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IN <br />APPLICATIO,. <br />FOR CONSTRUCTrN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR <br />STREET • EVERETT, WA 98201 •259-8810 <br />❑ DEMOLITION <br />❑ COMBINATION <br />❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />SIGN <br />PR�OJECT ADDRESS <br />L� T .}f �. S; C- f it hC✓% �F Z �� <br />�`!)k C. /<i <br />i <br />//72` <br />f 4Ve,ell`j <br />CANER <br />MNL ADp1E55 <br />CITY ZIP PHONE <br />C'/kef- c,�l�n <br />//T2-6 <br />Ar e,ree �ti. �'� zop ?TP-ol Z <br />(7 <br />M /ITAODRE!y <br />/ I CITY NIP PHONE <br />AFCMTECTT7 rSIGNER <br />MAIL ADDRESS // <br />CITY <br />71P <br />PHune <br />GENEGENE CONTRACTOR <br />MAILADDRESS <br />CITY <br />IIP <br />PHONE <br />STATE LICENSE <br />j <br />77v-/5&7' <br />J/.,MAA&'22i'MO <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSER <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: ❑GAS El ELECTRIC ❑ <br />EWORK, AREF T WVOLVED <br />CONTACT PERSON AND PHONE NO <br />ODE <br />biz �' r- <br />C &s� 5 <br />Sze--49 ", <br />1 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 />PROPOSED USE OF B(ALDINO <br />_ <br />2 GY/-4X <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />BLOCK a <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT <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 />• <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 R{�C9W AND 296.200 WAC. <br />PARCEL TAXI O NUMBER <br />X �``^�7'q'—� //L <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />_ <br />SIGNA DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBN O <br />MECHANICAL <br />NO. I TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C—A/HNDLG UNITS <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />H <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS <br />KITCHEN SINK III DISP <br />CLOTHES DRYERS <br />�— <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />; <br />WAT C' HEATER <br />i <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS PIPING <br />' <br />EXHAUST FAN <br />SUB TOTAL <br />f <br />SUB TOTAL f <br />; <br />PERMIT <br />f <br />PERMIT f <br />' <br />TOTALFEE <br />f <br />' <br />TOTAL FEE f <br />I' <br />�ws I1CB^0 I NCO nul V. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SFTBACK <br />PUN CHIECK NUMRPR <br />FEF .2 <br />nECFIPT NO <br />�297 <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />v <br />DYES ❑ NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLOG/T.I <br />UNITS <br />PLUMBING <br />T <br />MECHANICAL <br />' <br />_ <br />OCCUPANCY <br />ND O<$IORFS <br />OCCUPANT LOAD <br />BASEMENT <br />GROUP <br />-- <br />ADDIIIONAI. PI AN GIEGN <br />I <br />DYES ❑ NO <br />FIRE SPRINKLER REO'D <br />REASON <br />OTHER <br />FIREALARMREG-D <br />REASON <br />$UlE BUILDING $I1nC1unGE <br />' <br />z z{ <br />— <br />PUBIICWOnKs <br />TYPE OFr.ONST <br />PLANS APPgOVEDBY <br />CITY OF EVERETT <br />EMT <br />LOCAL SALES <br />�- <br />2� <br />TAX CODE IS 3105 <br />TOTAL <br />' <br />DATE <br />