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APPLICATIA FOR CONSTRUC*N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 •257-8810 <br />❑ DEMOLITION 7 COMBINATION ❑ BUILDING ; 1 MECHANICAL ❑ PLUMBING - SIGN <br />r— <br />ALUUHCJJ <br />Ilyl <br />Ziv PNOIE <br />-� �� s<ar�F (Izs) 337-01?O <br />fEN4R NALADWVESS LT' IIP PNp4 <br />OyJNCIti <br />MFOIAN.(':.LCCNTMLIOR AAa AppgEss CIlY IV RIWff iiATE LKENSE• <br />R rA LIOP .7AEAAlES.% CRY ITT PHONE STATE LK.EMSEA <br />nwnaEY2_ <br />ODNTNALl <br />PPCE'7F NpIK <br />U Z <br />HEATING SYSTEM: ❑ GAS T"ELECTRIC ❑ <br />CESGIOE VA)PK AND SdWiE FOOTAf.E ttRXVEO <br />/A¢A>GE L LF �ri <br />CONTACT PERSON AND PHONE NO <br />Ill 1 E-t OIJ `YLf- 299 <br />F� E 11LFJc.NLc <br />_Q1bM .i5"ro) FT 2' /{�{� L <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 COMPUED 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 WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOflS LAW 18.27 RCW AND 296200 WAC. <br />�d !/"�J <br />X > ' <br />PROPOSED usE of soap <br />LEGAL OESLRRTKNI OF PFWERTY ISNOWN BELOWOR ATTACH IWOC SI <br />LOT <br />_ <br />PARCEL*a I D. NUMBER <br />4i�l�-/�d/J-dd/-6�s <br />CONSIiI{ILi LOAN LENDER AWRESS. TELE•1gNE WMBER <br />/ <br />SWNANRE DATE <br />CITY BUS#SS lgENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />IN <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A)C-AHNDLG UNITS <br />BATHTUB <br />i <br />FORCEDAIR SYSTEMS <br />i <br />LAVATORY (WASH BASIN) <br />MEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />! <br />KITCHEN SINK & DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />DRINKING FOUNTAIN <br />! <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />PAS FIREPLACE <br />BACKFLOW PPEVENTERS <br />GAS RANGE <br />SINK (SERVICE -BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />! <br />I <br />I <br />I <br />SUBTOTAL S <br />SUBTOTAL S <br />i <br />PERMIT S <br />PERMIT s <br />! <br />TOTALFEE S <br />TOTAL FEE & <br />rw/ VrrIVG vac VPILT: I - <br />FRONT SET <br />Zo <br />REAR SETBACK <br />Zo <br />$IDEA JACK <br />-;gp <br />- <br />R/• CRECN NJV&R <br />3C <br />w — <br />FEE <br />28/ <br />PECEVTND <br />WE IoNE <br />` <br />LOT AREA <br />045 <br />wcA rSITE <br />❑m vw <br />FEES <br />VALUATION <br />FEE <br />DJrtuvu <br />&eZ <br />HEgNiLWRAlp1� <br />ZZdaq,4LAS <br />ICE ONEUIw <br />SIZECFBLOOTI <br />B3 S <br />RMVBMq <br />CCLVPANLY IA CE STORE$ <br />u-I Z <br />OLCIpµrLOAp BABEVtNt � <br />DYES <br />YECIW4AL <br />FP SF-11-ER REOD <br />REASON <br />ApgigNALR/JI p1EGR <br />OR1EP <br />FIf1E AlMUREOO <br />REASON <br />STAtf ll I sURCNNIOE <br />TYPE OF corttT <br />RAnsAwRovEoer <br />wiE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />POucw s <br />TOTAL <br />