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APPLICATIL.d FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259•8810 <br /> fl DEMOLITION f 1 COM�INATION 16'�UILDING f�qfECHANICAL I�1�PCOMBINQ f 1 SIaN <br /> PRO,IECT ADDRESS <br /> T- l'f�S�.Uo �O�A�`ejr..f'df'Lf.f <br /> owr+en uai��ooness cirr ��r rHonE <br /> Ca. /'-r14�'��C at.�'. �s.t_ �/(-z// �Yl'Th A�-J'_ .ra.l� �/�t� t B o1 t y 8/—�if S�5/ <br /> iEN T 61MI�pDRF.55 GIV IIP {`NONF <br /> 11Pf,11�O�E�iNER MML.VIORE55 CITV ]IP PHONF. <br /> ���/ l���/�.i/ sy_4.�'�,/� $�7���i 5� <br /> OENFP�LCONTMCTOR MAll�0Uf1E55 CItV ]�P PIIONF. ST�TEUCENSE• <br /> wI�2S���ST7,tJ�. 2/�n �iJ�'"IhtfL �Tf!LL ��0.2/ Yf�/-�iS�'r� L/iT'.�/�(TC��S�U <br /> MECN� 1 A CONTRACTMI MML�IXIRF.SS CITY 71P P110NE ST�iELICENSE� <br /> �.J�Tj4�I1c C CWST !�✓C. <br /> °WM�INOCONiR�CTOR M�IUODRESS CIfV 21P PNONE Si�TEIICENSE� <br /> s� _ <br /> .UNTR i PRICE DF WOfIN <br /> ��� _ HEATING SYSTEM: J1�8AS fl ELECinlC fl <br /> bESCRIBE WORN�Np SOUARE FOOT�OE INVOLVED CO UC PEPSON AND CNONF.NO p <br /> s — Ts� D��•�TAti�1 _ <br /> �� -r _ C2� !' - ��_ �rS/-yS'i4_. <br /> I HEREBV CERTiFV TW�T I HAVE READ AND F%PMINED THIS <br /> - - APPUCATION AND KNOW THE SAME TO BE TRUE AND:ORRECT.ALL <br /> PRO^OSED USE OF BUIILVNd PROVISIONS OF LAWS AND CPUiiJANCES 60VERNINO THIS'fVPE OF <br /> WORK WILL BE COMP'.fcD WTH WHETHER SPECIFIED HEREIN OR <br /> LEO�LL«CNIPTIONOFPNOPERTV�SNOWNBELOWOR�tt�CNTWOCOPIES� NOT. THE ORANTINQ UF A PEFMIT DOES NOT PRESUME TO OIVE <br /> �ot__aiocK or AUTHORITY 70 VIOV�TE OR CANCEL tHE PROVI510N OF ANY <br /> OTHEp STATE OR LOCIiL LAW REOULATINO CONSTRUCTION OR THE <br /> �54�� SCt 7 T �2��. C PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> ► � OWNFR OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> P�RCELll1% .NUMBEP CONTRAC10R5 LAW 1827 RCW AND 298200 WAC. <br /> �ONSiRUCT10N IO�N LENDEfi,�ODRE55.TEIER�ONE NUMflEA 6 * �� /r' Q�/ <br /> FION�tURE � �IE <br /> CIII WSMESSI�CF.NSE NO <br /> PLUMSINO MECI�4NICAL <br /> N0. TYPE OF flI(TURE OR ITEM FEE N0. TYPE OF FI.LTURE OR ITEM FEE <br /> T <br /> WATER CLOSET(TOILET) � �VC—NFINDL4 UNI1S—H.P. � <br /> / BATHTUB ' FORCEDniR5Y5TEMS—B.T.U. M E.A. ' <br /> � <br /> LAVATORV(WASH BASIN) � p HEAT PUMP � <br /> �_ SNOWER � v UNITHEAIEFS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRVERS i <br /> DISHWASHER � VENTILATION FAN ! <br /> �'j LAUNDRYTRAY � RANGEHOOD i <br /> CLOTHES WASHEH � WATEF HEATER � <br /> tU URIPIAL ' WOOD STOVE ' <br /> O OR�NKINO FOUNTAIN � (� METAL FIREPLACE(WP�D BURNING) —�- <br /> FIOOR DRAIN �- V FIREPLACE INSERT(WC,OD BURNINO) ' <br /> BACKFIOW PREVENTERS i QASFIREPLACE i <br /> SINK(SERVICE—BAR,ETC.) � OAS RANGE ' <br /> ' �AS PIPINO ' <br /> , EXHAUSTfAN � _ <br /> � ' <br /> -- � ' <br /> � <br /> —— � � <br /> SUB T07AL E )� ' SUB TOTAL S ' <br /> PERMIT E � PERMIT S �_ <br /> TOTALFEE 5 ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: SIL Ili <br /> FRONT SERf�CN / �EM SETB�LN SIOE SETB�CIt / PUN CIIECN NUMIfFR FEE RECEIPT NO <br /> 2/ � C — /09 3 <br /> USE ZONE ior�ne� WC�Ni SI1E FEES VALUATION FEE <br /> �` I /3 (3 I1VF5 fl NO AUIL�INO S � � �/ � <br /> NE1011LIMIT�TIOf UNITB ��INU S�ZEO�BLO(irtl �1i5 SF + <br /> �17� SF CaA� rwuewa <br /> a CUP�NCY Iq Of510�E5 OCCUP1N7lO�D B�SEMENI MECHINIC�L <br /> 3 q n rEs n r+o � <br /> FIPE RMREOD NE�SON ��D�TION�LPLANGIICCK _ <br /> '� ' ' 07HER I � % <br /> FIRESPRINNIERPF.O'0 e�50N -�� � <br /> �� - ST�IE PI1IL�ING SUf1CN�IlOE ) <br /> Nst .a Ns�rrnqv.�er CITY OF EVERETT runuc wonHs - <br /> �r7� �J,�� LOCAL SALES _ <br /> �1--IJ o�ic 12 TAX CODE IS 3105 TOTAL '2 G"E ' <br />