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APPLICATII �i FOR CONSTRUC7 _JN PERMIT <br />CITY OF EVEFETT • BUILDING DIVISION � <br />3200 CEUAR STREET • EVERETT, WA 98201 • 259-8810 <br />O DEMOLITION ❑ COMEIINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br />PWMBINGCONTHICION YMLA�ORESS CIT' ZIP P110NE Si�1ELICENSE• <br />CONTMGfVRI�EOFY/OnK ��\Il'�� <br />1(� <br />OESCPIOE WOfiK �NO SOUARE FOOI/�GE 111VOlVED <br />CpISTf1UCT10N IOIW lENOER. IJ1d1E55. TELEPHONE IN NBER <br />PLUM81N6 <br />NO. TVPE OI <br />WATER CLOSET <br />SHOWER <br />KITCHEN SINK 8 DISP <br />CLOTHES WASHER <br />URINAL <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINN ISFRVICF —RAH. Fl <br />FOR OFFICE USE ONLY: <br />fPON� SETO�CN REM SF.TBAGN <br />USEId+E �orenen <br />IIEIGII! UMIGTIUN NO OF DWEtUN6 <br />UNIIS <br />OCCU�'ANGY Iq(%SIM45 OCLUPANIlO�D <br />GRWP <br />FIPESPRINNLEPPEO'0 �F�50� <br />flNEAIMMREOD ��FAG(Nl <br />IYPEOLf,ONST �UNS�PPPOVEI <br />OAIE <br />FEE <br />HEATING SYSTEM: �S ❑ ELECTRIC ❑ <br />CONT�CT PE�SONAMD PNONE NO _ �__ <br />I HEREBY CERTIFY THAT I HAVE READ AND C%AMINED THIS <br />APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING T. :IS TYPE OF <br />WORY, WILL BE COMPLIED WITH WHETHEH SFECIFIEfi r1EREIN OH <br />NOT. THE aRA1�ITINO OF A PEHMIT DOES NOT PRES�ME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTAUCTION OR THE <br />PERFORMh4CE OF CONSTRUCTION. THAT I AM AJTHORIZED BV THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS �E �l 1 COMPIV WITH THE STATE <br />CONTRACTORS W 1B. �W 1ND 296200 WAC. <br />� / ^% r <br />x - <br />SIGN�IUfl � E <br />CIiY BUSINESS tICENSE Ilp <br />NO. TYPE OF EhUIPMEHT FEE <br />A/C—A/HNDLO UNfTS <br />FORCED AIP SYSTEMS <br />� UNIT HEATERS <br />� CLOTHES DRYERS <br />� RANGEHOOD <br />; WATER HEATER <br />i WOO� STOVE <br />� METAL FIREPLACE ( <br />� FIREPLACE INSEFiT <br />� GAS FIREPLACE <br />; GASRANGE <br />GAS PIP�NG <br />EXHAUSTFAN <br />TOTAL S � <br />MIT S � <br />�L FEE S <br />S�UE SETB�CN <br />WC�NI SIfE <br />❑YES ❑ NO <br />SIZE OF B100R1 <br />BASEMENf <br />❑vE5 ❑ NO <br />S <br />S <br />PlANC11ECNNUlABE11 IfEF I�ff.fIPINO <br />/�'��.)t� � <br />J <br />OWIfIINC <br />VlI1M01N6 <br />MECN�NILQ <br />�DO� IION�L i'l AN PRGN <br />OL�Ef1 <br />St�IE OJII�INR S�IOCIUfIGE <br />CITYOFEVERETT �`��p��r�^�� <br />LOCAL SAI.ES <br />TA7( CODE IS 3105 rora� <br />