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APPLICATII,N FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION ��,��� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl DEMOLITION fy�COMBINATION I� BUILQING I I MECHANICAL I 1 PLUMBING I—' SIGN <br />PROJECT ADDRESS <br />� _ � r��o�,e <br />��xirr�t �(.U���nt����—o„i _\z�� 96•,Zo3 Z 5��-- �9 % % <br />MNI �nLnRrsc C.ITY <br />PI�OI�F <br />AqC111TF.CTORDE51GNEp MAILqp�RE55 ❑lY 7iP PMONE <br />LLCONi'RrCiOR MAIL/DDR[SS ❑iY )iP P110NL SiAT[LICENSE� <br />� /-/�4N5o,v /v�y /1���(Zvt1�R �uY lfgLo3 259-29'cb OAuiNnun�, ��a <br />"� � ^�/^� ]IAIh LICENSE � <br />PIUMBINGCONTRnCTOR NAILADORE55 CIiV 21P PH09E STAiELICENSE� <br />CONiRqCT PqICE OF WOR — <br />Z S DOo '- <br />DESCRIBE WORKMp NO pSOUARE FOOTA E INVOLVEO <br />I ZO �7 T' q AS ��'� N�' � 1 �N I 5/J <br />�8 (.(Z �K 5-�- 1 A1 E�u (5 �t T H <br />HEATING SYSTEM: ! GAS �l ELECTRIC fl <br />COYtACT PlRSON A.Np PHp4E NO <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />PROPo/SEDUSEOFBUILDING p APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />? I%� :�� � 1') �� �� l\ i.Sl d�/�(C � PROVISIONS OF LAWS AND ORDINANCES 3UVERNING THIS TVPE OF <br />LEGALOESCRIPTIONOPPROPLRtt�SNOW eaowoaarTnc��nvocorie�p�i WORK WILL BE COMPLIED WITH WHETHcR SPECIFIED HEREIN OR <br />�or BLOCK � 8 pr C ENY0.J�LY �lRrc�DO �AUOTHORETV TOTVIOLA EAOR CANCELETHE PROVISION OF AINY <br />p OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br />q LK D!(3'� O" 00— LDT`S II� I L � 3 VI(1� � Qj PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />� 1 OWNER OF THIS PROPERTY TO PERFORN THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />PARCELTR%I.U. NUIdBER CONT CTORS LAW 1827 R IyAND 296.200 WAC. <br />'�i��l ��Of 8—D//'- F�oO 8 /� / <br />/ � �/ n p <br />CONSTAUCTION LO/.N tENDER. FD�RE55. TELEPHONE NUUBER { ��( ' /y�� /�, L�^ z/ � 9� <br />iI __— _ — l Vw..�v.�� ' l <br />SIGNRiURE Dr1TE <br />T`.�PE OF FIXTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 OISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ET <br />FEE <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK R[qR SETGACK <br />use znNc <br />❑EIGHT LIMIT4TION <br />OCGUPANCY NO OF <br />G OUP <br />FIRE AURM REOD <br />fIRF SPRINNLER RE( <br />rr�e or coNsr <br />� �1-J <br />LOTAREA <br />NO.OFDW[LUNG <br />UNITS <br />i.av <br />SIDB SEtA4CK <br />CITY OUSMESS LICENSE <br />NO. TYPE OF FI%TURE OR ITEM <br />A/C —AMNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNINGI <br />rinn <br />V4C4Ni SItE <br />I1Y[S I1 NO <br />ominiNc <br />512E Of �L�Gq I <br />� <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />INSERT(WOOD <br />GAS FIRE <br />GAS HAN( <br />GAS PIPI� <br />EXfiAUST <br />PLVMBING <br />M[CIIANIGFL <br />ADDIiIONAL PLAN CHECN <br />(;i11ER <br />SiA1G p111L01NG SURCMARGE <br />ruruc wonKs <br />TOTAL <br />SUB TOiAL S � <br />PEFMIT 5 � <br />TOTAL FEE S � <br />rr.e . � aeceinrNo. <br />�' ��.'��7 i <br />VALUATION FEE <br />9c ,_ O�, �%I _ <br />c. <br />