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APPLICATI(,.� FOR CONSTRUC7..)N PERMIT <br />CITY OF [VERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />i� DEMOUTICN COMBINATION i i BUILDING I MECHANICAL j�pLUMBING f 1 SIGN <br />PROJECT ADDRESS ����� � <br />%�?I �5"' }! j t (,4,� i rt 5_ 7 rs> •,-5 c ,:� <br />f�a�c- , �o<. <br />owrirn �rmi nnUnrs� <br />t�.nr nr rno•n <br />jl�..iiilr.4 1,1�II:.�t, /'��{ ���� �y-n�l�Sf <br />imnr�t - ---- �---- f�.G.al�i , (��r. i: j ' z: , � � <br />unn aDnnfsv atr nn �,,,..�. — . <br />♦RCIIITfGTORpfGICNCR MRII�f�pqESS Q1Y <br />zm r�wNe <br />r,rr+enni c-oNrnecTon �en �onness �i�� ��� <br />rr�nN� si��EticcNse� <br />uFc�uwcni.coNinncton r�ai�oonrss an 7ir mioNr staruc:Nse. <br />U�,�lir./—(11`1 (1�» /i..�� /!,.�. �1 E. L.,��:.G..��il�. L.� c,l��t y55��a� Uii �t�lYb'�PF <br />rivuaiNocorurnect n MniinnonEss �i�, li� <br />rr�oNF srr,rEur.eNse. <br />conrnncr <br />.,_.,.,....._ ...,....,,�.�,��.,,.�c rw�na� mvuivrn <br />1' f�^ � �n.�. (�, i � <br />rnoroseo use or ounniNa <br />I fO�l DESCRIPiIOH pF PROP! <br />�or ma:K <br />PnRCELTA%Ift NUMPER <br />C.�e-c' F1�,�� <br />l OW OP �TiPCII i WO COPIEF <br />or <br />GONSTRUCiION LOAN I ENt1FR, �DOBF.55. TElEP110NE NUMOFII <br />TYPE OF FIXTURE Ofl <br />WATER CLOSET �TOILETI <br />KITCHEN <br />LAUNDRVTRAY <br />CLOTFiES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACNFLOW PRGVENTERS <br />SINK (SERVICE — �AR. ET <br />SUB TOTAL S <br />PERMIT $ <br />iOTAL FEE S <br />FOR OFFICE USE ONLY: <br />rnoNr crmnr« nrnn srroncK sine srTnacx <br />U�F 7Q:': <br />HfI011t UMli�ilON <br />OGCIIDeNCv HU C <br />,nour <br />nRf eUfiM AE00 <br />ri��F srniN��iEn ne <br />rrre or covsr <br />ior�nr� <br />NO Or Pwf I I �qG <br />IINIIS <br />s:u� <br />HEATING SYSTEM: I I GAS I 1 ELECTRIC f�l <br />CUNIA(1t PIliSON�NO PIIONF NO <br />I HEREBV CERTIFV TNAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND HNOW THE SAME TO BE TRUE AND CORRECT ALl <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN Oii <br />NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO CIVE <br />AUiHORITV TO VIOLATE OR CANCEI Tl1E FROVISION OF ANY <br />OiHER STATE OR LOCAI LAW REGULATING CONSTiiUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION, THAT I AM AUIHORIZED DV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1P.27 RCW AND 296200 WAC. <br />x�-�^� � ���� �r-��-��� <br />SIGN�iI1RE /' O�iE <br />U <br />f.11Y pUSMC55lICENSC NO - <br />N0. TVPE OF FI%TURE OR ITEM FEE <br />A/C —AMNDLG UNITS — H.P. <br />FORCED AIR SVSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES ORYERS <br />VENIILATION FAN <br />RANGEHOOD <br />,3 WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WO00 �URNING) <br />FIREPLACE INSER7 (WOOD �URNING) <br />GAS FIREPLACE <br />GAS RANGE <br />EXHAUSTFAN <br />SUB TOiAL E � <br />PERMIT S �— <br />TOTALFEE S <br />ri�r�curesNun+nrn �rrF IRGCFlPTNO <br />vncav�snr <br />I � vF5 � � i�u <br />flU11DWC <br />�ire or num-� i <br />Pl1IMPMG <br />���A�� OASEMENI MEGII�NICAI <br />I1vF.s II No <br />ADO�IIOH�L PL�N C11F.CK <br />on�Fn <br />siarz Aunoiaa suncn�nr,e <br />iovmer CITY OF EVERETT runur,rronKs <br />LOCA'.SALES — <br />TAX CODE IS 3105 TOTAL <br />