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APPLICATIt.,i�l FOR CONSTRUCI ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />Il DEMOLITION fl COMBINATION � BUILDING f-I MECHANICAL r� PlUM81NG fl SIGN <br />PROJECT ADDRESS ' <br />^�^ MRIL�DDRE55 CITY 21P PHONE <br />1�1eiL ��`�'�n,�d '2101 IUHCNu� ST LUeice� �I3Z�'I 2s'�5�-�19`IS <br />TENANT qAILADORF.55 <br />GRY ZIP PIIONE <br />�RCHRECTpRpE51GN[R MRIlR0�RE55 LITY lIP PIIpNF <br />�AQs dxsi�* 3Coc�('fz {�Rard�..,N� eue�c.�t}' `i�zo� 25$-2YZY <br />GENEMLCCNTMLiOq MRILAO�PE55 CIIY ZiP PNON[ SiRi[LICENSE� <br />^. _ <br />^^" ^"••^_" CiTv ]II` PIIONE St4tF. UCENSE • <br />PIUMBINGCONiRACTpp M4ILRODRESS Cltt ZIP PHONE STATFLILENSE� <br />CONTRIICT PqICE OF WORN � n�� ' <br />OESCRIBEWORNANDSOUAP�' ...+„nVEU <br />✓-]Ad .13ed �« , ,�rth . <br />eunowc <br />O a— I HEATING SYSTEM: jiQ GAS f-1 ELECTRIC fl <br />GONiACT PF.RSONANp PIIONE NO <br />�-iv�v�S <br />LECIILOESCRIPi1pNOFi'ROPERTY�SHOWNB LOWORAT7AGNTWOCOPIES� <br />ior n' � I(a aiocrc r� oF ?1,�. S H�,..7 i��J� c( <br />Add; f:�n o! f✓eae�N k ed� ',,, <br />volu.�+t. � a F �)n�s (�Ats_ 2 / <br />PARCELTAI(IA.NUMBER <br />J(o7�'YJ /- Ul�—VCJU <br />CONSTRIICTON IO�N LENDER. �DIXiE55. TFIEPNONE NVMBEg-_ <br />./' _ <br />PLUMBINO <br />NO. TVPE OF flXTURE OR ITEM �E <br />WATER CLCSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />t!R'NAL <br />;)RINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />_ . 1L�L �1.4_, /1i.7 n . iyftr, U-�.c_ (.. <br />SUBTOTAL S <br />PERMIT $ <br />I TOTALFEE 5�-- <br />FOR OFFICE USE ONLY: <br />fRONTSFTPACK PEM SFTpA(;N / SIDE SEiBACK / <br />USE Z�� � lOT aRE � VRCANI SIT� � <br />fiYE$ I1 NO <br />NEIGNTUMITATION NOOFDWf.LLING 512EOfBLOGRI <br />/ UNII$ <br />`aD0 5�. � <br />OCCUP�NCY NO M SIpPiES OCCOPAN7 LOAD B�SEMENt <br />GPOUP ,I n <br />R3 I /l!/F4 IlYES �MO <br />'W <br />RIVq.ERREO'0 fiFA' <br />ND <br />-r,oNsr ri.nn <br />..�v <br />onTE <br />CITY OF FVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />�s�9-v94s <br />I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APP�ICATION AND KNOW THE SAME TO BE TRUE AND COfiHECT ALl <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIF�ED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME 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 BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X✓�/// ' � S� � <br />SIGN�� DATE <br />CITY BUSINE55 LICENS[ N0. <br />A/C — A/HNDLG UNITS — H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — H.T.U. M <br />CLOTHES DRVERS <br />RANGE HOI <br />WATER HEf <br />WOOD STO <br />METAL FIRE <br />FIREPLACE <br />GAS FIREPI <br />GASRANGE <br />GAS PIPING <br />E%HAUST F, <br />rinN <br />aminmc <br />rwunwc <br />N[CR4NICAL <br />Ap01PONAl PLAN C��fCN <br />OLIIER <br />STM[ OWtD@6 $I�RCHMGC <br />1'1IP11G 1vOPF5 <br />TOTAL <br />SUBTOTAL $ <br />PERMIT $ <br />TOTALFEE S <br />fEP / n � RFCFIP�NO. <br />