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APPLICATION FOR CONSTRU�:.JN PERMIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3700 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />i I DEMOUTION i COMBINATION i i BUILDING 1 MECHANICAL x PLUMBING I I SIGN <br />PROJECT ADDRESS _ , , „ <br />1V " <br />t <br />G[NCtIAI <br />�LEG <br />iot <br />unnenonrsc cnr <br />�(��IM-Vl. _g ZQ�L' <br />unn nnf rs; rirr <br />������L1�� <br />� on nesir�rtn Mn i �nnness arv <br />�� <br />lqNtR�Ci0f1 MMLPOpPfSS ���� <br />I�� <br />� CONIRALiOf1 M�IL�DD�E55 CITV <br />(� <br />f.ONIfiPCIOfI MAILADpRE55 ^^ ����� <br />� �l�J �L <br />P IOEOf_W 1N �� y <br />V1� � t � <br />WpRK AND SOU�PF. FOOT�f,F OIVED <br />��:�.±�„v.c� ,,�,-�c�.l,,r116-ttiu,l w�v'r-1.�;:i. <br />� use or nunoiNo <br />� <br />�;c irtion oF rnorenrv isr+owN eeiow on errnc�� iwr� cories� <br />OIc�C.N � Of <br />� � V�S� VY <br />% D 1MOFR <br />��� - CX>l - C�C- [�� <br />.710N 1 O�N LENOLf1. �DDRE55. TELCPIIpNE NUM�FO <br />TYPE OF <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASI <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRY TRAV <br />URINAL <br />DRINKING FOl <br />FLOOfi DRAIN <br />DACKFLOW PI <br />— �AR, <br />FEE <br />SUB 70TAL 5 <br />PGRMIT S <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />fROHT5Fit1�fN �FAf15fT0ACN <br />15ElONF �n����� <br />11[IGNT UMII�TION NO OF UW[LIMG <br />IINIfS <br />OCCUPANCY NO Of S10Ri[5 OCCII�� <br />GROUP <br />FlREAURMREOD �EASON <br />FIRF.SPPINNIERRFOD �F.�SIXJ <br />TYPE OF CONST PUNS � <br />URif <br />sine sEToncK <br />YRC�Nf Sllf <br />n/r/� rnonr /� 1 ��Z.ixO/���0�5' <br />S1.[S_��fLL�J��nr.�F' iI.��2"1 � "l� � <br />,—•�ir�._l,l1A•�_,�?40�3 355-Sv�- <br />JiP PI�OY[ $UtG UC[NS[ • <br />nn i'110Nf STATE lIC[NSE � <br />r�+one <br />HEATING SYSTEM: I i GAS ! I ELECTRIC f! <br />��"��'� OL'TT <br />I HEREDV CERTIFV THAT I NAVE FEAD AND ExAMINED THIS <br />APPUCATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TFIIS TVPE OF <br />WORK WILL BE COMPLIED WITIi WHETHER SPECIFIED HEPEIN OR <br />NOT. THE GRAN7ING Of A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />� THER STqTE OR LOCAL lAW REGULATING CONSTRUC710N OR THE <br />PEAFORMANC[ OF CONSTRUCTION. THAT I AM AUTHORIZED �Y THE <br />OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE ANU I COMPLY WITH TN[ STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />1:L��s�_.,.�t._ i-�z_-�,g <br />61�Nni111� Q�^ ,O OAIE <br />❑tYPU5MC55lICEN5CN0 u <br />MECHANICAL <br />N0. TVPE OF FI%TURE OR ITEM FEE T <br />MC —A/HND�G UNITS — H.P. ' <br />FORCEC "'R SVSTEMS—B.T.U. M E.A. _ �_ <br />HEATr'UMP ' <br />UNIT MIEATERS — B.T.U. M ' <br />CLOTHES ORVERS � <br />VENTILAiION FAN _ ' <br />RANGEHO00 <br />WATER HEATER <br />WOODSTOVE <br />METALFIREPLACEI <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />FAN <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE S <br />rinr�c�i[r�Nu�+nrn �reE InEcemtNo <br />IIY[S I, Nn pUIlU1H(i <br />sire or m.orii <br />riuvni�+r <br />PASK'CNL MECrUNIC�I <br />IlY[5 Il NO <br />ROUIIIONM PIAN C�Ik'.K <br />O�HF.R <br />SUI[ BUIIDING SUnf.1U11GE <br />CITY OF EVERETT runur, vronKs <br />LOCALSALES <br />TAX CODE IS 3105 � TOTAL <br />