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APPLICATIL N FOR CONSTRUC'li .ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />❑ DEMOLITION I I COMBINATION I I BUILDING I I MECHANICAL f l PLUMBING PROJECT ADDRESS 1 SIGN <br />DWN n •- I �:`• - � <br />MAn ADDness <br />T' rnr Tm <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR MAILADDFIESS <br />A q CITY 71P PHONE <br />�l ` �.�U/ f oYA DATE LICENSE <br />MECHANICAL CONTRACTOR MAIL AODRE55 ,QV t6 ft/ CrvrK 9�01 Z <br />PHONE STATE LICENSE F <br />DESCRIBE WORK AND <br />INVOLVED <br />— —I � IanIWN BELOW OR <br />LOTS 7 BLOCK <br />OF -A <br />CONSTRUCTION <br />Iff-. <br />8 <br />NUMBER <br />FEE <br />I UTAL FEE S <br />FOR OFFICE USE <br />ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />BIDE SETBACK <br />USE ZONE <br />(Z-4 <br />LOTAREA <br />6 Z I <br />VACANT SITF <br />—YES <br />CTI nNo <br />HEIGHT UMz TI y <br />NO OF DWELLING <br />UNITS <br />S!�FO—F BL I <br />I I � [AVTAJG <br />OCCUPANCY NO OFSTORIES <br />OCCUPANT LOAD <br />It CPAW 6i <br />BABEMENT <br />A <br />A <br />� <br />❑YES IYNO <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />HEATING SYSTEM: IkGAS ❑ ELECTRIC n_ <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 />CONTRACTOR LAW 18.27 RCW AND 296.200 WAC. <br />XSIGN un <br />CITY DUSINESS LICENSE NO <br />— AfHNDLG UNITS — H.I <br />CED AIR SYSTEMS B <br />T PUM— p <br />'HEATER---- S�BTU <br />THES DRYERS <br />nLATION F—'— AN <br />3E H05D <br />PUN <br />BUILDINO <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />ITEM I FEE <br />E.A. <br />TOTAL FEE S I I <br />FEE RECEIP,NO <br />VALUATION FEE <br />65 2v� /, a <br />7r �� <br />