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APPLICATIV�1 FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETf•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 9d201 •259-8810 <br /> fl DEMOLITION �l COMBINATION fl BUILDING fl MECHANICAL �PLUMBING f 1 SIGN <br /> PROJECT ADDRESS ' o � <br /> � 5 � s GiJ CG�Q,[�u.c F--�i'' �r�-e�.t � l✓,� %67v �/ <br /> OMRIER M�IL�WAF.FS C11Y IIP PNON[ // <br /> Cu-.SFi„vg TL-°a aZ�is /� C��S�.ve k'd �reu /� �A ' S62D�L <br /> TEN�Ni\ � MMI�WnF.55 nTY II� PHONE <br /> Ulih/n�iS r?20L�tcrv� Si4 � 2 <br /> �qGNIT[�f OR OESIONEfi MPII�IT�RE55 CiLY TIP PMONE <br /> OEMEf1/�:CONTO�GIOfI MML�IXlOE55 CIIV lin pIIONE SUiELICENSE� <br /> �iiiGvt �n C�Div��. S<<�s %CS' .s" a ..�a 5� 2,���t��T /r� �aF+.rPOSto77�t� <br /> MECH�NIC�I CONTR�CTOfi M�IL�DDRESS LIfV ZIP P110NE ST�TE UCENSE� <br /> PLUMBINOCONIR�CTOR M�IL�ODAE54 :IIY 21P PHONE STATEIICENSEI <br /> �pNTMCT PRICF OF VIORN <br /> HEATING SYSTEM: f"I GAS �I ELECTRIC fl <br /> OESCRIBE 1Wi1N�ND SdARE FOOUOE INVOLVEO CONi�Ci PFPSq111NU PNONE NO <br /> 9t�D s F %�NANT i�?��.,r„r ��,�li,,,� :2s�-y'6OS <br /> I HEREBV CERTIFV THAT I HAVE �;E4D AND E%AMINEO THIS <br /> PROP09E0 USE OF BUiIDINO APPLICATION AND KNOW THE SAME TO Ot?RUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIo TYPE OF <br /> ' WORK WILL BF COMPLIED WIiH WHETHER �ECIFIED HEfiEIN OR <br /> LEOAlUESCRIPIIWOFPR01FfITY�SNOWNBELOWOR�TTAGHTWOCOPIES� NOT, THE �RANTIN� OF A PERMIT DOES NOT PRESUMG TO GIVE <br /> ior aiocK ov AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> . OTHER STATE Oq LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8V THE <br /> OWNER OF THIS PROPERri TO PEHFORM THE WORK FOR WHiCH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PMCEI TM ID.NUMBEP CONTRACTOFS LAW 18.27 RCW AND 796.200 WAC. <br /> CONSTqtIClION IO�N LENDER.�OONESS.TELEPNONE NUMBEP X��iF'����f- pI-�� /" <br /> SION�TUR '� s� D�TE <br /> OC�Y <br /> LI fY BVSINESS IICENSE NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF fll(TURE OR ITEM FEE NO. iYPE OP EOUIPMENT FEE <br /> / WATERCI.OSET(TOILET) � A/C—MiNOLOUNRS—H.P. <br /> BATHTUU ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> / LAVATORY(WASH BASIN) � HEAT PUMP i <br /> SHOWER UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRVERS i <br /> DISHWASHEii � VF.NTILATION FAN � <br /> LAUNDf7Y TRAV � RANGE HOOD i <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAI � WOOD STOVE ' <br /> DRINKINO FOUNTAIN i METAL FIREPLACE(WOOD PURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WO00 BURNINp) � <br /> BACKFIOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVICE—BAH,ETC.) � OAS RANGE � <br /> ' OAS PIPIN6 ' <br /> i E%HAUST FAN i <br /> i � <br /> i � <br /> i � <br /> i � <br /> SUB TOTAL E 1 ' SUB TOTAL E ' <br /> PERMIT E V � PERMIT S i <br /> TOTAL FEE S � TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> fRONT FETfl�CN RER1 SFTB�LK SIDE SETBI1C1t PUNCIIECk NUINOFR fFE �ECFIPi NO. <br /> J �7h� <br /> useioNc �menen V�C�NISItE FEES VALUATION FEE <br /> � fIYES I: NO <br /> _ OUILDMC � <br /> NE16NT IIMITIITION NO OF DWF.LLINO 512E Of B100R1 i <br /> IINIIS pU1M(fINO _ i <br /> OCCUP�N(;Y NO(M S���FS OCLUP�NI�p�U P�SEAIENI MFCII�NIL�I <br /> OROUP <br /> f1YE5 II NO - � <br /> FIRE�UPMNEOD RF�SON �DO�110N�i.P1.�NCMFf,N i <br /> —�-- <br /> Olr1En � <br /> iIRFSPRINNLERRE00 RF�Sfri — i <br /> SIAIE BIIIl0�N0$IIfIC11AR6E 1 <br /> _ �� <br /> rvveovr,or+sr r�nNs�rrnovFnar CITYOFEVERETT rupucwonKs � <br /> LOCALSALES — -- ----'— <br /> „�,E TAX CODE IS J105 i07AL I <br />