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� <br /> APPLICATION FOR CONSYRUCTIQN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISIO!d �C��� <br /> 3200 CEDAR STREET• EVEFiETT, WP.99201 •::;,!�•8810 ��� <br /> f I DEMOUTION f 1 COMBINATION I � BUILDING ��MiSCHANICAL i ' PLUMBING f I SIQN <br /> PROJECT ADDRESS < � <br /> 112`� `�-^. C l� Srrm <br /> ovmrn Men.eoor+ess cirv rr rrromr. <br /> ��N,• CrN�- ��Jc, � 1rz'z `i� �1i�� �•� e.�2� . 33�1 -e93s <br /> iFN�NT u.n ennnvxs nn ,-��- r��oNF --- <br /> �ncNrtecron�sienin rn.��•nnness - r,nv nr ���car --� <br /> f:ENC11Pl CONipnCiOfi M�il��pRC55 ;�.Ilv piP nV)4i. cfa(IICENSF� <br /> .l7�4—rr 4-- <br /> MFCN�NIUI CONTR�f,iOl1 MAq ApOPF55 ❑1V )IP P11CNf STQf IICEN[F� <br /> :S�A'YVi� <br /> PI IIMPING CONIRPC70N Nnq eppnE55 GfY IIP pIqNE STAIF.UCENSE� <br /> CONTMCT PNCE Or WD111t <br /> HEATING SVSTEM: I �GAS � I ELECTRIC I 1 <br /> DESCRIpE M/ORN�NO W�IIIRF�OOT�6F 1NVIXVED CONi�Ci P!nSON eN0 PIIfN1F NO � <br /> _. ♦1�p_^� S <br /> teo� r. � <br /> I NEREBV CERTIFV THAT I HAVE REA� AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROPOSFO USE OF pItlLDRf� FROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS iVPE OF <br /> � ' ��'�� WORK WILL tlE CUMPLIED WITH WHETHER SPCGFIED HEREIN OR <br /> �eae�oescnirriorianaorenrvis�rovmneiowoaertecNiwecoviasi NOi. THE GRANTIN6 OF A PFRMIT DOES NOT PRESUME TO 61VE <br /> iot 1 n�ocr or AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF �NY <br /> �p �L OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> f �-�T C'�r G (a-2� C�Re-S r� PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTIiORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE aND I COMPLV WITH THE STATE <br /> reac¢i.Tex i n NUMncn CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> � /�/�c <br /> CONSIf111CTIONl011NIFIJOF11l1WAE55.�FLF.P110NENUMflER „ �~� � 1 ✓ <br /> _ 91fiN�iU IE DMC <br /> f,ITY PUSM(55l ICCNSC NO <br /> PLUMBINO ` MECHANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C-AMNDLO UNITS-H.P. �^ <br /> BATHiUB � FORCED AIR SVSTEMS-B.TL. M E.A. ' <br /> LAVPfORV(WASH BASIN) � HEAT PUMP —�— <br /> SHOWER � UNITHEATERS �-B.T.U. M � <br /> KITCHFN SINK 6 DISP � CLOTHES DRYERS i <br /> DISHWNSHER VENTILATION FAN � <br /> LAUNDRY TRAY ; RANG[HOOD � <br /> (:LOTHES WASHEH WATER HEATER � <br /> URINAL ' WOOD STOVE <br /> DHINKIN6 FOUNTAIN i METAL FIPEPLACE (WOOD BURNING) i <br /> --+— <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD OURNINd) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ' <br /> T <br /> SiNK(SERVICE-BAR.ETC.) GAS RANGE � <br /> �--- <br /> GAS PIPING <br /> _ <br /> i ERHAUSTFAN � <br /> __- — - <br /> ____ - - <br /> SUB TO1AL S � SUB TOTAL f ' :7 � ' <br /> PFRMIT S � PERMIT S / �. � � <br /> TOTAL FEE S � TOTAL FEE f 7� ' - <br /> FOR OFFICE USE ONLY <br /> fRONtFFiP�f.k f1F�flGFiflAf.k SlfkGfih�fY. PI�NCI�Ff.NNl1MBT ffF �(-� �ff.FIPfNO <br /> ���J(j <br /> uSPtor+r iotnn[e v�c�qt :nv FEES VALUATION FEE <br /> "--' --_—_ __ _—._—T_ <br /> ��vFF '�Nn piIIIf11N1: � <br /> i <br /> IIE1011IIIMITAl10N NUOiUWFLLIIM SiZEOfPtI%TII ---"�"-�--'--- � - � � � <br /> UNIIS PUINHI4G � <br /> _._ —__ --_--_. _ _ . __—�—_._ <br /> OCCIIIMN(:v M')015ryrq5 OCCIIP�NIIOM� P�SFMf'�t NFIAI�Mf.�l � <br /> r,nam � <br /> i IYFS i i NO —_ ____ .._.__.—_—". . . .. —..—.. • ... <br /> fIRE�U11MnFOlt nf��t�Y npUi110NM1`I�NCr1ff,N i <br /> _ —_-- ___"___�-- _ <br /> nt�rtn <br /> nnvsrnmKiFnnron-- mn�nm — -- � ----- �--- <br /> �rmr nun invc sunr.run,c <br /> ._____ _—__. __ __ _— —__. <br /> tvrForcor+s� � rinHs�rrnovrnm CITVOFEVERETT ���m �-.vi �r � <br /> LOCALSALES -_ _—. _ ._ _ _ _ 1___- <br /> ,,,,, TAX CODE IS 71�5 iotnl L � <br /> ------ -- -- — -- - - -_ _ _ __ _ ,_ _ _. <br />