GROUP <br />IOTAREA <br />NO Of DWEILING <br />UkIIS <br />OCCIIPANi LOAD <br />Pf-ASOY <br />RE��ON <br />PLANSAPPPOVE❑ <br />f)AlE <br />SIDE SETBRCK <br />Va��47 SItE <br />IIYES fl NO <br />SRE OF BIDGRI <br />IIYES I1 NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAx CODE IS 3105 <br />HEATING SYSTEM: f l GAS fl ELECTRIC fl <br />CONTACT P[RSON AND i'HONE N0. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPI.IED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�VE <br />AUTHORITY "f0 VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERfORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WQRK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1027 RCW AND 296200 WAC. <br />i � <br />X �,L��� � �.� /z-6 —9�— <br />SIGNRTUAE DATE <br />CITV BUSINESS UCENSE NO. <br />NO. TYPE OF EGUIPMENT <br />A/C — A/HNDLG UNITS — H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE i <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS PIPING <br />EXHAUSTFAN <br />PIAN CIIECN NUMOf:R <br />�cU� 3 :� <br />DUILDING <br />PU/MPWG <br />MECIUNICAL <br />ADDII IONM. PLAN CHF.CK <br />O7HER <br />Sin1E �pILDMG SVfiCMnRCE <br />runnr.wonKs <br />TOTAL <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE $ <br />�EF I ��CEIPTNO. <br />FEE <br />