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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 • 257-8810 <br />I DEMOLITION xCOMBINATION , BUILDING F. 1-1 MECHANICAL ❑ PLUMBING SIGI <br />DROJECTADDRESS l-7Z1 MC OOu -!}LL T EVEaETT <br />wNLE MMLAWRESS Lln ZV R10ML <br />IchTLi9 MVN(r6A 1-721 AA<1�o„!�„I <br />EA"Ntdit <br />01 <br />426-ZSOI-162(o <br />TENANT MAILADDRESS <br />AYDV E I <br />CITY <br />ZIP <br />E1gNE <br />ARCNI1CLT p10EBLiNER MAILADOPESS <br />CITY <br />ZIP <br />FKNE <br />bE5\&-K300E5 1115 MhD(5oN ST EV646rr <br />9g203 <br />4ZS 353-0531 <br />OCI(ERAL LONTPACTOR LI AOORESS <br />CONS- INIc Po BOX 1364-7 <br />GtY <br />M;11C4eek <br />lln <br />gbog2 <br />Rlp( STALE LCENSC• <br />IS75432L; WE(RCI*005J <br />_WE(. <br />MECNANgALCONTRACTOI WILAOCRESS <br />CITY <br />ZC <br />PNQNC STATE LICENSE. <br />N IA <br />FLUMBINOL RACTOR MAILAOORESS <br />CITY <br />ZP <br />FRONE SOME LICENSE• <br />0 A <br />CONTRACT PRICE OF N9EIF ODO <br />HEATINGSYSTEM: 13GAS ❑ELECTRIC ❑ N 94 <br />DESCRIBE NDRA AND OGOTE, FOOTAGE lOL'�ARAE <br />5Z 5F <br />ADDIror� <br />COAQrAR4E, NO <br />W E1K zs 75 -i263tt <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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH INE STATE <br />\LAW <br />CONTRACTORS <br />r� 10.27 RCW AND 296.200 WAC. <br />X—P/,1�J�EJv� 1I/IS OI <br />vnowss0 uj�jF or BmLDINn <br />Ice <br />LEGAL OEGCFRTICAT OE PT ERTY ISNOYNN BELGNrn ATIACN TMV COR61 <br />LOT I + Z BLOCK 53 or EVE N%l IA <br />a p <br />43BB-353-01(-000q <br />PARCEL TAA I D TA IMB <br />CONSTRUCTION LOAN TENDER ADOnESS. TELETYgNE NUMBER <br />SI NMURF IIATE <br />CITY BUBMSS LICENSE W <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC —A UNITS <br />BATHTUB <br />! <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />! <br />SHOWER <br />I <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />I <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />! <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />I <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />! <br />EXHAUSTFAN <br />1 <br />i <br />SUBTOTAL <br />5 <br />SUBTOTAL S <br />_ <br />PERMIT <br />S <br />I <br />PERMIT S <br />TOTALFEE <br />Sl <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY! <br />FRONT SETBAC I <br />�IWEY <br />REAR SETBACK <br />/ <br />BIDE SEEM <br />RAN O/ $EP _^ <br />G.f//ZL/G)/[ <br />E[E /E 1 <br />RECEIVE NO <br />USEZCNE <br />'7 <br />L <br />LOT AREA V( <br />/' <br />VACANr57 <br />nYEs <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />Ski <br />NEgNi LMltAt ! <br />MD CF OMELLRAT <br />"'B I <br />BIZEO&fl<TI <br />252 s.F <br />PLUMBMO <br />OCCUPANCY M651CRES <br />OCCUPANT LOAD <br />PAYMENT <br />nlEs <br />MEOMNICK <br />AD0,0044 PlAM CMELK <br />FRE SPRMKLER REG D <br />REASON <br />OTNER <br />TIRE <br />E ALARM <br />RGSON <br />STATE BuadNG EUS«+ThiF <br />TYPEOFCONST <br />/V� <br />BANS APPROIED BY <br />il <br />OMF t <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />R lc1VcR+s <br />TOTAL <br />