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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION T <br />3200 CEDAR STREET • EVERETT, WA 98201 •257-8810 <br />fl DEMOLITION COMBINATION 'i BUILDING 0 MECHANICAL ❑ PLUMBING ❑ SIGN <br />IPROJECT ADDRESS n 113 �q✓/F- r , 14;?4X l T- LAP %6 zU 3 I <br />3 <br />ARCHITECTOROESGNER <br />MAIAOONESS <br />CI1Y <br />zw <br />MgN4. <br />GCNERALC AACTOR <br />MAILACDNESS <br />CITY <br />TIP <br />PNpIL <br />STATE UCENSE• <br />MECHANICALCOMRACTOR <br />MAE ADDRESS <br />CITY <br />ZIP <br />PnONE <br />STATE LICENSE• <br />PLUMBVlOECNTPACTOP MAI.ADOPESS Ott ZIF PPONC STATE LICENSE• <br />CONTRACT PACE OF WGnK <br />HEATING I SYSTEM: GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK ANpSWAPE f00TAGE NYOLVCO <br />—ate B- �r�.Li — <br />CONTACT PENS APOINgNE NO <br />a�<rE svvt�-¢ zsz s�SLx� <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 WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND 296.200 WAC . <br />� C <br />1Z10 <br />X I <br />PPovO5Eo u5Ea BIIPDv1G <br />UU <br />LEOESLRWGALIgNCFPAMEWY(SHOWN SELOWORAIL{NT)NOEONESI <br />LOT SLEEK. Cl 2 l <br />h JP41-18T <br />PARCEL TAX IO NU MBER <br />CONSTAUGTKIN LOAN LENDER, ADOPESS TELEPHONE NUMBER <br />5G14NRE DATE <br />CITY BUS WESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />Z- <br />WATER CLOSET(TOILET I <br />AC—AHNDLG UNITS <br />I <br />BATHTUB <br />RCED AIR SYSTEMSAT <br />PUMP <br />SHOWERT <br />HEATERS <br />KITCHEN SINK A DISP <br />THES DRYERSDISHWASHER <br />M <br />NGE HOOD <br />LAUNDRYTRAY <br />TER HEATERCLOTHES <br />WASHEROD <br />STOVE <br />URINAL <br />TAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAINEPLACE <br />INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />! <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />I <br />t <br />SUBTOTAL S <br />( <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />TOTAL FEE 41 <br />TOTAL FEE S <br />O 1 0 <br />/YKNI V. �m zv <br />E PONT SE TRACK <br />PEAR SETBACK ' <br />SGE SETBACK <br />PLANCNELK NUMBER <br />FEE <br />�IJ�G L% <br />RELHPT NO <br />use 101.E <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BukDw <br />, <br />DYES 0 NO <br />NEIGNTIIMPATj; <br />ONELLRIO <br />SUE OF BIDGPI <br />Z S <br />MUMSING <br />OCCUPANCY <br />I WCA SiMES <br />OCCWANT LOAD B+SEMEN} <br />MECHANICAL <br />pi -I <br />2 <br />DER <br />NuruucHEcn <br />�j <br />TIRE SPNINKLLPPLOD <br />REASON <br />DINNER <br />OTHER <br />O <br />FMEALARMPEGOD <br />PEASON <br />STALE BUILDING SUNCNAPGE <br />TYPE Of CONST <br />PLANSAPPROVEDDY <br />CITY OF EVERETT <br />PUBIC WOPKs <br />LOCAL SALES <br />TOTAL <br />�}- <br />13 oY <br />TAX CODE IS 0105 <br />DATE <br />