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APPLICATIts FOR CONSTRUCTON PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />32DO CEDAR STREET A EVERETT, VIA 98201 A 259•BBIC 04ff <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br />PROJECT ADDRESS: % %7-O <br />001"Atli Coll:A.S . 7720 Ga r.b„er Rd. Fvrrr?_ 98208 35 3 -01 25 <br />OWNER 4uLA OPESS <br />an ZIP ppi <br />TENANT MAIL ADDRESS <br />rJ 1Y lip PLOVIE <br />ARCWTECT CALL DESIGNER 4YI ADgIESS <br />CITY I,, p,LOAE <br />GENWA"LICONTAACTOI AL.L."ES[ <br />r.11Y ZIP PIIONF SIAIC IKEN$F• <br />uE KAtTAACTm AIAS AGEi <br />CITY I" PHONE STATE LICENSE <br />PLUWNG COVIRACIOR ALL, A iSS <br />CITY Ip. NIONE STATE LKENSEA <br />CONIMCI PLACE UI WgIN <br />,,C <br />HEATING SYSTEM: ❑ CAS ❑ g ELECTRIC !o�1 <br />LCSCwBE WAIN Nq SQUARE FOOTAGE WVOLVED <br />,L Y1 51`a 11 O x lfrfar IC <br />III Ch:mj e <br />Cb11AC1Ptn&GLAVopLoVFNO <br />and W,aj Stove. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER 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. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WPICH <br />APPLICATION IS MADE AND I COMPLY WITH THE S"ATE <br />CONTRACTORS LAW 18.27 FICW AND 22/f9966.�.200 WAG. <br />X .rAi7�)'T�L F/L% (i. W!/ 3/l % /9 % <br />PnoroBED u6E a euLlrNc <br />LEGAL DESCRIPTIa OF PROPERLY ISIOWN BELOW On Anr.CmWO COPIES) <br />LOT BLOCK Or <br />PARCEL TAX 10 AILAIBEn <br />00,1ISTRUCnp1 LOAN LENDER, AOWIFSS. IELENIONE NUMBER <br />SIGNAIME DATE <br />CITYBNSNFSS LCENSC VO <br />PLUMBING <br />f1ECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />110. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />UNITS <br />BATHTUB <br />_NC—MINDLG <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />�— <br />SHOWER <br />HEATERS <br />KITCHEN SINK A DISP <br />_ <br />_UNIT <br />CLOTHES DRYERS <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />C) ' <br />TIC) <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAB PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />f I <br />SUBTOTAL f <br />PERMIT <br />S <br />PERMIT f <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />FILAR SETBACA <br />9CE BFiSACN <br />PIA, C�II�E.c.ASII411-1r. <br />IEF <br />'11.0 <br />USL ERNE <br />LOI AnEA <br />vACANI 4R <br />OYES ❑ No <br />FEES <br />VALUATION <br />FEE <br />—I <br />------------- <br />--- <br />Dml Dum <br />HEIGHTL1411ATION <br />OCCUPANCY Ig irmss <br />GROUP <br />NO OF DWELLING <br />UiS <br />SIZE OF 91. G I <br />Pl11YflWTi <br />YFCIIAMC4 <br />OCCUPANTWAD <br />BASE4ENf <br />❑rFs OLIwD <br />ADp11011Al A AN ON CA <br />FILE SPILVKLER AEG D <br />WASON <br />DIIKA <br />nREALARMREO'D <br />RFA." <br />S1AIE nl ,mn sLITICIIAME <br />TYPE OF IONST <br />PLANSAPNLLDVER BY <br />DATE <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />MieleW AR <br />-- <br />TOTAL <br />