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-�. r• <br />APPLICATIG.1 FOR CONSTRUCT.,JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />� <br />CI DEMOUTION fl COMBINATION I BUILDING WMECkIANICAL f�LUMBING f-1 SIGN <br />PROJECTADqR�SS� �r� A ,{ _ <br />l / d' /hJL <br />Mna nooness <br />TENANT <br />� <br />zm , r�+oNE <br />PRCHITECTORUESIGNER MAILA�ORE55 Gltt ZIP VMONE <br />GENERALCONTRACTOR MAIL�DDPE55 CITY ➢P PNOVE STATEUGENSE� ' <br />//'/"iS <br />MECHRNICRLCONTRACTOR MAILADDRE55 CITY ZIP PIIONE SLttF.IICENSE� <br />PLUMBINO CONTRAf,TOR MAlI.A0DHE5S CIN ZIP PW-./M1£ STATE LICENSE � <br />OF <br />�a,�� (9G8��- f� i s� <br />�rf_� /lo �O ��J9J �//9 <br />t Cl � O��M �� r <br />LEG�I �ESCRIPiION OF PROPERTY �SHOWN BELOW <br />LOT �/ BLOCK ZZ� OF_ <br />C..ef I a�' 5�����.� <br />CONSTRUCiIONL NLENDEN./�DURES: TELEPHO;ESNUMBE��� <br />' T'« S L Y V <br />.--.-�+�-+'-= 1 � • <br />PLUMBIN6 <br />NO. 7VPE OF FIXTURE OR ITEM FEE <br />� WATER CLOSET (TOILET) � <br />� BATHTU9 <br />3 LAVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL 3 <br />PERM�T $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK_ � REARSETAAf. / SIDESETBAC� <br />cy-c'i . <br />USE ZONE LOT AAEA �. -,,I VFCANT SITE <br />� a�«% I'lYES ❑ tJ0 <br />NEIGHT LIM TION J NO. OF DWELLING SIZF �F BLOGRI <br />/ UNITS '1i_i(ps f LIVl�14.�. <br />5 F G <br />OCCl1PRNCY NO.Of570RIE5 OCCUPANTLOAD BASEMENT <br />GROUP <br />D.� Z N�d nrrs o <br />PIRE SPPINKLER REO'0 REASON <br />D <br />TYPEOFCONST PLi1N5P <br />CITY OF EVERETT <br />LOCAL SALES <br />s TAX CODE IS 3105 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC <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 AUTHORIZEO BY THE <br />OWNER OF THIS PROPERTY �O PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RC1".' AND 296200 WAC. <br />— � i <br />,,,,_ y- �a - 9s� <br />I NPTURE D�TE <br />CITY 6USINESS LICENSE NO <br />MECHANICAL <br />NO. TYPE OF FlXTURE OR ITEM FEE <br />A/C — AMNDLG UNITS — H.P. � � <br />%�FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE (WOOD 6UFNINv) : <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />EXHAUST FAN � u � , <br />SUB TOTAL 5 <br />PERMIT 5 <br />� TOTAL FEE �_ <br />.3 h<, . yy <br />PLAN LHEC M�ER FEE / RECEIPT NO. <br />' .�v� / � 2 0_.. <br />BUILOING n� ��. `l X I '� <br />PLUMOING � (/U <br />T <br />MGC114NICAL � � ; n� <br />� <br />ADDITIONAL PLAN GIIECN i <br />i <br />OTNER � � L�� <br />i <br />STATE DUIl01NG SURCHRRC+E �[ � /. �) <br />PU9LICWORNS _'J( ) �(�(�? <br />TOTAL I.� � ��I� <br />