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� <br />APPLICATIOI., FOR COI�ST�UCTI�...N PERMIi <br />CI:Y OF EVERETT • BUILDING DIVISION � <br />3200 CEDAt� STREET • E�'ERETT, WA 98201 • 259•8610 <br />❑ DEMOUTION ❑ COMBINATION ❑ BUILDING ��MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: /,� /_ .✓i� .J, � _ . ) <br />TENANT iANI�Drv.if.5$ <br />OROESIGNCR M�II <br />CIIY <br />PIIONE <br />GENEMICONiRaCTOB MMI�pORE55 CIiY,� IiP P�IONE SUTEIILENSE• <br />l9t'7��VDA.�sC� L✓iT �Irlv �7>c�zl'R�ral�rl.�/'�� c7>�l_-;-r q3Z �3 ��oc j,zsr�-v9iS ar.��-r�.+oc ��w <br />N[CN�NICRI CONTRACTOR M�IUDDRE55 CITY ZIP PIIONE STRE LI�ENSE • <br />PLUTABINGCUNTRA�7pp MAILADDRE55 CITY ZIP PHONE SiQEIICENSE• <br />�!, s S ��, rs' * �� <br />DESCRIBE WORK ANL SOU�RE FC2!AGE INVOLVED <br />?ilISTR<�. GrIS )�� <br />`� Ct�f�T2.�'7R NL��-- i� � � <br />c <br />LEG�I OESCRIPTION OF PROPEqTY (SHOWN BELOW pfi ATiFGF TWO COPIES) <br />LOT BLOCN OF <br />PMCEL TAX I.D. NUMBER <br />LONSTRUGTIONLO�NLEN�ER.A�DRESS.TELEPNONENUMBEH <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEFi <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />! ",! �NDRY LP!.Y <br />CLOTHES ='fASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />SUB TJTAL $ <br />PERMIT $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBRCK PER{iSETBAGK Slpc <br />USE ZONE <br />NEIGIIT LIMIT�TION <br />OCCUPANCY NO 0[SIpmES <br />GROVP <br />FIpE SPRINKLER REO'0 <br />LOTAFEA <br />NO OF OWEILING <br />UNIiS <br />tORO <br />VACANT $IfE <br />❑vE5 ❑ NO <br />512E OF OLOG/fl <br />BASEMENT <br />❑YES ❑ NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3705 <br />HEATING SYSTEM: f�GAS ❑ ELECI'RIC ❑ <br />CONTACT P[RSON ANp PHONE NO <br />1 HEREBY CERTIFY THAT I HAVE READ AND EX�MINED THiS <br />APPLICATION AND KNOW THE SAME T(1 Bt TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCFS GOVEPNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETFiGR SPECIFIED HEREIN OFi <br />NGT. THE GRANTING OF A PERMIT DOES NO' PRESUME TO GIVE <br />: UTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHE(i STAT.^-. OR LOCAL LAW REGULATING CONSTRUCTION OR THF: <br />PERFORMANCG OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATt <br />CO�TqACTORS LAW 18.27 FCW AND 296.200 WAC. <br />X / H ^/ ' � J (C <br />5 G e URE D�TE <br />QiY BUSINESS IICENS[ NO. <br />MECHANICAL <br />N0. TYPE OF E�UIPMENT FEE <br />A/C — FVHNDLG UNRS <br />FORCED AIR SYSTEMS <br />UNIT HEATERS <br />CLOTHES DRYERS <br />RANGEHOOD <br />MEiAL FIREPLACE <br />GASRANGE <br />GAS PIPING <br />SUB TOTAL $ <br />PERMIT S <br />TOTALFEE 5 <br />PUNCIIEC� U,MAB� C/ I fEF ( REf.FlPf NO <br />S �CY � <br />O111L�ING <br />PLIIMOING <br />MfGIPNICnL <br />/ �DIf10NnL MAN �IIf.CK <br />ou�en <br />SiAI[ OUIIDINf.511fiC114fIGE <br />runnr,woqe5 <br />TOTAL <br />