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APPLICATIO : FOR CONSTRUCT►.1N PERMIT <br />CITY OF EVERETT • 9UILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COAABINATION p'BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />OWNER MULADpiE55 QiY ZIP PNONE <br />� . . . r . � . . � <br />iEWWi YNlA00RE55 dTY ZIP P1 NE <br />� �/as-� s�Q- / yplo <br />�1i1LIMlECT Oq DESIGNER MAIt ADORESS Cltt LP nwnuc <br />MUMBINGCONTPACTOR M�ILADDRE55 pITV IIP PHpNE STATELICENSE• <br />DESCRME MVIiK • SIXI�RE FOOTACE INVOIN <br />_C.were c� Gvov�t }=1. <br />3s� Jc I 3 � x 2 v� C <br />Pol,� /X3ea•.. Cw..crr.�� <br />P110POSED USE OF BUILOIN6 <br />Q O AT� �A1� <br />lEWl0E5CipPT10N OF PROPERTY ISlqNTI BEU <br />iot �� e�ocu c <br />D�� _ � . VuL / <br />PAi10ELPVII.D. MMABER <br />.s'v �'� -- v � n — <br />GONSTRUC710N LOAN LENDER.IIDORE_ S5, IEIEP <br />� (.Jh 0 Y" lJT7�u7� <br />�ure�iici <br />� <br />Ib—ovu� <br />TYPE OF FlXTURE OR ITEM <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FIOOR DRAIN <br />BACKROW PREVENTERS <br />PERMIT f <br />TOTALFEE f <br />FEE <br />FOR OFFICE USE ONLY: <br />fRONT SETB�LN REAR SETBACK SIDE SETB�Ck <br />ZP�, � S , <br />USE ZONE LOT APEA y��/W} $��E <br />�, Z36�o� o�ES � <br />HEIGNTLIMIUTION NO OL OWELUNG 512E OF BLOGRI <br />� � I UNIiS � _� .__ <br />❑YES <br />ovr.or+sr YL/1NSPPYNUVE06Y� CITYOFEVERE7T <br />LOCAL SAIES <br />T—�.1 o�rF �i/�4-.t;'� TAX CODE IS 3105 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC � � <br />CONT�GTPERSON�N�PHpNENO / � <br />d n,.tir a.� G��lvvC. . �"�C� —..S'S� �3z b <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 8E TRUE �ND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br />NOT. THE 6fiANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />, AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <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 TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />x�� �J �� �i��97 <br />516 �TUHE 011TE <br />Q�h �r <br />CITV BUSINE55 LICENS[ NO <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />NC—A/HNDIG UNITS � <br />FORCED AIR SYSTEMS ; <br />HEAT PUMP � <br />UNIT HEATERS ! <br />WOOD STOVE <br />FIREPLACE INSEflT <br />GAS FIREPLACE <br />FAN <br />SUB TQTAL E <br />PERl;�f f <br />TOTF L FEE E <br />fEf, _ �� I NECEIPT NO <br />(I�� <br />owinwc �' � � + — <br />� <br />PlUM01NG i <br />— T <br />MECNRNIL�L � <br />_ i — <br />PDD171ON�L �IAN C11fCK � <br />�� �. <br />O�IIEA � <br />ST�IE DUILDING SURC11nR6E L ' � `�� <br />PIIBI IL WOPKS <br />TOTAL / � _ fj �%� <br />