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�. � <br />APPLICAT14.�1 FOR CON�Ti�UC7 _JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 96201 • 259-8810 <br />I� DEMOLITION fl COMBINATION fl EWILDING f-1 MECHANICAL (l PLUMBING fl SIGN <br />PROJECTADD�ESS � 1 ,r �� .�j���/ <br />n., li�., .,, <br />ARCIIITECT <br />� <br />GENERAL C <br />PRICE OF WOfiK <br />AND <br />/Y <br />MRIL FDDRF55 CIIY <br />,� � AS�- %� � <br />MAIL AO�RE55 CIIV <br />MAILPOOf�E55 � <br />i _ V <br />MRILAD FE55 CIiY <br />MRILApDRF 5� Cliy <br />� <br />fRGE INVONED /� � S \ <br />�rHiuiur,v i i <br />` ,PROPOSED USE OF BUILOING <br />���; >ff['rf/-.A <br />'� LEGR� DESCRIPTION OF PPOPERTY �SMONT! BELOW OR RTTACH <br />LOT BLOGK OF <br />O,%ZrP-/>.S3-/�/3 �i�5� <br />�3'2� -6.53 - o'/L -GDG� <br />Pr1RCEl TA% I.D. NUMPER <br />��9-� �/��'�n � <br />CONSTRUG90N LOAN LENOER, �DURE55. TELEPNONE NUMBER <br />TVPE OF flXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHFN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />SUBTOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />fRONT5ET8ACN R[M 5[T� <br />B/ <br />USEZON- LOT�REA <br />C�' <br />HEIGNTUMITFTION� NOOF�WELLING <br />9A UNI75 � <br />�CJ <br />OCGUPnNCY NO OFSi0RIE5 OCCUPAN7LOAD <br />GROOP <br />�-� 2 N/� <br />FIREALr1RMRE0'0 REASON <br />Y�s onn. <br />FIRESPRINKLFRREO'D REASON <br />y�'S o�l,A <br />E OF COkST <br />�- ���f� <br />� I SIDE <br />�0 . <br />-11.9 <br />•L!".c:.7 <br />zm <br />�IIONE <br />�� �- <br />PIIONE <br />PHONE <br />PIIONE <br />rnurve <br />HtATING SYSTEM: f� GAS <br />c�' «�J 67i-a�Tr <br />/UA 9�a.�6 <br />�s �.�- � <br />STATE LICENSE • <br />$TATE LICENSE i <br />STATE UCENSE � <br />CTRIC ❑ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AI.L <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME'i0 GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHEH STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I 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 />CONTRACTOFiS LAW 1827 RCW ANU 296.200 WAC. <br />x <br />SIGNATURE DATE <br />CITY BUSINE55 UCENSE NO. <br />IIGAL <br />TYPE OF FI%TURE OR ITEM <br />A/C — AIHNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. I <br />HEAT PUMP <br />UNITHEATERS—B.T.U. M <br />CLOTHES DRYER ; <br />VENTILATION FAN <br />RF,NGE HOOD <br />WATER HEATER <br />VACANt SILE FEES <br />�IES fl NO O111L01NG <br />srze �r o�.ocm <br />/ % 3 � rtuMniNc <br />BASEMENi MECH4NICAL <br />f7YF.S NO <br />ADOIPONAI PLAN CNECK <br />OTII[R <br />smre omioiNc sunc�+nnce <br />CITY OF EVERETT runucwonKs <br />LOCALSALES <br />1 TAX CODE IS 3105 TOTAL <br />SUB TOTAL 5 �— <br />PERMIT $ i <br />TOTAL FEE $ ' <br />��'9;i 70 <br />F[E RECEIPT NQ � <br />V LUATION FEE <br />ro.6oZ.7o /_�7 f0 <br />