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APPLICATII .+! FOR CONSTRUCti �aN PERMIT <br />CITY OF EVERETT • BUILDING OIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDGING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: �o�I'J �AAD20/�1A Z�Ut�J��-_lT� <br />OWNER MuI�DDRE55 CITV 2iP PHONE <br />�,,, �; a� K�,-�r ( z,-a Fs�.� 1 a+ 5 ttil�po rr.o.,,� �'� �rr C.c.b 9�'�0� 3 3 9- � S�l <br />TENN1i 1A00HE55 CITY ➢V PNOHE <br />�'^" C <br />ARGMTEC77RDESIGNEN MAIIADOFE55 CI"/ IIP PHONE <br />�` �iZ-23(oc7 <br />WNTMGT VRICE OF WJi1K <br />� 4.�p HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />DESLqBE WdV( AND Shc/JIE FOOTKiE INVOLVEO GbNTFCT PERSON �NO P11pNE NO <br />t�a���,>r��v��S-r� <br />Pf10PO5ED USE OF BUldNO <br />�c�u o¢scnicna+ ov aavEan �s�wvm ee�ow on �n�cH rwc <br />LOT BLOCN OF <br />PAHLEL T/JI I.D. NUMBER <br />CpHSTRUCTIONLOANLENDER.A00RES5.TELEPMONENUMBER <br />PLUMSINO <br />NO. TYPE OF Fl%TURE OR ITEM <br />WATEH CLOSET (TOILEn <br />BATHTUB <br />UVATORY (WASH BASIN) <br />SHOWER <br />KRCHEN SINK 8 DISP <br />OISHWASHER <br />IAUNDRY TRAY <br />CLOTHES WASHER _ <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEPS <br />SINK (SERVICE — BAR, ETC.) <br />1 <br />SUB TOTAL f <br />FOR OFFICE USE ONLY: <br />FNONTSE78/iGl( HEAPSETBACN <br />USEZONE IOTAHEA <br />MEIGHTLIMITATION NO Q'OWELLINfi <br />UNITi <br />OCCUPANCY NO Oi SI(%tlE5 OCCUPANT LOAO <br />TYPE <br />D�IE <br />SI�E SETBACN <br />I HEREBY CERTIFY THAT I HAVE fiEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br />PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIEO 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 LOCAI LAW RE6UUT!N(i CONSTRUCTION OR THE <br />PEHFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />UWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />COPLTRACTORS lAW iB27 RCW AND398:�00 WAC. <br />CITY BUSINESS <br />TYPE OF EOUIPMENT <br />FORCED AIH SYSTEMS <br />HEAT PUMP <br />v.�, "�, rN� <br />1NOOD STOVE <br />MEfAL FIREPLACE <br />PLAN CIIECN NUMBER <br />V�GViT SITE <br />❑YES O NO BUIIDING <br />SIZE OF BLIXLf.I <br />Pl11MBING <br />1SEMENT MECH�NIL�L <br />❑YES ❑ NO <br />RpDIIIONM PIAN CNF.LN <br />OTNEIi <br />ST�IE BUIlD�N6 SIIRCNAOGE <br />CITY OF EVERETT ruanr.wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />J�t7 <br />D�TE <br />SUBTOTAL S �/U ; <br />PERMIT S � <br />TOTAL FEE f .�i_ <br />FEF RECEIPTNO <br />VALUATION �_. FEE _� <br />� <br />