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APPLICATION FOR CONSTRUCTION PERMIT <br />e ITV OF EVERETT • BUILDING DIVISION <br />41�1/%I , )1 3200 CEDAR STREET • EVERETT, WA 9AP01 • 259-8810 <br />DEMOLITION ' ' COM61NATION K BUILDING MECHANICAL PLUMBING SIGN <br />PROJECT ADDRESS <br />blq Olsr PLRca� ,SGCyERrrr Q�')L.'P <br />)WNFn MAIL ADOPFSS CITY <br />lip rnpn <br />P.E. �vr INA 9Q_ _ 3k �_Ybs_7 <br />AnCMTr..CT OROESIGNEn MAIL ADDPFSS CITY 71P <br />P�p 09"Tr yrR qP-Q{ <br />riFNEfLCONiMCTOB MAl1 AINln S city lip PUONI 3Y7-N�`er A'I "rrNsr. <br />Iwaxwk kC , ucG (r1� U Ayel Sx, Eyir 92 DOC / MIQt LOSS PP <br />MECHANICAL CONTRACTOn MAIL APORF55 CITY 71P PIKA ST.1 E LICENSE • <br />PLUMBING COMPACTOR MAIL AMMESS city 71P PHONE STATE LICENSE <br />CONTRACT PRICE OE VY011K <br />HEATING SYSTEM: kGAS r I ELECTRIC I I <br />UEsu(� Vg111t ANN�WEE �uOEV.O -3 L9� -/ <br />G 6vIILAG/N <br />- <br />NTACT PERSON AN�DOIONE NO &c? — <br />J <br />I 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 />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 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 PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONtRA lAW 18.27 RCW AND 29 Al <br />X • / !)/ <br />/ <br />PROPOSED USE OF BUILDING <br />�Q QCG P <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIE91 <br />LOT — BLOCK Or <br />10120 2i)fAY6. Af ,&, I�VER�rr Wd <br />'---T- <br />PARCEL TAIL 10 NUMBER <br />CONSTRUCTION LOAN IENr)F.n gIDRFSS. TELEPHONE NUMRFn <br />RIONA IRE r��/O� <br />/ DAt(� <br />CITY BUSINESS LICENSE ND <br />PLUMBING <br />MECHANICAL _ <br />NO. _TYPE OF_EOUIPNI FEE <br />AID- A/HNDLG UNITS -H.P, ' <br />NO <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET, <br />I <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />I <br />SHOWER <br />' <br />UNIT HEATEPS-B.T.U. M <br />KITCHEN SINK 8 DISP <br />I <br />CLOTHES DP 'ERS <br />i <br />DISHWASHER <br />' <br />VENTILATION 'AN <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />I <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />�- <br />METAL fIRFPLACE (WOOD BURNING) <br />I <br />_ <br />FLOOR DRAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />_ <br />BACKFLOW PREVENTERS <br />OAS FIREPLACE <br />SINK (SERVICE - BAR, ETC) <br />I <br />' <br />OAS RANGE <br />GAS PIPING <br />�- <br />' <br />EXHAUSTFAN <br />I <br />- <br />I <br />I <br />I <br />I <br />SUB TOTAL $ <br />' <br />SUB TOTAL $ <br />' <br />PERMIT $ <br />I <br />PERMIT $ <br />I <br />TOTAL FEE $ <br />' <br />_ <br />TOTAL FEE $ <br />_ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SMACK <br />REAR SMACK <br />SIDE SETBACK <br />MAN CHECK NU R <br />FEF <br />RECEIPT NO <br />USE IONF <br />tOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BltlldNf: <br />r <br />�J <br />AYES I1 NO <br />1E101/T LIMITATION <br />NO a DWELLING <br />51I' OF BLOG'T I <br />PI UVOINO <br />UNITS �1 <br />z76 t.s SF Lrvi A t <br />OCCUPPANCV <br />WrB SILKYFS <br />LCCIPANIL'OAD <br />BASEMENT <br />MECHANICAL <br />GR <br />f <br />Z <br />/Y <br />IIYFi 0170 <br />ADd11ONAL PLANCHFCK <br />l <br />U <br />' <br />FIRE ALAnM REDO <br />BTASON <br />OTHER <br />EIIIF SPRINKIFn REOr) <br />RFASON <br />-- <br />STATERIAMINnSIMCHAME <br />_ <br />/!J- <br />O <br />TYPE OF CONST <br />PI ANB APPPgVF Q BY CITY OF EVERETT <br />I <br />rURUr, WORKS <br />Q 11•+F <br />LOCAL SALES <br />I -Al <br />S- I TAX CODE IS 3105 <br />TOTAL <br />DATE Z2 <br />