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.. 1- <br />APPLICATIOb. FOR CONSTRUCTk%jN PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING l�j MECHANICAL ❑ PLUMBING ❑ SIGN <br />PJOJECTADDRESS: SOS S s �Ver WTI 1920 <br />.r-t 1 i f— ni n , QOws '7A/. '2t/O-7 V't/R <br />TENANT MAIL AROnr SS CRY 71P NIONE <br />ARCHITECT OR DESIGNED MAX ADDRESS CITY 711• PIIONF. <br />CONDIACIOD <br />IA), <br />MAIL ADC <br />PHONE %TAIC IICENSF N <br />lJA9ata3 ZSS•y9/p .l�f'AWI�A�ti��� <br />NKINL STATE LICENSE , <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 11P PNIONE STATE LICENSE <br />CON) T PRICf. WORK <br />3S""a/S. / 7 <br />HEATING SYSTEM: KGAS ❑ELECTRIC ❑ <br />DESCRIBE WORK AND SWARE FOOTA(IEINVOLVED <br />CONTACT PE.RSONANDNIdIF NO <br />Jri 4pn ��n�.T <br />I, <br />L Fa - <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 />PROPOSED USE OF RUILMNO <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY ISIgWN BELOW a1 ATTACH TWO COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK _ _ DF <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 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />�Y '• Q <br />PARCEL TAX I D. NUMBER`�Fj..`.T <br />CDNSTRUCTION LO.W LENDER, ADDRESS. TE LEn10NE NUMBER <br />S All F DATE <br />CITY BUSINESS LICENSE NSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />AIC—AAINDLGI)NITS <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />' <br />__UNIT HEATERS <br />KITCHEN SINK A DISP <br />) <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />I <br />WATER HEATER <br />CLOTHES WASHER <br />, <br />WOODSTOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />; <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />j <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />; <br />(TAS RANGE <br />-r— <br />SINK (SERVICE — BAR, ETC.) <br />, <br />GAS PIPING <br />' <br />EXHAUST FAN <br />, <br />I <br />, <br />� <br />SUB TOTAL <br />f <br />' <br />SUB TOTAL f <br />I <br />17 <br />PERMIT <br />f <br />PERMIT f <br />' <br />TOTAL FEE <br />S <br />' <br />TOTAL FEE f <br />run vrrn.c vac vIYIi-F. <br />FRONT SETRAC`( <br />REARSFTWX <br />SIDE SETBACK <br />NANCIXSCXMRMLFR FEF <br />RFCFIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />DYES ❑ NO <br />0010ANO <br />�- <br />NEI611T LIMITATION <br />NO OF DWELLING <br />UNIT% <br />SIZEOr BLOORI <br />PLUMBING <br />MFCHANICAI <br />` <br />, <br />OCCUPPANCY <br />NO M $IMES <br />OCCUPANT LOAD <br />BASEMENT <br />❑YES LT NO <br />-- <br />--- <br />ADDIRONAI n AN CINCK <br />-_ <br />) <br />' <br />---�— <br />FIRE SPRINKLER REO'D <br />REASON <br />DNRR <br />FIRE ALARM REDO <br />RF ASON <br />STATE flIX1 ON(T SIIIKIIAII(IE <br />' <br />' <br />NIM N' wrIDKR <br />-- <br />TYPE Of roNsl <br />MANS APPROVED By <br />CRY OF EVERETT <br />LOCAL SALES <br />- - <br />-"---- <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />