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APPLICATIa.1 FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl DEMOUTION �l COMBINATION fl BUILDING Il MECHANICAL PLUMBING fl SIGN <br />-�J2 Y� �_ 5�- �F�-� \ I � C'�i' - P I �L � <br />�YY lri <br />ARCHITECTORUESIGNER MAILADDRE55 Gltt ZIP PHONF <br />n �. �-. <br />rwmomuwninnr,iUH MAILADDRE55 Cltt ZIP PHONE <br />/� � �1`1 SiATE LICEaNS-E •� <br />CONTPPCT VRICE OF WORK G�� � �' " - � � ' --""^�" � vl� � � �SU� Z� '�Q,lCJ7'�' � / <br />�� Cx7U HEATING SYSTEM: f l GAS f� ELECTRIC f 1 <br />DESCRIBE WORK AND SOUnRE FOOTAGE INVOW ED CONTACT PEFSON AND PHONF. N0. <br />LOT BLOCK <br />PARCELTA%LD.NUMBER <br />bca2rbc����o1 -cx��l- <br />CONSTRUCTIONIOANLEN�ER.A00AESS.TELEPHONENUMBER <br />PLUMBING <br />NO. TYPE OF <br />WA1"ER CLOSETi <br />BATHTUB <br />( LAVATORY(WASF <br />SHOWER <br />KITCHEN SINK 8 <br />� DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHE <br />URINAL <br />DRINKING FOUN7 <br />FLOOR DRAIN <br />BACKFLOW PqEV <br />SINK (SEFVICE — <br />OR ITEM <br />I HEREBI' CERTIFV THAT � HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TH'c SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TkiIS TVPE OF <br />WORK WILI. BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />iwocoaiesl NOT. THE GRAN'fING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOflITY TO VIOLATE OR CANCEL THF PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTpRS LAW 1827 RCW AND 296200 WqC. <br />FEE <br />0 <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSETPACN REAR SETPACN <br />USE ZONE lOT AREA <br />HEIGNTUMITATION NOOFUWEIUNG <br />UNIIS <br />RGO'D <br />SIUE SETBACK <br />VAC4NT $ITE <br />f1YE5 fi NO <br />CITY BUSINE55 <br />NO. TYPE OF EQUIPMENT <br />A/C — q/HNDLG UNff3 — H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRVERS <br />VEN7ILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE 5 <br />PLAN CIIECK NUM9FR I FE[ I RECEI('T NO <br />BUIL�IIJG <br />SIZE OF BLOGrtJ -- <br />PLUMAING <br />BASEMENT MFC11nq�CAL <br />IIYES �1 NO <br />Aflpl IION�� P�.�N GNf.CN <br />OiNER <br />STAIE OUILDWG SUPCII�RG[ <br />CITY OF EVERETT ruxnr, vronHs <br />LOCAL SALES <br />TAX CODE IS 3105 707AL <br />