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APPLICATIG./ FOR CONSTRUC7.Jli PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f l DEMOLITION I I COMBINATION Xt BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br />PROJECT ADDRESS _ <br />1zv QID' �� i�+�jV I7); <br />owan MA ADD% }5 CITY 711, Pllo`:E <br />SLr 141AAw,16,tNW1 IOZZO 2a9 NE zbNVt3 FD. tot- `1b°33 6P66,61-o6ao <br />Ifo✓l <br />MECIIANILI CONTRO..'.TOn MAIL ADDPE! <br />PI UMBING CONTRACTOR MIL Awn, <br />�p,2a S (264)\ir3 -PHO <br />�Y ICI NE lzO6J`'o- M4,7O <br />PIIf,VE STATE LICENSE <br />CITY ZIP PHONE STATE LICENSE A <br />CITY 71P PHONE STATE LICENSE• <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: KGAS I l ELECTRIC fl <br />DESCRIBE W(1RK ANDSO� TAj',GEINV� <br />CONTACT/ WAND PjillN U�r� <br />1 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. IHE 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 />APPL.fjT,ION IS MADE AND I COMPLY WITH THE ^TATE <br />CO TORS LAW 18.27 RCW AND 296.200 WAC. <br />X [/i/wL� <br />PH SED USE TBUILD USE '[�IN/O <br />LEGAL DESCRIPTION OF PROPERTY (SIKWN BELOW OR ATTACH IWO COPIES) <br />LOT BLu.,K OF <br />_ <br />�M <br />PARCELTAK ID. NUMBER <br />COMB TION LOAN LENDEn. ADDRESS. TELEPHONE NUMBER <br />SIO DATE <br />CITY BU7INESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />O. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />AIC — AMNDLG UNITS — H.P. <br />' <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 HEATERS— B.T.U. M <br />' <br />ITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />D HWASHER <br />' <br />VENTILATION FAN <br />T— <br />' <br />LA DRY TRAY <br />RANGE HOOD <br />i <br />CLOT S WASHER <br />I <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING UNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PRE TERS <br />OAS FIREPLACE <br />i <br />SINK (SERVICE — B ETC.) <br />1 <br />GAS RANGE <br />' <br />' <br />GAS PIPING <br />1 <br />EXHAUSTFAN <br />1 <br />1 <br />' <br />1 <br />I <br />' <br />' <br />1 <br />' <br />SUB TOTAL E <br />' <br />SUB TOTAL E <br />' <br />PERMIT E <br />I <br />PERMIT f <br />1 <br />TOTALFEE $ <br />TOTALFEE S <br />' <br />cnn nccirc Lice nNly J! /L// { ///- <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PUN CIIEQKNOMR <br />�Z`Yi//(L//Yy�^�r'nAwnONALPLANCHEClK <br />r. / <br />RECEIPT <br />v�FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE. <br />I IYES (I NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />UNITS <br />SIZE OF BLDGRI <br />IZL 3Zri 7. 1 <br />LI •n/ASEMENI 1 ' I <br />M-VALUATIUM <br />tOUPLANCY NO OE 510RIE5 <br />OCCU^POF <br />8` 2 <br />OCCUPANT LOAD <br />¢ YES NNO <br />FIRE ALARM /RED D <br />4ri % <br />REASON <br />� ,E/�j <br />I//Y��'LYV <br />DH,ER <br />FIRE SPRINKLER REGD <br />/ k-,/ <br />nEASON <br />LArP 1nOVE'ZVDIBBy <br />STATE BUILDING SURCHARGE <br />/ <br />Y <br />TYPE OF CONST <br />_N <br />PLANS <br />IAIm <br />DATE L 7 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOS IS 3105 <br />Punt c WORKS <br />1 TOTAL <br />i <br />=i <br />