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APPLICATIG J FOR C�ONSTRUCT. .1N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 259-8810 <br /> ❑ DEMOLITION O COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBI��G ❑ SIGN <br /> PROJECTADDRESS: /�/O(, GOM,�j/��F'/� /�dL. ��/��cTT� Gt/'� • '�j�Z� / <br /> OWNEP /J MNLAppRE55 GI7Y ZiP PIIONE <br /> /}�oG'GKnT /)ULqT�✓/L /yoC :!.orir.��D A✓�. EUuz=��.t//I. �<Zo/ (2„G) Zs 1-S'�o6 <br /> TF.N�NT MAILApORE55 CIIY lIP PIION[ <br /> SANIE A5 q.�gov'E <br /> ARCHRECTOf1OE51GNEf1 M�IIADDRE55 LIfY !IP PHONE <br /> GENEReLCONTMLTOR MNUODRE55 CIIY Iit' PHONE SGTEIIC[NSE• <br /> <SaM� /�s �r,od,� <br /> � MECNANICAI.CONiR�C70R M�IIADDRE55 CITY 71P PIIONE SiATEUCENSE� <br /> PLUMBING CONTR�CTOii MML AUDRE55 Qtt IIP PNONE SUiE LICENSE� <br /> CONTRACT VRIGE O�WOHN <br /> �/ '-' HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ,� N�JlU� <br /> DESCRIBEV/ORKANDSOUAREFOOTAG INVOLVEO � / COtIT�CT{'Et150NANDPHONENO <br /> ?- CA G A2/iG E 2�1 X Zl/ n.o'E�T ,Csu�A7�t'�� �zo�J 2 -s -y�� <br /> 5 7� s�. Fr <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflECT ALL <br /> vaoros�ouseornuiioiyc���C � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �E�� E IPTIONOFPROPERtt�SNOWNBELOWO{I 7TALHTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ��T���S�°�3) Bi�K ZR9 oF I�'I " ��_ ApDti . ��� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> E'�I!, PERFOHMANCE OF CONSTRUCiION.THAT I AM AUTHORIZED BY THE <br /> OWI�IER OF THIS PROPERTY TO PERFORM THE WORN FOR WHICH <br /> APPIICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> �ElTex I.D.NUMBER TftAE� LAY�-i82Z�ICW AND 296200 WAC. <br /> ysc6-zas -o�o -o�� ` .[' � <br /> CONSTPUCOON lON!LENDER.�ODRE55.TELEPHONE NUMAER X S � �J— I ' 7 �j <br /> SIGNA U11' O�TE <br /> CITY BUSINE55 LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNRS ' <br /> BATHTUB ; FORCEDAIRSYSTEMS � <br /> LAVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER ' UNITHEATERS ' <br /> KITCHEN SINK&DISP i CLOTHES DRYEflS i <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDfiY TRAY ; WATER HEATER ; <br /> CIOTHES WASHER � WOODSTOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) i <br /> FLOOfl DRAIN � GAS FIREPLACE � <br /> BACNFLOW PREVENTERS � GASRANGE ; <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING � <br /> � EXHAUST FAN <br /> _ ; <br /> � i <br /> SUB TOTAI S SUB TOTAL S ; <br /> PERMIT S � PERMIT 5 � <br /> TOTALFEE 5 ' TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSETA�C�/ RE�RSFJBAfN SIDESETBACN/ PL�NCIIECKNU1AOfR fEf �/O RFCFIPINO <br /> ' " s J <br /> USEZONE � IOTAfIEA v�cnNrsire FEES VALtlATION FEE <br /> ❑YES ❑ M1O OUIL�ING �^ � '�' <br /> V Z� 1 <br /> NEIGHTLIMITATIO�' � UOIrOiOWEIIING 5�2EOFBLDGRI � <br /> fj7(o S,F, rwuowc _ I <br /> T <br /> OCCUPANGY NO Oi 90wC5 OCCUP�Ni L0�0 BASEMENI IAEGIInNICM � <br /> GROUP ! <br /> �1 I OYES NO � <br /> FIiiE SPRINKIER REO'0 �EASON �U�IIIONRI.PUN CIIfCN i <br /> �— <br /> on�er ; <br /> FIPEAIARMREO'D AE�CON -- --� <br /> SLAIE pUIIDING SURCHAROE '�`� <br /> TYPEOFf.ONSi PlANSRPPROVE�BY CITYOFEVERETT runnr,wonKs ; <br /> �.J 1} LOCAL SALES '— <br /> �—hf oATE s $ 9(o TAX CODE IS 3105 TO7AL <br />