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— ,� <br />APPLICATI�,N FOR C(1NSTRUCI �ON PE�iMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 e 259-8810 <br />❑ DEMOLITION fC$ COMBINATION fl BUILDING fl MECHANICAL I7 PLUMBING fl SIGN <br />PROJECTADDRESS �?/,�r-- �/-y�y �T S� , �. vE1�E Ti- <br />�7� [� <br />OWNER MRIL�DMIESS CITY ZIP PHONE <br />Metco Homes ° T^ �Qoia n.,tl,otl_F.vnrett Hwv. Bothell WA 98012 (206) 316-0261 <br />TENANT <br />ADDRE55 <br />,_.,r <br />E OF WORN 9� o y�� <br />C� E�^REFO 7Afi V �§OIG PLKN�I(( <br />5 <br />'�/f)PF_�`' /loSO Crur�.,, + z <br />�U�G � -` FAN <br />LEGAL �R�P110N OF PROPERtt <br />�or 3 BIOCK _ <br />Creek Phase 4 " <br />�aw oa �nncH nvo <br />��� t o f <br />idae" <br />�,l �U- B�D -G�Y S ' r.cu_�- <br />CON57RUCTIONIOMlLENDE�' <ODRESS.TELEPNONENUMBfR <br />NO. <br />TYPE OF <br />WATER CLOSET� <br />BATHTUB <br />LAVATOHY (WASI <br />SHOWER <br />KITCHEN SINK & <br />DRI�lKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER3 <br />SINK ISERVICE - BAR, El <br />ITEM <br />SUB TO <br />PERMIT <br />TOTALf <br />FOR OFFICE USE ONLY: <br />FRONTSETBALK REM SETB�CK <br />��� � <br />USEZONE ' � IOTAREA ,��� <br />S <br />HEIGHT IIMITATION NO OF DWEILINCa <br />�. a ONITS <br />—[1 IontEf3/19/`i� <br />$ <br />ciTv zir <br />CITY ZIP <br />>�,� S'-s8 - <br />CIiY 21P <br />CITY T.IP <br />CIiV ZIP <br />rnurvt <br />,._. <br />STATE LICENSE � /�ET'C'( <br />p��" oS/ e <br />PIIONE S IATE LICENSE � <br />HEATING SYSTEM: �j�GAS rl ELECTRIC f-1 <br />�ONTACT PERSON AND PHONE NO. <br />r�^r� Mr(`rary '�16-0261 <br />Mike Mietzner �xt. 32 <br />I HEREBY CERTIFY THAT I HAVF READ AND EXAMINED THIS <br />APPLICAI ION AND KNOW THE SAME �f0 BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES CaOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TF.c 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 REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEATY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADc AND I OOMPLY WITH . THE STATE <br />CONTRACTORS LAW 1B.?_7 RCW AND 296.200 WAC. <br />SIQHATUR <br />i•(ETCOC293K'7,� o�r <br />CITY BJSINE55 LIC[NSE NO. <br />� <br />wt; - wnnu�u um i a- n.i <br />FORCEu ,oIR SYSTEMS - B. <br />HEAT PUMP <br />UNIT HEATEFS - B.T.U. M <br />RANGE HGOD <br />WATEfl HF.ATER <br />'NOOD STOVE <br />METf.6 FIREPLACE I <br />FIRePLP.CE INSERT <br />GAS FlfiEPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />r S /C /�� <br />PIAN ClIECK NUMBF.R <br />VACANT SIIE �Cw__ <br />'lYES f1 NO OUIIDING <br />'2`+��I LI✓��U+ PLIIMBING <br />6, S. F AR.� G� <br />B�SEMENT � � MECIIRNICAL <br />f1YE5 fy�NO <br />AODIIIONM1� '.AN CHf.CN <br />0T11ER <br />STATE BUIl01N0 SURCtUBGE <br />CITY OF EVERETT ruouc woans <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />M E.A. <br />SUB TQTAL $ <br />PERMIT $ <br />TOTAL FEE E <br />FEE�ga. e�3 � ����,., ,.�. <br />FEE <br />�� <br />