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APPLICATIOr! FOR CONSTRUCT.ON PERMIT <br /> CITY OF EVERETT•BUILDING D(VISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-8810 <br /> fl DEMOUTION I� COMBINATION rl BUILDING �� MECHANICAL �, PLUMBING f i SIGN <br /> PROJECTADDRESS ����.���G ���, �—�C��TT wl7' 9�`� �-0� <br /> orvr+ea unn woacss cin iv rr+�+c <br /> ��Y���'��`-� �7zs col/>y,rve �vc��� Yd10 arz -o.�!' sc <br /> iEN�NT �/ MRI14DOpF55 CITY ZIP PMqaE <br /> N% lL��r� ya K.' a7?.S o L=v� ef� Y�.,�a.� i� y — o �'oo �' <br /> A4CNITfGTORpE51GN[F MRILApUFE55 [ITY JIP PHO��F <br /> ' '[�1 <br /> G[NCML CONiMQOR MMl RppR[SS pfV :Iv r �r � ,ciAiF IICFNSF• <br /> l�-��Ss�k •30�? a��Aoc,u 5'�4��/e 9l/�1 A14�-r-�s��Yo o�s- <br /> MECHANiGAI COMFA�Tpp Mn R�OPE55 LiTY 71P PHONE �1niF UGCNSE• <br /> PWMBING CONTRRf,IOq N41110�RE55 C�TV 71P PNONE STRiE UCENSE• <br /> CONt T PRIG O�wOnN <br /> HEAi ING SYSTEM: f �GAS '"1 ELECTRIC f� <br /> DESCPIDE WOR✓.nND SW/AF.FOOTnGE INVOlVEO GONTnGT ttiR50N�NO PwJNE NO <br /> ��� � <br /> 1 HEREBV CEFTIFV THA7 1 HAVE FEAD AND E%AMINED THIS <br /> PROfO5E0 USE OF BUILDING APPLICATION AND KNOW THE SAME TO HE TRUE AND CORREG? ALl <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WI7H WHETHER SPECIFIED HEREIN OR <br /> .' LEG�lDESCRIPf10NO�PRD1'EHTY�SHpWtIBELOWORAiTACNTW0001'IES) NOT. THE GRANTING OF A PERMIT DOES NO1 PRESUME TO GNE <br /> ioi Biocu ov AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OA THE <br /> PERFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH <br /> APP�ICATIOIJ IS MADE AND I COMPLY WITH THE STATE <br /> PIIRCELiA%tD.Mn.1BER CONTRACTORS lAW 1827 RCW AND 296200 WAC. <br /> CONSTRULTpN IO�N LENDER.�DOf�E55.7ELEP110NE NUMBER x G/ -,-� <br /> SIGN�t11ilE OATE <br /> CITY 6USMF55 LICF'!SE ND <br /> PWAASING MECHANICAL <br /> NO. TYPE OF FI%TURE OR I7EM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSE7(TOILET) A/C—AMNDLG UNRS—H.P. � <br /> _ BATHTUB � FOFiCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATOiiY(WASH BASIN) HEAT PUMP i <br /> SHOWER � UK�IT�HEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP i CLOTIiES DRYERS <br /> DISHWASHER VEN !LATION FAN � <br /> LAUNDRY TRAV � AtJGE HOOD � <br /> CLOTHES WASHER WATERHEATEF � <br /> URINAL � WOOD STOVE ' <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ; <br /> SINK(SERVICE—BAH.ETC.) � GAS RANGE <br /> ' GAS PIPING � <br /> i E%HAUST FAN i <br /> � � <br /> SUB TOTAL $ SUB TOTA� $ � <br /> PERMIT $ � PERMIT S —i— <br /> TOTALFEE $ � TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fRONTSFTPRGK RF�BSETAACN SIDESETPACft PIANCI1Ef. UMAff1 fFF FFCFIPTNO <br /> ����J <br /> usezor+[ toiane+ WCANISIiE FEES VALUATION FEE <br /> IIYES li NO � <br /> flVIIpING � <br /> HFIGNT LIMIUiION NO O�OWELUN6 SI2E Of BIOGRI <br /> UNifS PLUMBM6 i <br /> GHOUO�NCY NO(I45�OFiES OCGUPAM LORD BASEMENt MECM4NICRl � <br /> IIYES �1 NO � <br /> FlREAUFMREO'0 f1F�5pY AOD�110NALPlANCNF.CN � <br /> ou�En � <br /> fIRF.SPRINNIFRRf.00 RF�40V I <br /> � <br /> RTAIE BUIIDMf SUi1C11RR0[ i <br /> tYPEOfr,ON9 rinNsnrvnovsnor CITYOFEVERETT �'���UCWORNS <br /> LOCAL SALES — -- <br /> �„rE TAX CODE IS 3105 TOTAL <br />