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APPLICATIrV FOR CONSTRtJC" �ON ! ERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-881r, <br />❑ DEMOLITION ❑ COMBINATION fl BUILDING f-1 MECHANICAL Cl P�UMBING ❑ SIGN <br />PRO.iECT ADDRESS <br />Z1G ��:n�.=, /��e.• �i�.7i�/ <br />� ��tt :,� <br />.�f !Eie-Fzra�� � <br />CIIY IIP <br />6 �i-az�r <br />C�Nfrs /Yi_ r�,o,� �6 A.<scc- /.�� ,�rkse�n ,(�ur tdEza-r �vA r�aas �3-�ha33� <br />RPCH�ITEC�T�ORDESI ./� MAIL�D�RE55 CITY ZIP PHONE <br />i-iH�M� <br />GENERPLCONTRRCTOR MAILr1DDt1E55 CIfY ZIP PIIpNE S7ATELIGENS°. <br />MECHANIC�LGONTRACTOR MAILAD�RE55 Cltt ZIP PHONE STFTEUGENSE� <br />PLUMBINOCON:neCTOR MRILADDPESS CITY 21P PHpNE STRTEIICENSE� <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />FOOTAGEINVOWE� /� � \ CONTAGTPERSONANDPHONENO. <br />N��Hi,uiu.�. � 1 <br />lOT BLOCK OF <br />CONSTRUCTON LORN LENDER. AUDRE55. TELEPHONE NUMBEII <br />PLUMBING <br />NO. <br />WA?ER <br />Ki fCHEN SINK & DISP <br />LAUNDRYTRAY <br />CLOTNES WASHER <br />URINAL <br />OR ITEM <br />SUB TOTNL $ <br />PERMIT S <br />TOTALFC-E $ <br />FOR OFFICE USE ONLY: <br />FOONT SfiTOACK REM SETBACK 510[ SETOACN <br />USE ZONE I LOT RREA � VACANi SITE <br />nres n r+o <br />NEIGIIi LIMITATION I N0. Of OW@'LING I SL:E 0 <br />UN17S <br />r �NNS�UwlS OCCUPANTIOAD <br />2 Nn <br />1(1EOD qER50N <br />� y or2o, <br />NLERRE00 REASON(� <br />S v �t'l <br />�- � N it I onr� s a 3-9 a <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WOR,< WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 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 I AM AUTHORIZED BY 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 />QTY BUSINESS UCENSE N0. <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />AIC — A/HNDLG UNITS — H.P. T <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br />HEAT PUMP ��— <br />UNIT HEATERS — B.T.U. M � <br />CLOTHES DRYERS � <br />VENTILATION FAN � <br />RANGE HOOD � <br />WATER HEATER � <br />WOOD STOVE � <br />META'_ FIREPLACE (WOOD BURNINGI � <br />UUILOING <br />r u�ucrri. <br />�� PlUh101NG <br />SEMEIJ�I 7 �1EGIIANIGAL <br />❑YES f !O <br />— ADDITIONAIPIANCN[CK <br />onien <br />STATE OUILDINQ SU�iLH�RGE <br />CITY OF EVERETT Pueuc wonKs <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAL $ <br />PERMIT 5 <br />TOTAL FEE S <br />J��i�J <br />fEE RECEIPTND. <br />VALUATION I <br />.�19. q�G.3 /4 <br />