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APPLICATIOR FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET AT EVERETT, WAS 982.01 B (425) 257-8810 *Aff <br />❑ DEMOLITION ', COMBINATION ❑ BUB.DINO ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:=`3�-3 ZI s�- pr. _3-el <br />TENANT MAN AIIO1[$5 <br />S+ <br />MECHANICAL CONIMC TOR MAIL ](MESS C,ry IIR PHONE STATE LICENSE <br />NUMBING Cp1TNA1:I00 MAILAOORESS CHI ZIP PHONE STATE LNPNSEF <br />Cp11MC1 MpC[ Oi WJllt <br />Tf n <br />HEATING SYSTEM: AS ❑ELECTRIC ❑ <br />OESCWBEWOR,1AN05011APE.T INVOLVEDFOOTAGEINVOLVEDPF <br />O <br />1 P <br />CONTACT n50N �$HONE N0 -219 -- <br />.(��as�� <br />S I-� <br />T\ <br />ARCEF F a ae A lULDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME M BE TRUE AND CORRECT ALI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING (IF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <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 PERFOPM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COk PLY WITH THE STATE <br />rO ...... CTPE4,LAW 11,.27 RrAV AND296.2% WAC. C Q <br />X 'C' C�F•�V ✓S 21'2J—q�1 <br />LEGAL D'r:SCP NCEI OFP ERTY ISHONII BELOW OR AfIACH TNOCORE51 <br />� 3 BLOCK GF �I U flhA/cc-c1t <br />PABOEL TAX m NUMDER <br />CON[TRRCRONIOANLENOSR. ADONESS. THEPHNENINBER <br />sI ua DATE <br />CITY "NESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EWIPMENT <br />FEE <br />3 <br />WATER CLOSET(TO!LET) <br />ri <br />A/C —A/HNDLG UNITS <br />2_ <br />BNfHTUB <br />FORCED AIR SYSTEMS <br />3 <br />LAVATORY (WASH BASIN) <br />CJ <br />HEAT PUMP <br />SHOWER <br />(' <br />UNIT HEATERS <br />( <br />KITCHEN SINK A DISP <br />I <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />Q <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNINGI <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />I'ri <br />GAS RANGE <br />_ <br />SINK (SERVICE — BAR, ETC.) <br />3 <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL S <br />SUBTOTAL $ <br />PERMIT S <br />PERMIT $ <br />TOTALFEE S <br />TOTALFEE f <br />enn nerve Alec nMl V. <br />i BONT SC1flACR <br />BTARSFInACX <br />SIM SETBACM <br />PIAN CAECA NVMETN <br />FFF <br />RECENT, NG <br />59 D •_L <br />GSEIONF <br />101 AREA <br />VACNE1 RIE <br />FEES <br />VALUATION <br />FEE <br />nIBIn r <br />_ <br />o/,- <br />/1 a oa D <br />❑,t5 D HG <br />HEIGHT I IMITATION <br />NOOF OWEWNG <br />MNIl4 <br />SIZE QBI 1 <br />%�'� O�% <br />nUMAING <br />OnCUPPANCT WN$IMES <br />OCCUPANT LOAD BASF4EN1 <br />MECHANICAL <br />C2 I/- ( 7 <br />❑YEs Nn <br />ADO111GNA:.nAN uac11 <br />Fl SPPWNEER REO'IT <br />MABnU <br />OTHER <br />TIRE AURM REOD <br />REASON <br />STATT SUn DAG SIIRCHARCE <br />i <br />TYPE a C'ONSI <br />MANS APMOVED Br <br />CRYOFEVERETT <br />NIN Ir. woRBS <br />I <br />LOCAL SALES'--`— <br />TOTAL <br />�/ <br />TAX CODE IS 3105 <br />GALL <br />