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APPLICATI�.N FOR CI�NSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f-1 DEMOLITION fl COMBINATION I� BUILDING I7 �1ECHANICAI I1 PLl1MBING Y�SIGN <br />PROJEI'T ADDRESS <br />Z� �, m�v,� v,�.:� <br />QIIG�N� V� �' � O AIpILAD�S�Q 4> �v����7y ZII' {+IIONE <br />IJ <br />lE �tT /� AIAILAODR[SS 1 CITV �II,� 'IP (� P/�N]O�NyE (� I� <br />AR�`7 �TOFi ��CaN[fi `' �`� MAILAD��SS� �GlN�S� C� ' ��.�i �.(�^ W � . �(J �Oi.� (Ll�i�).��, ^ V� � � <br />�. Yv� . C-c�� 5-Iw�c-�T� � t� w� p063 2-r� Zm C� - I`� I`I �� <br />Po ��' 6� �S i-� �P �, `l � <br />GENERA�4jC�ONTMCTOq MAILAU�RESS CIIY I PHONE SiATELICENSE� <br />MECHANI ALCONTRAC�`�MAILA �RE$$I� ��� ZIP �b�PHONEI l STATEUCENSE� <br />PLUhIBINGCONTRACTOR 6�AILA�URESS CIN 21P PHONE STATELICENSE/ <br />CONTRACI' PRICE OF WORK I� SS � <br />� <br />DESCRIB-E} W�O�RK ND SOUARE FOOTRG�E] INVOIVI <br />X"��uJ y 2 %� v �I <br />� �i�- <br />s <br />PPOPOSED USE OF BUILUING <br />LOT BLOCK OF. <br />CONSTRUCTION LOAN LENDER. RDDRE55. TELEPNCNE NUMBER <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNDRYTRAY <br />CLO7HE5 WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />S�NK (SEiiVICE - BAR, <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONTSETPACK REAR SET�4CK SI�ESETBACK <br />USE20NE <br />HEIGHT LIMITATION <br />HEO'D <br />FEE <br />0 <br />0 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONTACi PERSON AND f'110NE NO. <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAM�NED THiS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TIiIS 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 />CO �j'ACTO LAW 18.27 RCW AND 296.200 WAC. <br />I�j' � n �� �� -a�l-�(� <br />5 TURE ATE <br />CITY BUSMESS UCENSE NO. <br />MECHANICAL <br />NO. TYPE OF FI%TURE OR ITEM FEE <br />A/C - A/HNDLG UNITS - H. P. � <br />FORCEDAIRSYSTEMS-B.T.U. M E.A. ; <br />HEAT PIIMP � <br />UNIT HEATERS - B.T.U. M ' <br />CLOTHES DRYERS � <br />VENTILATION FAN � <br />RANGEHOOD i <br />WATER HEATER � <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNING) i <br />FIREPLACE INSERT (WOOD BURNING) ' <br />GAS FIREPLACE � <br />GASRANGE ! <br />E%HAUSTFAN <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />PIANCHECKJJUh10EP I FEE I AECEIPTNO. <br />��i . ).,, -. <br />LOTAREA VACANTSITE 1'CW <br />fIYES f� NO BUIL�MG <br />NO.OFOWEWNG 52EOF9lOfiRl. <br />UNIiS p�UM01NC <br />OCCUPANTLOAO BASEMENT MECMnNICAL <br />(7VE5 fl NO <br />REASON AO�IiIONAI PLAN CHECK <br />OTIIER <br />REASON <br />STATE DUIL� W G SURCHARGE <br />PlAN5r1PPROVED �V ,� � CITY OF EVERETT �'UOUC WORKS <br />I I .. S_� y LOCAL SALES - <br />,,..� TAX CODE IS 3105 TOTAL <br />