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--, .- <br />APPLICATIOrI FOR CONSiRUCT.�N PERMIT <br />CITY OF EVERETT � BUILDlNG DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-881� <br />C] DEMOLITION fl COMBINATION I�l BUILDING fl MECFiANIC.4L f� PLUMBING I-1 SIGN <br />PROJECT ADDRESS <br />Z� � / – / � -�-N S % L'Er= <br />N e-L"TG�JQ ?% Z! IG�TN ST, c� \ <br />MAIL ADOF@55 Q iV <br />ARCHITECT U9 <br />.E vEQ�_7 ,—, cJ�� <br />ZIF PIIOUE <br />� ,— w� �rn � <br />21P <br />Zol <br />z�i�-30Z1 <br />GENEAALCONTRAC70R MAILA�UR[SS CITY ZIP PHONE STATELIGENSE� <br />MECHnNICALCONTPACTOR MAILF�DRE55 CITV ZIC PIIONE STATEUCENSEN <br />/�r�,�n e�v _ <br />�WM9INGCONTRACTOR MAILFDDRE55 CIN 2IP PHONE STATELICENSEM <br />DESCRIBE WOPK ANO SOUAPE FOOTAGE INVOLVE� <br />%NSTA�Lq�ioN �F F,L', <br />P(_(�LET SioV� <br />PqOPOSED USE OF �UILDING <br />LEGAL �ESCRIPTION OF PROPEflTY �SHOWN BELOW <br />l0T BLOCK OF_ <br />CONS?RUCTIONLOHNLENDER.A�ORESS,TELEPHONENUM�ER <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />LAVATORY <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DP.INKING FOUNTAIN <br />BACKFLOW PREV <br />SINK (SERVICE — <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FPONTSETBACK RE�R SET�FCK <br />USE 20NE <br />HEIGHT LIh11TATION <br />LOTFREA <br />tJO. OF DWELLING <br />IINlTS <br />FEASON <br />PIANS APPROVED BY <br />Q�� <br />FEE <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC Ll <br />CONTACT PERSON ANU PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TCi 8[ TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHEF SPECIFIED HEREiN OR <br />NOT. THE GFlANTING OF A PERMIT DOES NOT PRESUME TO �IVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR T'riE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THe STATE <br />CONTRA T RS LAW 1827 RC AND �200 WAC. <br />. r-, `� � ll�(8-9 <br />. NATIIRE DATE <br />CIN BUSINE55 LICENSE NO. <br />MECHANICAL <br />NO. TVPE OF FI%TURE OR ITEM <br />A/C —AMNDLG UNITS — H.P. <br />FORCED AIP. �YSTEMS — B.T.U. M <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />2, WOOD STOVE <br />METAL FIFEPLACE (WOOD BURNING <br />FIREPLACE INSERT (WOOD BURNIN( <br />GAS FIREPLACE <br />GAS FANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SI�E SETBACK I�'�N CHECK NUMBER <br />VACANT SITE �c�� <br />f7YE5 ❑ NO pUIL�MG <br />SRE OF ��DG�J. <br />PLUM�ING <br />BASEMENT IdECMAN�CAL <br />❑vE5 fl NO - <br />AD�ITIONAI PLFN LHECK <br />O7HER <br />ST�TE 9WLOIYG Sl1RGHFfiGE <br />CITY OF EVERETT rueucwonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TO7A� <br />SUB TOTAL 5 <br />PERMIT S <br />TOTALFEE 5 <br />FEE RECEIPTNO. <br />FEE <br />