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APPLICATIO'. FOR CONSTRUCTI�N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION �iCM���� <br /> 3200 CEDAR STREET• EVERETT,WA 90201 • 259•BB10 <br /> ❑ DEMOLITION ❑ COMBINATION � BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> J . : ` d � <br /> 9JECT ADDRF� �, �(%� =l.f� %r�'I.i l� i .L.=�.1 <br /> i �r� <br /> ����1?y� !� � �ir�� 1l�• )�.t/ ,,;"f{c (� �.�� ��S o� -�� it� <br /> OWNER / MI1R�bORE55 CIiY bP PNONE <br /> TEN�HT MNUODRF.55 GiY 71P PIIDHE <br /> eRLNITECTORDES�GNE� MMtAD0�E55 CtlY /��' ��IONE <br /> GENER�ICONiMCTON MML��D�k55 G�iY 7i� P�10NE SI�IEUCENSE• <br /> MEC IC�LCONTR�CTOR M�IlAD0aE55 CITV lii' P110NE ST�IEI�CENSE� <br /> It� P� � <br /> PlVM01NGCONTRICTOR MMLADORE55 CIiY DP PNONE SiATEIICENSE <br /> CpNTRACT PRIGE OF WOf1K HEATING SYSTEM: ❑GAS ❑ ELECTRIC G <br /> DESC BE WOf11t 0•uOU�RE F 1 1NVOlVED . ' GONULI t'CASON�NO PHONE NO <br /> -7v�-4 � -c � �.`�. <br /> 9N � <br /> I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT All <br /> VR.^405E0 Ls�oF��iNa PROVISIONS OF IAWS AND ORDINANCES GOYERNING THIS TYPE OF <br /> � WOHK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lE0Al0E5GRIPTIONOFPROPEPTYI�p'�'NBEIOWpiATTACNTWOCOPIES� NOT. THE aRAN71NG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT B�ocK aF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTMORIZED BY THE <br /> OWNER OF TN 5 PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPUC!�T�9N�)f S E AND I C�PLY WITH T STAT <br /> CONTAI�CYOHS LA �182TniC1�.A�¢.t96.2p0 WAC. � <br /> PMCEITA%I.U.MIMBER , ,: . ' �-'(,,� ' / � f �,% � <br /> � ���j <br /> � , � t''� ` ;� .L.J,f • (/ . <br /> CONS7PolGilON IOAN LENDER,�OqiE55.TEIER�ONE NUMBER <br /> ♦SMNIITURE � O�1E <br /> � CITY BUSINESS IICENS[NO <br /> PLUMBIN6 MECNANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. T'PE OF ECUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS ' <br /> BATHiUB ; FORCED AIR SYSTEMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNITNEATEfiS � <br /> KITCHEN SINK 8 DISP � CLOTHES DRVERS � <br /> DISHWASHER RANG[HOOD ' <br /> UUNDRY TRAY ; WATER HEATER � <br /> CIOTHES WASHER � WOODSTOVE ' <br /> URINA� ' MEfALFIREPLACE(WOODBURNING) ' <br /> DRINNING FOUNTAIN � FIREPIACE INSEAT(WOOD BURNING) � <br /> FLOOR DRAIN GAS FIR[PLACE � <br /> BACKFLOW PREVENTERS ; GAS RANGE � <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING � ' <br /> EXNAUST FAN <br /> � <br /> � � <br /> SUBTOTAL E ; SUBTOTAL f �— <br /> PERMIT S i PERMIT S � <br /> TOTAIFEE f � TOTALFEE f ' <br /> FOR OFFICE USE ONLY: <br /> pqONT SETB�GK AE��SF.IB�LR SIOE SETB�CN �UN LIIEGN NUMpGO <br /> rEF nFtfmte�o <br /> U5E 2W+E lOf�f1EA "�����•S�rE 'FE S VALUATION FEE <br /> ❑YE$ �NO p�p�plNO � <br /> HEIGNTIIMIT�T10N NOOfDWEILIHG SIZEOFBIDGRt � <br /> , UNIIG P111u0w6 __�_. <br /> OCCUPANCY NO Of S��PIfS OL�UP�NI IOSD BASEMENI MEf.11nNILeL <br /> GRWP ❑YES ❑NO ' <br /> �DU�IIpNeI.PI�N C�V.CN _ <br /> FINESPRINNLERREO'0 �EASON <br /> on�en <br /> � <br /> FIREMARMNEO'0 AF��ON <br /> S1AIG�IIIIDM6 SIIPCIUf1GE <br /> TYPEOGf.ONST �UNSAPP�OVEDOY CITYOFEVERETT runur.won�s __;_ <br /> LOCALSALES — <br /> ,•,�r TAX CODE IS�105 TOTAL _. <br />