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APPLICATI4.� FOR CONSTRUCT�JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 �„EDAR STREET • EVEREIT, WA 9820J • 259•8810 <br />/ <br />❑ DEMOLITION O COMBINATION ❑ BUILDING �]�MECHANICAL ❑ PLUMBING p SIGN <br />PROJECTADDRESS: ��(j,� ,Sj= �Vera�i� 1M�,1� i�'l., , <br />._....... �uuienoarss cnr <br />��P Ci�CNE <br />ARCHITECTORDESIGNEF MML�ODRE55 <br />��ry ���' PMJNE <br />PLUTABINGCONTR�CTOR MAILA�ORE55 Y�N C..S�,] 011�� <br />V <br />��ry Z�P PHONE STATE UGENSE • <br />LEGAL <br />LOT _ <br />VN�LE <br />WORK ANO SOUAqE FppT�GE <br />��Flc.�,�,�- a <br />BLOCK <br />PMCEL TN( I.D. NUTABER <br />U� <br />�� <br />CONSTRUCTION IOAN LEHDEfi, AOORE55, TELEPI/ONE NUMBE� <br />N�• I TYPE <br />FLOOR <br />SINK <br />COPIES) <br />FEE <br />HEATING SYSTEM: C GAS ❑ ELECTRIC O <br />� o� - � � �-v�oc� rY��fC_ �0�- 3i4�G��� <br />I HEREBY CEHTIFY THAT I HAVE �iEAD AN� EXAMINE� 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 COMPLIED WI7H WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE Oq CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGUUWTING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTpUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORM THe WORK FOR WHICH <br />APPLICA�ION IS MADE AND I COMPIY WITH THE STATE <br />CONT� A TORS �pW 1.27 RCW AND 296.200 WAC. <br />� <br />X � r����l� � <br />51 A URE O�Tc <br />L <br />CITY BUSINESS UCENSE NO. <br />NO. I TYPE OF EQUIPMENT FEE <br />� /VC—MiNOIf:IIAIRS <br />� FORCED AIR SYSTEMS <br />(WASH BASIN) <br />� HEATPUMP <br />' UNIT HEATERS <br />�INK & DISP ; CLOTHES DRVERS <br />�R ' RANGEHOOD <br />lRAY � ....___ . <br />SUB TOTAL 5� <br />— PERMIT g <br />TQTAI FFF t <br />FOR OFFICE USE ONLY: <br />FRONTSETOACK REAR $FTBAGN SIOESETB�CN <br />USEZONE LOiAREA VACANi51iE <br />--} ❑YES O NO <br />HEIGMT LIMITATION N0. pF OWELLING I SRE OF BI�GR.� <br />UNIfS <br />IO�D <br />��M <br />DAtE <br />❑YES ❑ NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX COOE IS 3105 <br />WOOD STOVE <br />METAL FIREPIACE (WOOD <br />FIREPLACEINSERT(WOOD <br />GAS FIHEPLACE <br />GASRANGE <br />GAS PIPING <br />[XHAUSTFAN <br />PIAN CIIECK NUMpEfI <br />OUILf11N(i <br />PIUMOMG <br />MECIIANIGAL <br />�DDI IION�L PIRN CII[CN <br />Oi11ER <br />STAiE �Wl01NG SUf1CHnpGE <br />�uoi ic wonKs <br />TOTAL <br />SUB TOTAL S <br />PERMIT b <br />TOTAL FE� E <br />iEF �� I qEf.EIPT NO <br />