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APPLICATI�.� FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STFEET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL �PLUMBING ❑ SIGN <br />PROJECT ADDRESS: Q 1 ��� T� ���_�� <br />OWNER MMLApDRE55 Cltt 21P IIONE <br />?��3G D �� Cr�;� � �l �.(( �a- "�� _ � ����L��o�' �,S;i -/.�s <br />TEN�NT MAL�ODR SS �' G1Y 71P PuONE <br />�f�M� <br />ARCIIITELTORDESIGNEf1 M�II�O�tiE55 C�1Y 71f' PIIONE <br />�r�� -1 � � ., w <br />� CIIY IP PIIO`1E SfR1E IICGNSE i <br />(��oe�ll��f��C.���S�l`l`� l��K'IN�1Htd� <br />Q7Y IIP PIIONB S7AIE LICENSE � <br />_- �f� M -� <br />PLUMBINGCONTR�CTOF MAILADJR�SS CI1Y IIP PHONE STATELICENSE• <br />cor+ra�ct <br />LOT <br />�ND <br />OF PROPE <br />_ BLOCN <br />1►�L9 <br />CONSTHUCTION LONI LENDEfl. �ODFESS, TELEPHONE NUMBEII <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & OISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />CINI[ lCFRVICF — RAR FTC 1 <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN RERR SF.TBACN <br />USEZOHE <br />IIEIGNT LIMITATION <br />OCCUPANCY NOC <br />GROUP <br />IOTAnEA <br />NEATING SYSTEM: �7 GAS ❑ ELECTRIC ❑ <br />CONI�CT P[f150N AND PIIONE NO <br />��il:L �i��/Ci��� -�-"5i�-��i- rt�%i� <br />I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME 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 f3RANTING OF A PERl.91T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VInLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE C1F CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO P RFORM THE WORK FOR WHICH <br />APPLICATION IS E ,I � MPLY WITH TNE STATE <br />CONTRACTOR W . 7 AND 296. 00 WAC. <br />S -% L � <br />9C,u�tuR i " � / onTF <br />CITY BUSINESS LICENSF. NO <br />NO. I TYPE OF E�UIPMENT � FEE <br />rvu—rvnivvw vmw <br />� FORCED AIR SYSTEMS <br />� HEAT PUMP <br />� UNIT HEATERS <br />� CLOTHESDRYERS <br />� RANGEHOOD <br />; WATER HEATER <br />� WOOD STOVE <br />�— MEfAL FIREPLACE (VJOi <br />: FIREPLACEINSERT(WC <br />i <br />i <br />SUB TOTAL 8 ; <br />PERMIT E � <br />TOTALFEE S J <br />sioe ^Ere�cK <br />NO OF DWELLING <br />UNIiS <br />�PP110VE0 OY <br />GAS FIREPLAC <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT E <br />TOTAL FEE E <br />ri�N ciiecn ruuunrn � rer � nEcrmr r+o <br />V�C�NI S�TE r«� <br />❑YES ❑ NO p111101Nf. <br />SIZE OF OIOGRI <br />PlUM01NG <br />BASEMENL MEC���NICAt <br />❑YES ❑ NO — <br />ADOIIIONRI. f UN C��EGN <br />0111E0 <br />StAIE OWlDM6 SUnC11nRGE <br />CITYOFEVERETT ruoiir.wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />0 <br />