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APPLICATIG_� FOR CONSTRUC7.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />p DEMOLITION � COMBINATION ❑ BUILDIN.'^a � MECHANICAL p PLUMBING ❑ SIGN <br />PROJECT ADDRESS: �LO �� � +C�IM I� � 1 � EL�' �.�� � <br />♦ � � LI7Y � 21P PIIONE � � <br />TENANT MAILADORE55 <br />ARGHITELT OR DESIGNER MAII �O�RE55 CITY IIP PNONE <br />:pNTMGT PRIGE OF Y/OPN _� �� r <br />�- -r � � �- <br />�SSRIBE/ W,OFN �N� SQU�RE FOOTAGE INVOIVED � �` �; �� <br />��V1 �,�N����� � <br />Ir' �`f�L � r� i��� �_ n1'� <br />PRJPOSED USE OF BUILUING <br />LEGAL UESGRIPTION OF PROPERTY ISHOWN BELOW OH ARACH 7W0 COPIES) <br />LOT BLOCK OF <br />PMCEL TAX I.D. NUMBER , , ,� � _ n �� � �i ...�-�/ �y , <br />CONSTRUCTION LOAN LEHDER, ADDAE$S, TELEPNONE NUMBER <br />PLUMBING <br />NO. TYPE OF F�XTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d DISP <br />DISHWASHEF <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN REAR SETBFGK SIDESETB�LN <br />USEZONE <br />MEIGIIT UMITATION <br />OCCUPANCY NO ( <br />GROUP <br />FIRE SPRINNLER REI <br />FIRE AUNM REO'D <br />HEATING SYSTEM: ,�GAS ❑ ELECTRIC ❑ <br />CONUCT VERSON AND PNONE NO , \ i - � , ( fl � , � <br />r • <br />�? `�7'�- �_� -i I� ( t <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORPECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEfiNING THIS TYPE OF <br />WORi< WILL BE COMPLIED WITH WHETHEFi 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. Tf 1AT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH <br />APPLICATION IS COMPLY WITH THE STATE <br />CONTRACTOR W AN� 96.200 WAC. <br />/ � <br />X DAT <br />SIGN�TURE <br />CITY BUSINESS UCENSE NO. <br />TYPE OFEQUIPMENT � FEE <br />A/� — NHNDLG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE � <br />FIREPIACE INSERT <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />0 <br />SUB TOTAL E (J <br />PERMIT E � <br />TOTAL FEE S ' � <br />PLANCIIECK NUMBER PEF I�ECHPT NO <br />lOT AREA V�CANT SITE <br />❑YES ❑ NO OUIIDINC <br />NO OF DWEILING SRE OF BLOGRI <br />UNi15 FlI1M01NG <br />OCCUPFNT IORD B�SEAIENT MEC/IRNICAI <br />❑YES ❑ NO <br />FDDI IIONRL PL4N GIGCK <br />fIFA50N <br />oi���n <br />RE�SON <br />$TAIE BUII�MG SURC11�f1GE <br />PLANSAPPROVE09Y CITY OF EVERETT �IIBUf, WORNS <br />LOCALSALES <br />oqTE TAX CODE IS 3105 To7Al <br />