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APPL�CA7`��..+1 FOR CO�ISTRUC7.ON PERMIT <br />CITY OF tVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8�10 <br />❑ DEMOUTION Cl COMBINATION ❑ BUILDING � <br />MECHANICAL PLUMBING f] SIGN <br />PROJECT ADDRESS �� ,� I � 3 �Q � <br />o„M�. �e , <br />�J Ma� nonaEss n � � <br />�/�i /L C'! ( �� 3 / 33 �d iY�Ccm{t/, [. (�E��Li JL� ,70NE �/ � "��`�S./ <br />TENANT MAILAOORE55 V <br />PHONE i <br />ARCHITECTOR�ESIGNEP MAILAOORE55 <br />CITV IIP PHONE <br />LO7 <br />OF <br />SOUARE <br />OF PqOPI <br />_ BLOCK <br />INVOLVE� <br />. ... , . i ✓ v ti'DvJ'FJ��' <br />CONSTRUCTION LOAN LENOER. ADDRESS. TELEPFIONE NUMBER <br />y <br />�� � PIUMBING <br />�� <br />„ ; NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />: KITCHEN SINK & D�SP <br />DISHWASHER � <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK(SERVicF—aew crc� <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN REAR SETBACK <br />USEZONE <br />HEIGHT LIMITATION <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />'— � HEATING SYSTEM: <br />GAS ❑ ELECTRIC i� <br />I HEFEBY 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 TVPE OF <br />WnRK WILL BE COMPLIED WITH WHETHER SPECIFIED HERE�N OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE 7R LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEH OF THIS P TY TO PERFORM THE WORK FOR WHICH <br />APPLICATION MAD I COMPLY WITH THE STATE <br />CONTRACT S LA��r� Zg6.200 WqC. <br />CITV Bl151NE55 UCENSE NO. <br />TYPE OF flXTURE OR ITEM <br />Ni. —AMNDLG UtJITS — H.P. <br />FORCED AIR SYSTEMS — B. .U. M <br />HEAT PUMP Q�G <br />UNITHEATERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WOODSTOVE <br />METALFIREPLACEI <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT g <br />TOTAL FEE $ <br />/ <br />SIDE SETBACN PIAN CHECK N@dBEq FEE RECEIPT N0. <br />C—�j? r- � <br />LOTAREA VACANTSITE FEES <br />OYES ❑ NO <br />ouuoiNc <br />NO.OFDWEIIING SIZEOFBLOG?I. <br />UNITS <br />PLlIM91NG <br />OCCUPOVTLOAD BASEMENT <br />MECNANICAL <br />❑YES f7 NO <br />REASON ADDITIONRL PLAN CNECK <br />REASON OTHER <br />STATE BWLOING SURCHpRGE <br />PLANSAPPROVED BY CITY OF EVERETT PU�LIC WORKS <br />LOCALSALES <br />]ATE TAX CODE IS 3105 TOTAL <br />FEE <br />:�J <br />:t <br />� <br />� } .'ry <br />�� <br />� FSa i <br />,�^�1� <br />(7V <br />{vY�� <br />. . :��'`'.vv <br />�r i <br />� ;+F <br />���F � <br />A`n <br />;, <br />'':� <br />. ;f.�i <br />