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APPLICATIt,�! FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOUTION fl COMBINATION rl BUILDING ECHANICAL fl PLUMBING fl SIGN <br />PROJECT ADDRESS <br />Z5/v �-f l�l�c.�n� r.� �4u� <br />OWNER <br />25 <br />CIiV 21P <br />•RCHITECTORDESIGNER MqILR00RE55 CI1Y ZIP PHONE <br />Zo�-Z59- <br />C+ENENRICONTRACTOq NAILn0�RE55 CITV 71P PNONE STATELICENSE� <br />M�i-EcAffEi4-TIN6,zNC.RFS �b BoX g9'�% N�KTF� BW D Z980i�5 ZQ6z9 N/-68cao ,qEffCi4l�`f55 Mk- <br />PLUMBINGCONiRACTOR MAILADDRE55 CIiY ?IP PHONE STATEUCENSEI <br />SOU�RE FOpT�GE INVOLVED <br />LOT BLOCK OF <br />5/S�v -59f3 -oz I -- coo I <br />GARCELhVII.D.NUMBER <br />CONSTRUCTION LOAN lENOER, �DDRE55. TEIEPNONE NUMBER <br />PLUMBIN6 <br />NO. TYPE OF Fll(TUqE <br />WATEH CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK h DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKfLOW PREVENTERS <br />SINK (SERVICE - BAR. E7� <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REAR SETBRCK <br />USE ZONE <br />HEICHT LIMITATION <br />6ROUPANCV NO.0 <br />FIRE �LARM REO'D <br />FIRE SPHINKLER RE <br />TVPE OF CONST <br />LOTAREA <br />NO OF OWELLING <br />UNITS <br />BY <br />HEATING SYSTEM: � AS ❑ ELECTRIC ❑ <br />GONT�CT PERSON AND PHONE N0. <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AIJD 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 PqOVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THqT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />x ��GC� `/- ZZ- 9.S <br />51 URE DATE <br />oZ�F q � z <br />CIiY BUSINE55 LICENSE NO. <br />FEE N0. TVPE OF FIXTURE OR ITEM FEE <br />' A/C-AMNDLGUNITS-H.P. <br />; � FORCEDAIRSYSTEMS-B.T.U�jM E.A. <br />� HEAT PUMP <br />' UNIT HEATERS - B.T.U. M <br />i CLOTHES DRYERS <br />� VENTILATION FAN <br />� RANGE HOOD <br />SIDE SF.7BaCK <br />VACANT SITE <br />f7YE5 f� NO <br />SIZE OF BLOGQi. <br />BASFMENT <br />pYES fl NO <br />CITY OF EVERETT <br />LOCAISALES <br />TAX CODE IS 3105 <br />WOOD STOVE <br />METAL FIREPL <br />GAS FIREPL <br />GAS RANGE <br />GAS PIPING <br />BUILDING <br />PLUMBING <br />MECHRNICAL <br />ADDITIONRL PLAN CHECN <br />OTHEP <br />STRTE BUILDING SURCIIRRGE <br />PUBLIC WORKS <br />TOTAL <br />SUB TOTAL S <br />PERMIT $ <br />TOTALFEE $ <br />FEE RECEII`TNO. <br />