5118 S 2ND AVE 2018-01-01 MF Import

APPLICATf ^ N FOR CONSTRUC' ON PERMIT CITY OF EVERETT • BUILDING DIVISION � 3200 CEDAR STREET • EVERETT, WA 98.^.01 • 259-8810 ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING JJd' MECHANICAL ❑ PLUMBING ❑ SIGN PROJECT ADDRESS �/� )/7 y�� S� M1 OWNEfl MAILA�nRFCC (� _._. �e-- ��- c ,. PIVMBINGCONTR�CTOR MAILADDRE55 CIIY IIP PHONE STATELILENSE� DESCPIBE WORK AND SOUARE FOOT�GE INVOWED LOT PAi;CEL °PROPERtt BLOCK _ LOAN LENDER, �UDRESS. TELEPHONE NUMBER TVPE WATER CLOS BATHTUB LAVATORY(W SHOWEii DRINKING FLOOR DF BACKFLOV SINK (SER TRAY WASHER FOR OFFICE USE ONLY: FqONTSETBACK REFR SETBRCK USE20NE LOT�qEA NEIOHTLIMITRTION NO.OFOY/ELL1N0 UNITS O��UP,INCY NOAFSTORIES OCCUP�NTLOA� ITEM TOTAL HEATING SYSTEM: ❑ GAS ❑ ELECTRIC O CONTRCT PEPSON ANO PNONE NO. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAM� TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS HND ORDINANCES GOVERNING 7HIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. SIGN�TURE p�I�' ��l�'�^ CITV BUSINESS IICENSE N0. MECHANICAL FEE NO. TYPE OF FIXTURE OR ITEM � AIC —AMNDLG UNITS — H.P. ; FORCED AIR SYSTEMS — B.T.U. M E.A. ! HEAT PUMP Q J1A9�7,1 WnTER HEATER WOODSTOVE METAL FIREPLA� FIREPLqCEINSE GAS FIREPLACE GASRANGE GAS PIPING EXHAUSTFAN SIDESETB�CN PUNCHECK /U�MBER CI�J �� V�CRNT SITE FEES ❑VES ❑ NO BUILDING SIZE OF BLOGRI. PWM0ING BASEMENT MECNANIC�L ❑YES ❑ NO r1DDIPONAL PUN CNECK OTHER STATE BUIIDING SURCHMGE CI7Y OF EVERETT PUBLIC WORKS LOCALSALES TAX CODE IS 3105 TOTAL SUBTOTAL FEE � RECEIPTNO.