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0 <br />ApF-i�i�!�T3�:�' �!!R CONS�RUC'1`'"�N PERMIT <br />CITY OF EVERETI' • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMGLiTION fl COMBINATlON fl BUILDING I� MECHANICAL �l PLUMBING fl SIGN <br />PROJECT ADDRESS/• 6 2 Q Q a k�'S A v e �"� ��t'�}- <br />lp U <br />OWNER M��lA0�RE5 CIiV ZiP PH06E <br />�arte1 S�,cckei� ec P� l�U�r S17 LykP S�e��.s b,�A 98258 33Y-v5o'� <br />TENANT MML�OORE55 CIIY 21P FHONE � <br />UQ� a K� f'110NE <br />ARCHRECTORDESIGNE(i MNLAUDRE55 ��TM 71r <br />GENE�ALCONT(IACTOR MAILADURE55 <br />CITY 21P PIIONE ST�iEUCENSE� <br />��n, Zip PMONE STATE LICENSE � <br />MECH�NICALCON7F�CTOR M��LADDRE`S • <br />oLUMBINGCONTRRGTOR MRILA�DRE55 <br />Cltt ZIP PHONE STATE IICENSE • <br />oF wonK <br />OF <br />LOT <br />FOOT�GEINVOLVED <br />s f- <��r� Zb <br />/Dr y<r R� o� a� <br />BLOCK <br />s,''� <br />PARCELTA%I.O.NUm ^Gn -^/ � O <br />L'� ��� v <br />CONSTRUCTiONIOANIENDEH.AD��ESS,TELEPNONE NUMBER <br />NO. TVPE OF FlxTUA <br />� WATER GLOSET (TOILET <br />BP" � <br />L! ;Y (WASH BASIN <br />Sh .cR <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAI_ <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEI <br />SINK (SERVICE — BAR. <br />SUB TOTAL S <br />FEE E <br />rosv <br />�2 <br />FEE <br />FOR OFFICE USE ONLY: <br />FFONTSETPALK PEAR SETBAGK 90ESETBRf.K <br />USE ZONE <br />IfE1G11T LIMITATION <br />OCGUPANCV NO ( <br />lOT AREA <br />NO OF [JWELLING <br />UNIIS <br />HEATING SYSTEM: f I GAS fl ELECTRIC fl <br />CONTACT �ERSON AND PIIONF NO <br />I HEREBY CERTIFY THAT I HRVE 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 />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED 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 1827 RCV� AND 296.200 AC. <br />� Z-8-96 <br />SIGNA RE D�TE <br />CITV BUSME55 UCENSE NO. <br />NO. TYPE OF EQUIPMENT I FEE <br />PJC — A/HNDLG UNI I S— n.r. <br />FOFCED AIR SYSTEMS — B.T.U. M <br />HEAT PUMP <br />i in11T HFATFRS — B.T.U. M <br />FAN <br />METAL <br />GAS <br />SUB TOTAL $ <br />PERMIT 5 <br />TOTALFEE S <br />FEF IAEf.EIPTNO. <br />p�pNC11ECNNUMO� � <br />VACANTSRE - <br />f1YE5 fiNO ppILDING <br />si1[ or owc:rt i <br />� <br />PIUNPMG <br />SEMENi MECHANIf.�L <br />�IYE$ I1 NO <br />_ ADU1110NnL �'LAN C��F.CN <br />��_ <br />OT��ER <br />5Tq1E O�PIpINC SUf1CINRG[ <br />CITY OF EVERETT rueucwonks <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />�r <br />