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APPLICATIG.1 FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION �C,���� <br />3200 CEDAR STREET • EVERETT, WA �fi201 • 259-8810 <br />�, DEMOLITION COMBINATION � BUILDING ' MECHANICAI y( PLUMBING i' SIGN <br />PROJECT ADDRESS <br />�C� I " 1�� -1 i� J I I _j,) I j i I <br />01WlRI 114t1 ADPqf SS (:IIY <br />SI.����� ia� V,AAotir_ .�41> 7G � ��. {t.��� E v�_.-� �" <br />in�npi u i nnnnres `-------- i�.�7r �-- --- <br />� <br />-u.—. _ _ ___ _ _rnnr�t <br />nnnurrcTonoesiovcn Mnn�nuness cnv rin PIIONF � <br />ffN[IUl CONiqACTOp 4AlI.�UPf1E55 CIIV )IP PIIONf $LAIF I.ICFNSE • <br />MFCIIANICALCONit1�CiOf1 MNIADpPE55 CITY 71P PNpHF. SiA1F11CFN5E� <br />Pl1�lAPi !6 WNIf14ClOf1 MAII FDpRE55 ('ItY )tP PHONC StA1F IICENSE � <br />�v���.4 ('I.,.,.,.S:,a. ` n ���\�i 'G7� �:j 5 .��p� i)Ni7r•r lY 'I".— <br />covmncr rmr,e or wnnK � <br />�fSCRIpF. WORKANDSOUMF. fOOt�GF INVOtV20 <br />rnoPOSFD <br />�.[tl�L uF.scnipll@! oF rnorF.nTV �SMOWN OEIOW 011 RT1Af.11 rwo CorIE51 <br />iot o�ceK or <br />CONSTRUCTION IOAN LENDER. �p[MESS. TElEP110NE NVMPFIt <br />PLUMBINO <br />NO. TVPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />,3 BATHTUB <br />� LAVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />DACKFLOW PREVENI <br />SINK ISERVICE — �A <br />FEE <br />0 <br />SU�TOTAL S if' <br />PERMIT 5 Q <br />TOTAL FEE $ � � <br />FOR OFFICE USE ONLY: <br />rnor+r sFrnn« nrnn sF.nacK smE sernncK <br />U�f ZANf 10TAItU y�C�Nf $I1F <br />ftYfS tl Np <br />i�Eirrrt uMi��TioN No or nwriur+c svr or m.ocn i <br />uHns <br />nnE srawni.en nea�n <br />IIdFY�III <br />iv�u <br />IOnD I PASEMR�1 <br />I1VIS ql) <br />CITY OF EVERETT <br />LOCALSALES <br />TA% CODE IS 3105 <br />HEATING SYSTEM: i i GAS ' i ELECTRIC I� <br />rUYrnCt rf I1cpN nNn PIiO�? NO -- <br />I HEREBV CEiiTIfY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. AlL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHEfi SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUC710N. THAT I AM AU7HORIZEO �V iHE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS M�DE AND I COMPLV WIiH THE STATE <br />CONTRACiORS AW 1A.27 RCW AND 296.200 WAC. <br />� <br />X - /� ��� (�- � `i ) <br />SICNAIUfiF � D�IE <br />l),UliLli ��1� /e�' <br />GITYpU51ry1SCc11CFN5f il0 <br />MECHANICAL <br />N0. TYPE OF FIX?URE OR IiEM FEE <br />A/C — MHNDLG UNITS — H.P. <br />FORCED AIR SVSTEMS — B]�.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRVERS <br />VENTILATIDN FAN <br />RANGEHOOD <br />WOODSTOV[ <br />METAL FIREiPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING <br />GAS FIREPL ACE <br />GAS RANGE <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL S <br />P[RMIT $ <br />TOTAL FEE $ <br />PI�NCHFCKI�IIMIifl1 �fff �P[CFIPiNO <br />nun ni�,a <br />ri ur,�nwr <br />MfC11RNICAI <br />App1110NA1 PI.AN CM[CN <br />omrn <br />sinir ounoir�n stmcr�nnce <br />runiu:woneg <br />TOTAL <br />/; <br />