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APPLICATA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT• BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 9B201 •257-8810 <br />DEMOLITION COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING 1 SIGN <br />PROJECT ADDRESS <br />C '.\.,Y.h.DWESE CItV .i CN011E <br />L�I�/Fi F H. NAVL,'4� z 13L H�taic�.y4y� E� c�aT tir r7Y�� U1.-)ISO <br />1[I:aiI MATLADONESS CITY ZIP PHONE <br />ARCMTECT ON RESGNER MAR ADDRESS CITY DP p10AE <br />HWLglg5 CLVES98/STATE III <br />L/fgcry(,0"19CRr SYCNA R# L3oa2fo9z3aoH <br />MECNANCALCONTPAC1pR MA4ADCPf SS CITY ZIP PHONE STATE LICENSE <br />RVMBIIq CQ`1tPAGip1 MAILADONESS CITY ZIP PINCUS STATELCENIE. <br />caKTaACTPACE a swRx <br />HEATING SYSTEM: ❑GAS El ELECTRIC <br />FOR OFFICE USE ONLY: <br />'S <br />1-! <br />DESCRIBE wvax Ax0 SWARE ROOTAGE MV0.Yt0 <br />Uf f?7EY' A <br />UH <br />CONTACT PEasoNARD RTDTiE NO <br />r sL�rND. (r�ryTr wiRE /zF <br />fr l9 1 <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED TIIIS <br />APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORN WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESJME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION UR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE THE STATE <br />CONTRACTORS LAW I3.27 RC\Y AND 296.200 WAC. <br />%a_.A,"/ /t'-Of <br />PROPOSED USE uRuanlrG <br />LEDU'DEscasilDN OE PaatarvllstN[oaN snno�w�o..R ATTACH my covrt5l <br />LOT J�aLocx�W N <br />I i NP 4fuE-g�- Aon %a E T'�G' F7— <br />PAacfuAx iD NUMBER <br />D03632 3S6Oo/o/ <br />CONSTRUCIKIH LOANIEIOFR. ADDRESS TELEPHONE rA1M0CR <br />5 AiNPE DATE <br />CITY 91151RESS LKENSE,h] 3 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A'C—A'MNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />� <br />LAVATORY (WASH BASIN( <br />PL <br />HEAT PUMP <br />i <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />1 ANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING( <br />i <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />i <br />SINK (SERVICE — BAR, ETC.( <br />GAS PIPING <br />EXHAUST FAN <br />I <br />i <br />T <br />i <br />1 <br />SUBTOTAL 5 <br />SUBTOTAL <- <br />PERMIT E <br />PERMIT S <br />� <br />TOTAL FEE S <br />TOTAL FEE 5 <br />aPOxT SEtBACx <br />PEAR 6ElBALK <br />SIDE SETBACK <br />P171D7MCY�2 <br />ECE <br />RECEIPT NO <br />USE ZONE <br />miAIIFA <br />vACANi SITE <br />FEES <br />VALUATION <br />FEE <br />aurtonu <br />❑vEs Dra <br />REKwi wrtAlan <br />HDaaYEuw <br />SAtEOP IA06T1 <br />ImlTs <br />rtuuavG <br />axXmAncr <br />cPam <br />aasnwEs <br />accwN+r LDAo <br />eASEusur <br />MECRAracAL <br />i <br />Ong aND <br />ADDIibNKPIANCRECY. <br />EPE SPf11NgEP REOD <br />REASON <br />OM[a <br />[HE AIMMPE00 <br />REASON <br />BiAR BURDM] BUPCIUPGE <br />rrPE acoxsr <br />PLANS APaROVEn ar <br />CITY OF EVERETT <br />PUBLG wvPxs <br />LOCAL SALES <br />TOTAL <br />TAX CODE IS 0105 <br />DATE <br />