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5�:;:' :;�':. <br />i� " <br />: ,. <br />� . <br />APPLICAT11,�1 FOR CONSTRUCI.ON PERM1� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR S'fREET • EVERETT, WA 98201 • 259-�810 <br />f 1 DEMOLITION f 1 COMBINATION f I BUILDING I I MECHANICAL I 1 f'LUMBING fl SIGN <br />PROJECT ADDRESS <br />ARCHITCCT OR OESIGNEfi <br />Id�IL ADURESS <br />IAAIL ADORE55 <br />�M L��DIlE55 <br />V�.S�• <br />MAIL AD�RE55 <br />%'� ,� �" �� <br />�� cm z v <br />�s— :� ;� L=��»� �� <br />ciTv zir <br />CITY 21P <br />� ri+or+e <br />� ,a�--/ a,s-a - > > � � <br />PlIONE <br />lIP y�PHONE <br />�-�r� -I <br />ZIP PHONE <br />STATE LIC[NSE � <br />p <br />PLUMBINGCONiRRCTOR MAILAD�RFSS Cltt ZIP PHONE STATELICENSEd <br />OESCRIBE WORN AND SOUARE <br />LEGAL OESCAIPTION OF PROPERN (SHOWN BEIOW <br />LOT /CS 9LOCK Of_ <br />?ARCELTA I.D.NOMBER <br />�9�/-c�oo -/o��-000l <br />CONSTRIICTION LOAN LENDER. AD�(1ESS. T[LEPHONE NUMDER <br />NO� TYPE OF FIXTURE OR ITEM <br />� I WATER CLOSET 4TOILET) <br />LAVATORY <br />KITCHEN SINK & DISF <br />DISHWASHER <br />LAUNORYTRAY <br />CLOTHES WASHER <br />UFINAL <br />DRINKING FOUNTP.IN <br />FLOOR ORAIN <br />SINK (SERVICE — BAR, <br />SU8 TOTAL S <br />PERMIT S <br />TOTP,L FEE 5 <br />FOR OFFICE USE ONLY: <br />FFONTSETDACK F@4fi3ET�ACN <br />�c, 7 0 <br />USE ZONE /�7 LOT AREA <br />�� � � 5� <br />HEBHTLIMITATION NO.OPDWELLING <br />2- UNIiS <br />OCCl1PANGY NO OF Si0PIE5 OCCUPANT L0�0 <br />3PPINNLER REO'D <br />OP CONST <br />7�� <br />FEE <br />N <br />HEATING SYSTEM: �I GAS fl ELECTRIC <br />cor+rncr rEnsoN nr�o ri�oNe No <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAMC TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR �ANCEL TF1E PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TFiE <br />P[fifORMANCE OF CJNSTRUCTIUN. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOP.K FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />X- p/"/� c l ��� 1_ �' /(� <br />'1 JATVRE � DATE <br />CITY OUSINE55 LICENSE NO. <br />h7ECHANICAL <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />A/C —A/HNDLG UNITS — H.P. _' — <br />FORCED AIR SYSTEMS — B.T.U. M E.A. ; <br />H[AT PUMP � <br />UNIT HEATERS — B.T.U. M ; <br />CLOTHES DRYERS � <br />VENTILATION FAN ' <br />RANGEHOOD i <br />WATER HEATER ' <br />WOODSTOVE ' <br />METAL FIREPLACE (WOOD BURNING) � <br />FIREPLACE INSERT (WOOD BURNING) ! <br />GAS FIFEPL <br />GASRANGE <br />GAS PIPING <br />EXHAUST FF <br />SIDE SETBACK �LAN CIISC <br />S � <br />VAG�NT SITE <br />nvEs �o om�oiruc <br />orei cRi <br />g � � A00,7, uN �h rwmoiNc <br />'I Sf C.:'J.4���R-i3O J <br />BASEMENT MECHANICAL <br />❑VES �O <br />°Y CITY OF EVERE7T <br />LOCAL SALES <br />'o c- TAX CODE IS 3105 <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />MBEA fEE RECEIPTNO. <br />O��' /�� �`� //,�,�i' <br />qD�ITIONAL PLAN GHECK <br />OTNER <br />STATE BUILDING SURGHARGE <br />PUBLIC WORKS <br />TOTAL <br />9 <br />