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c <br />APPLICATI/' V FOR CONSTRUCT flN PERMIT <br />CITY OF EVERETT • BUILDING CIVISI �N � <br />3200 CEDAR STHEET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION [[g"BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br />PROJECTADDRESS:� 13p�S i�,,,,,,� �� Qvf <br />�RCItlTECT Oii DESIGNER M1Ul ADDRE55 dTY )IP PMONE <br />MEGMIWICMCONTRA�TOR MIUL�D01 <br />�(7 <br />%UTABINGCONTRA�TOR 4�ILM . <br />0€SCN�EE N D SW�pE FOOTAGE INVOlVEt1 <br />� . I 1 t-�'�_�.-�s� ^� � _ <br />VROPOSED USE OF BUILDIN(i <br />iew� oescmvnaw a vnorenn <br />LOT BLOCN _ <br />� <br />PIVif.�l Tll\ 1.0. MIMBER <br />�95a Zt�% Gt�� Oq�9 <br />CONSTRUCIIdi IOAN IENDER, ADd1E5S. TELEPl10NE tA1MBER <br />�' <br />WA7ER CLOSET <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHJJASHER <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK fSERVICE — BAR. ET <br />FOR OFFICE USE ONLY: <br />FRONT SETpACN PE�R SETBACK <br />USESONE <br />HEIGIIT LIMITATION <br />LOi APE� <br />LIIY <br />rn�ne SI�TE IICENSE � <br />�3��-3�1v-c�1sr5 _ <br />ZiP VMONE - btA4E UCENSE � <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONTIICT PERSp1 ANp PHONE NO <br />I HEREBY CERTIFY THAT 1 HAVE REAO AND EXAMINEU THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF NWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE 6RANTING 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 AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORI; FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRA%TO 1827 RCW AND 296.200 WAC. <br />x ��1� � i ` 1 6 `1 � <br />SIGN�TURE O�TE <br />CITY BUSINE55 tICENSE NO. <br />OR ItEM FEE NO. TYPE OF ECUIPMENT FEE <br />' A/C—NHNDLG UNfTS <br />; FORCED AIR SYSTEMS <br />� HEAT PUMP <br />' UNIT HEATERS <br />i CIOTHES DRYERS <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />NO OF OWELLING <br />UNIfG <br />OCLVP�NfIO�D <br />SIDE $ETBACN <br />WCANf SITE <br />❑YES ❑ NJ <br />SRE OF BIOGR I <br />❑YES ❑ NO <br />WATER HEATER � <br />WOOD STOVE � <br />MEfAL FIREPLACE (VYOOD BURNING) � ; <br />FIREPLACE INSERT (WOOD BURNIIJG) i <br />GASRANGE <br />GAS PIPING <br />IXHAUST FAN <br />SUB TOTAL S <br />PERMIT S <br />TOTALfEE S <br />PI�N CIIECM NUMBER <br />�� 3�� <br />OUIlDIN6 <br />PlUM01NG <br />MECN�NIUI <br />�ODI710N�L PIAN �Hf.LN <br />.�111Ef1 <br />S7�lE OUIIDING SIIRCruf16E <br />°Y CITY OF EVERETT ruanr. wones <br />LOCALSALES — <br />TAX CODt IS �105 TOTAL <br />f_'F I REf.F.1PT NO <br />v <br />� <br />i, <br />