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APPLICATIi N FOR CONSTRUC :�ON PERMIT <br />CITY OF EVERETi • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />C] DEMOLITION Cl COMBINATION fYT BUILDING fl MECHANICAL f 1 PLUMBING f�l SIGN <br />PROJECT ADDRESS � <br />lZi� r�fi�pRa,��r �Vr,�v�`��r1,r�r�, g6Za3 <br />OWNER MRILADOFESS CITY ZIP PHONE <br />D�NN�S � K�TI+N �-usr/�-FSaN i2�s i�//,°p/�aw�t �9v� �u�rc�€r� 339-i�7i <br />. <br />MRIL AOORES$ p�ry <br />1/7 , ��ZG �r� S. 3u� �VE <br />MAILAUDPESS p�ty <br />SiATE LICENSE • <br />MtGneNIGRLGONTARGTOR MAL�OORE55 CITY 21P PNONE STRtEUCENSE� <br />PIUMBINGCONTR�f.TOR MPILRDURE55 CIiV IiP PHONE STr1TELIGENSE� <br />CONTRnCT PRICE OF WORK <br />`�� 000 <br />DESCFIBE WORKANO SOUARE FOOT�GE INVL�I.VED <br />I��DDITIUN - Zz - a4 � h.�� <br />pl�llC �hqUlnow �r sr��RS = i� a <br />400 �uc� g�.r�t �,v $/35�A�I�NT = /� <br />PROPOSEO USE OF BUILUING <br />5!Nl�� J�/��Ilw <br />LEGALDESCRIPTIONOFPROPERTY�SHO BELOWORATTACHTWOC <br />�or 37'�13fIF BLOCK oF �NIIPG�� lfl <br />� ��I'i <br />PARCELTA%I.D.NUMBEF <br />v���7+ <br />GONSTpUCT10N LOAN LE <br />urc <br />�-r�o _ <br />�Y-(137 �2(Zro — <br />9, AD�RESS, TELEPHONE NUMBER <br />,A�rc.�— #/ - 9�- <br />OF FIXTURE OR ITEM FEE <br />=T fTOILETI i li ��iii — <br />LAVATORY (WASI <br />SHOWER <br />KITCHEN SINK 8 <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. ET <br />SUB <br />FOR OFFICE USE ONLY: <br />FNONTSETBACK / PEA� SETBALK <br />USEZOlJ� � IOTARER <br />// / <br />��.1 <br />IIEIGIITLIMITATION NOOFUWELLING <br />�J Q\ > UNIIS <br />U -�/x.31 2 I <br />FIRE A qM REO'D RF.A50Y <br />r <br />HEATING SYSTEM: fi�iAS fl ELECTRIC f� <br />CONTACT PEHSONAND PIIOGF NO. . <br />I HEREBY CERTIFY THAT I IiAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAIAE TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED W;TH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OP 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. 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 �� $� E <br />CONTRACT RS L W 1B.27 W A D 296. 00 WAC. / <br />X 2 /�i' <br />SIGNAT E 0 TE <br />CITY BUSINE55 LICENSE N0. <br />MECHANICAL <br />NO. TYPE OF E�UIPMENT FEE <br />— n.r. <br />-- B.T.U. M E.A. <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />E%HAUST FAN <br />SIDE 5[T0�('j( / I AhN C11ECK NOMBEg <br />/ ,5 .5G0��/ <br />G <br />VACRNT SITE EES <br />fIYES fiNO BUIL�ING <br />SIZE 01' HL�G�fi <br />Sq � S�f0 S f�f� PI.IIMBING <br />BASEAIE�NT MECII/NICAI <br />MYES fl NO <br />ADDI110N�L PLRN CHFCK <br />OTNER <br />STAiE Ol11lDINf, SUOCfIARGE <br />CITY OF EVERETT runur.wonns <br />LOCA! SALES <br />� TA% CODE IS 3105 70TAL <br />$ � <br />S i il � — <br />FEE ^ � � /i 'I RECEIPT N0. <br />„ � <br />Y �— <br />�'�� 7. 23 <br />