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APPLICATION FOR CONSTRUCT �ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />LUMBING f-I SIGN <br />❑ DEMOLITION fl COMBINATION �l BUILDING �l MECHANICAL f 1 P <br />PROJECT ADDRESS <br />/�i S //.[ iu-�� l�� <br />cm �� dr riwr+E <br />. � __ <br />IEN�NT Mnll�fl�RE55 ��rY liP � <br />�RCHITECTORDESIGNEP MAILA��RESS CITV 71P �NONE <br />CIiY <br />ruoue . <br />�OGJ S%} Q< <br />x <br />�rw.c•�� • _",� . <br />MECNANILALCONTRACTOR MAILAODRESc CITV 21P P��ONG STl,TELICENSE� <br />PLUMBINGCONiRACTOR MAIIADDRESS CITY ZIP PHONE STATEUCENSE� <br />DESCRIBE WORK ANO SOUAR� FOOTAGE INVOLVEU <br />LEG�L DESCRIPTION OF PROi'tnrt �nnvrvn o0 <br />LOT � BLOCK 3� <br />�. . i r. � , .�L <br />u <br />PARCELTnxiA.rvuuneH <br />SS3G-3�4-a��3-- voN <br />CONSTRUCTIONLOAN LENDER.RDDRESL TELEPHONE NU1.18ER <br />Np, � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (l OILET) <br />SHOWER <br />KITCHEN SINK & DISP <br />LAUNDRY <br />URINAL \ <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACK=LOW PREVENTERS <br />SINK (SERVICE — BAR, ET <br />FOR OFFICE USE ONLY: <br />FPONTSETBACK REAiiSFTBACK <br />USE ZONB <br />IIEIG/IT �IMITATION <br />NO <br />0 <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE $ <br />SIDE SETBACK <br />HEATING SYS1'EM: Cl GAS fl ELECTRIC Cl <br />CONIAGT PEFSON AND Pf10YE NO. <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 OFi CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY W�TH THE STATE <br />CONTRACTORS LAW 1827 AND 296 200 WAC. <br />x �/ � /i �ie�G�r � - ,� — J � � <br />$IG ATURF DATE <br />CIN BUSWE55 UCENSE NO. <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C — MiNDLG UNITS — H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNITHEATERS—B.T.U. M <br />CLOTHES qRVERS _ <br />WATER HEATER ' <br />WOOD STOVE <br />METAL FIREPLACE <br />GAS FIREPLAC <br />GASRANGE <br />GAS PIPING <br />EXHAUST FAN <br />SUB TUTAL 5 <br />FEE S <br />PLANC��GQKNUUOER / FGE IRECEIPTNO. <br />LOTAREA VACANT511E rc�o <br />f1VE5 Il NO BUIL�ING <br />NO. OF OW[ILING 512E Of OI�CR� <br />UNITS PLUMCING <br />OCGUPANTLUAD BASEh1ENT MECMANICAL <br />C7YE5 fl NO <br />RD�IiIONAL PIAN CRECK <br />RFASON <br />OTIIER <br />RE�SON <br />STATE OUILOING SURGIInfiGE <br />rinNsnrrnoveoev (;ITYOFEVERETT ruoucwonKs <br />LOCAL SALES <br />_.._ TAX CODE IS 3105 70TAL <br />� <br />