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�' APPLICATIVr1 FOR CONSTRUC? �ON PERMIT <br /> CITY OF EVEAETT• BUILOING DIVISION �.-/ <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 d l <br /> f-1 DEMOLITION i 1 COM8INATION r i BUILDING f-1 MECMANICAL f 1 PLUMBINL', SIGN <br /> PROJECT ADDRESS <br /> �(�rnnn��Ess �7 cin zir rHovc <br /> /iEN �7E'�`-1/'f�I� �/"I SC�]�F c��L/��S � �Z [f�GL� /�(.¢ S �YJ <br /> � MpILADpqE55 ���f�L � <br /> GTY <br /> '< <1t�J7 tif,� f� v f3 a��s �- gz or,P_ ����3Y x�� Eii��3 ,�a� <br /> �RLNR[�7pnpF51GNFR MAllpDpqES <br /> J�����v Gltt liP � PHONF <br /> N � � <br /> �.K � , iSZ�� 5 '`"�T; 3la/o:'ixP+� �i,i "t�����-JJ� 5r.r�� �il 16� <br /> ICALC TRA� R N11L�DfMESS CITV �� � ' <br /> Z�P P��E STATf UCFNSE� <br /> r-9� y� -- �,2 �� � <br /> ri. erc�e ca,ranr,roa Mn nonaess arv <br /> z1P P�E STALE LICENSE� <br /> �ONiRACtP . F WnqK <br /> O� C HEATING SYSTEM: I l GAS f l ELECTRIC f-I <br /> DESCRIBE W N RN $OURRE FOpTAGE INVpLVED COYTRCT PFFSON AN�PHpNF.NO. <br /> �-4k►o �r,S� • � .oA . 1�.n-VllOGb <br /> .�'•tti,Jc R,,�� ry D SGt, � �rXa <br /> , Y1 bI 'v � HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> 'onoroseouse �niarx� APPLICATiON AND KNOW THE SAME TO BE TRUE AND CORREC7 All <br /> PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TVPE OF <br /> lEGl1LDE5CRIPTIONOFPqppEqry�g{py�rygE��WOqpnA�HTWOCOPIES) WORK WILL BE COMPUED WITH WHETHER SPECIFlED HEREIN 0/i <br /> � NOT. THE GRANTING OF A PERMIT DOES N07 PRESUME 70 GIVE <br /> wr e�ocn or AUTHORIT'� TO VIOLA7E OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT101J OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZ[D BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK Fl,�.ri WNICH <br /> APPLICATION I$ MADE AND i COMPLY WITIi ThIE STATE <br /> P�RCELVUf ID.MIMBEN CONTRACTORS I.AW iB27 FlCYJ AND 286.200 WAC. <br /> CONSTPUCTIpNIO�NLEN�q,qpp�E55.TElEP1qNENUMgF.q /� // b���,�t ����� <br /> ✓ X- ( F/ <br /> SIGNaTUfiE / � �qTE <br /> CITY PUSINC 5 UCE .E NO�� <br /> PLUMMIN6 MECHANICAL <br /> �• TYPE OF FlIfTURE OR ITEM FEE NO. TYPE pF EWIPMEN7 FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNOLG UNRS—H.P. r— <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i HEAT PUMP —�— <br /> SHOWER ' <br /> ' UNIT HEATERS—�.T.U. M � <br /> KITCHEN SINK 6 DISP i CLO�HES DRV[RS � <br /> DISHWASHEIi VENTIlAT10N FAN � <br /> , LAUNDRVTRAV � RANGEI100D � <br /> _ CLOTHES WASHER WATER 4EATER —�— <br /> � <br /> URINAL � _�yy00D STGVE i <br /> ' DRINKING FOUNTAIN :E7AL FIfiEPLACE (WOOD AUqNING) ' <br /> _ FLOOR DRAIN � FIREPLAC[INSER7(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GASfIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) � GAS RANGE —;— <br /> ' GAS PIPING � <br /> � E%HAUS7FAN <br /> i <br /> � <br /> ' — � <br /> � <br /> SUB TOTAL $ � SUB TOTAL S � <br /> PERM�T $ � PERMIT $ � <br /> _ TOTALFEE E � 7pTALFEE $ � <br /> FOR OFFICE USE ONIY: <br /> ('RMlTS4TpRCK PGAqSFTBACR SIDF:SETBnCN PIANCHE R IMOFP fCF RFCHPTNO � <br /> . ` <br /> usc ioN�� � nacn vncnrui sirF FE S VALUATION FEE <br /> J � L�G S f. i�vEs �No eull oivC T— <br /> i <br /> NE'�IT LIMIT�iION NO OF pWEILIN� SIIE O!BLJGRI � <br /> UNi1C <br /> � ,F l-�� � � PLUNIPINO i <br /> OGCIIPRNCY NO Ot�fORiES OGCUi'RNl LO/D 8.15EMENT � <br /> GROUP MECHANICAL � <br /> f1YE5 iINO � <br /> FlREALARMREOT qF�50N AOO�IIONnLfRRNC11/GR i � �i <br /> v <br /> on�en ; — <br /> nnesrniNHiEr�neo�� nFnc�N ; <br /> Si�fiF.tiIII1�14.oVRCNRRGE �/ <br /> V <br /> rvnEorcows�— vinvsavr`}��vrnnv CITYOFEVERETT runiir.wones <br /> �I—/��`I �� LOCAL SALES <br /> onie � TAX CODE IS 3105 � 7o7a1 � � �i <br /> A __ t, r <br /> � Y �� <br />