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APPLICATI�.N FOR CONSTRUC'. �ON PERMIT� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-B810 <br /> f-1 DEMOUTION f 7 COMBINATION f� BUILDING �AECHANICAL �i PLUMBING f � SIGN <br /> PROJECT ADDRESS <br /> ��-�G � �i,l �f�/ -�:�.�== �� �Y�3�C./ <br /> OWNER ,� AppRE55 Cltt ZiP PH0�1C <br /> �/ �i � � <br /> �L�,�f l> �.�7 y /��'� l�� aL',� /7�/ _��r..�"r� � � <br /> lENA4T n � MAILP�`U/RFSS ��� i�P i'NON6 <br /> ���uL/f �C�� I U��� <br /> �RCMITCGTUFDFS�GNC� MRIIF pllE55 CITV 7i� PNONF <br /> cENErwV11111t�LyJ1 tt�ILnIf1L111C1�. 'I�M (]iv r�r rHo• . 5r4[IICI"qsE. <br /> ��� �i��Z <br /> MECH .. 0.1Qf . �1 CITY t lIC P�IONF GTAtEUCENSE� <br /> s�ntF wa sa�se <br /> PLUMBING WNIRRCTOR MRIL�DOfiE55 C�TV Tlo MIONE $TPTE 11GE�5E� <br /> cor+mect rnic�or wor+K� � • HEATING SYSTEM: �GAS � I ELECTRIC f l <br /> , — � <br /> DESCRiBF W�K FNb SOUARE F U E INVOyV� CONiPG :ASON A���HE N �n/, ,, ���/����/ -//� <br /> � v �� <br /> ��� �i1"i i �/-/� �� �GL .'a��SL�� � . <br /> .) ) i / '� � i :/' <br /> — [' i / � <br /> I HEREOY CERTIFV THAT I HAVE READ AND E:tAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PRM'OSEDUSE OF BUILDING PROVISIONS OF LAWS AND OFiDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIFD HEREIN OR <br /> LEWLDESGRIMIONOFi'FOPEAn'(SNOWNBELOWORATIRGHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�VE <br /> ior e�oc�c or AUTHORITY TO VIOLATE OR CANCEL THE PROV�SION OF ANV <br /> OTHER STATE OR LOGAL LAW HEGULATIN6 CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNEP OF THIS PROPERTY TO PERFORM THE WORN�. FOR WHICH <br /> APPLICATION IS JdAUE �D I COMPLY WITH THE STATE <br /> P�RLELT�%IO.MIMBEN J ' CONTRACIOR 7 CW 9E200 WAC. �) / <br /> S - '1 - " ;�7G y � (. J <br /> CONSTRUCI iON 1 OnN l ENUER.IIDORESS.TEIEPIIONE NVA1pER X — <br /> SIGNA1lIR �� � <br /> GTY pU51NE5'il.iC[NSE ND <br /> PLUMBIIiG MECHANICAL <br /> Np, TYPE OF FlXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ----�— <br /> WATER CLOSET(TOILET) A/C—NFINOLG UNITS—H.F? ' <br /> BATHTUB � FORCED AIR SVSTEMS—B.T.U. M E.A. �_ <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UIJIT I�EATERS—0?.U. M ' <br /> KITCHEN SINK 8 DISP CLOTHES DRVERS ' <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRYTRAY { RANGEHOOD <br /> CLOTHES WASHER � WATER HEATER — <br /> UFINAL WOOD STOVE � <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BUANING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PHEVENTERS ; GASFIREPIACE I <br /> SINK(SERVICE—BAR.ETC.) GAS RANGE <br /> GAS PIPING <br /> i EXHAUSTFAN <br /> i <br /> � <br /> � <br /> � <br /> � _ , <br /> � <br /> SUB TOTAL S i SU�T0TI1L $ i � <br /> PERMIT $ � PERMIT <br /> i <br /> TOTALFEE $ � TOiALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> ��E aFr.rirT No <br /> fRONT SFTPACH RERft SFTORCN SIDE$EiAPf.N �I�N CHCCN N M5� <br /> FEES VALUATION FEE <br /> use zot+E iot enen vncaNr sne , <br /> i ives i� No nminiNc � <br /> H[IGNT IIMItA7�GN NN'OF UWELIINC 5�2E Of pllNi�I i <br /> PIUMPIhC ' <br /> 1 <br /> 1 <br /> Oc.:urnNc:� rvi o�smra�s or.cunnNr ionu nnseMcr+� irrriur+icni :_ <br /> cnour — - - ' <br /> IIYES i� Mn � <br /> ppp111pNA1.f9AN W�f.�K i <br /> f�REAUPA�IICOT fifA50Y � <br /> O1HCIi � <br /> � � <br /> fIRFSPRINNI[RAFOD ��A��N S1AlEt1U�l0ICG511AGNA0GE � <br /> i__ <br /> tvPEorr.oNsr rinNsnrrnovennv CITYOFEVERETT rmi�r.wonKs _:_ <br /> LOCAL SALES — — ; <br /> i��ji TAX CODE IS 3105 70TAL - <br />