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APPLICATII�I FOR CONSTRUC�N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT. 1NA982o1 • 259-8810 �. <br /> / � ��, <br /> I I DEMOLITION ` i COMBINATION i BUILDING `— 1VIECHANICAL � PWMBING f I SIGN <br /> PROJE T AD RESS — — <br /> , � s - � ��c� ��/�� ���G << �-� � � ��,�s� � ,�a� " � <br /> owr+rn •\ // /ny iynrnm�ss crtv / nr ji E <br /> —�[� JD/I�i1� �( � �U�� C� h,�(� �0 i,L1', �� �/�,...�� �r.�C�'� �..� — �J r.j '� <br /> I <br /> 1[NRNt �aFI1.AD�PF55 CiIY liF Pllnqp <br /> pf1C1PTCCTORbE51GNEP MMLADURE55 CIIY ZIP PNOYE <br /> GENEP4LCONTRACTIX7 MMIApI��lf55 C�1Y ZiP MION[ STATELIGENSEM <br /> MECHAHIGAL CONTRACTOR F55 GiY ZIP PIIONE STFTE L�GFNSE t <br /> � 1A' � d�; �T„� ���c 3�nGl F„�� ���.�1C�'r= .�������� ��'� � 3'aQ/ <br /> L� N � � ��1y Zm PNo.1E SiATCL�cEr�SE <br /> PWM01��—�.GONTR/C10P MAILAODfiE55 �/ � � � /� _ �.`�^ <br /> lL �Y (� <br /> conrnnc.�nicE oF wonK D� HEATING SYSTEM: I '�GAS ( 1 ELECTRIC fl <br /> OESCRI9E WORK AN�SOUARE FOOTnC+E INVOLVED GONtACT F(n50Y A�lO PHONF NO <br /> 7-;,,. L-� �, <br /> /+ / / % �' S Q - <br /> ���'it n '�vn� �`/S 1 ('PT c7 � �> �i4 S -�' � � _ � � <br /> ` �d IG ��EBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �� � ,,� � U✓I l -O� �1P�� �l� � APPUCATION AND KNOW THE SHME TO BE TRUE AND CORRECT.ALL <br /> opUseouseoceuaon+c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF � <br /> WORK WILL 0[ COMPLIED WITH WHETHER SPECIFlED HEREIN OR <br /> LEGALDESCFIPTIONOFPBOPERTY(SNOWN9ELOWORAT7/AlITY/OGOP�E5) NOT. TH[ GRANTING OF A PERMIT UOES NOT PRESUME TO GIVE <br /> �pr 9LOCK Or_ AUTHORITY TO VIOLATE OR CANGEL THE PROVISION OF ANY <br /> OTIiER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTfiUCTION.tHAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TJ PERFORM THE WORK FOR WHICH <br /> APPLICATION IS NADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78?7 R W AND�0 WAC. <br /> PARCELTA%LU.NUM9ER � <br /> � '� 3�'S <br /> CONSTRUGPON LORN IENDEF.AD�AESS.TELEPMONE NUMOER X �Q"�"J DR E � ' <br /> SIGNATI� <br /> Gi1Y AUSMF.55 LICFNSf 110 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A�C—AIHNDLG UNITS—H.P. ' <br /> BAThITUB ; FORCED AIR SYSTEIdS—B.T.U. M E.A. _� <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOVJER � UNIT HEATERS—B.T.V. M � <br /> KITCHEN SINK 8 DISP i CLOTHES�RYERS ' <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDFY TRAV � PANGE HOOD � <br /> CLOTNES WASHER i WATER HEATER ' <br /> WOOD STOVE � <br /> URINAL � ' <br /> DRINKING fOUNTAIN i METAL FlREPLACE(WOO�BURNING) � <br /> i FIREPLACE INSERT(WOOD BURNIMG) ' <br /> FLOOR DRAIN � <br /> �ACKFLOW PREVENTERS i GASFIREPLACfl ' <br /> SINK(SERVICE—BAR. [TC.) � GAS RANGE ' <br /> � _�_ GAS PIPING � <br /> — ; EXHAUSTFAN ' <br /> i � <br /> i <br /> � <br /> � � <br /> SU�TOTAL 5 i SUB TOTAL $ i <br /> — PERMIT S i PERMIT S � <br /> — TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: arr.Eiv.No <br /> PLANCHEGKIJIIMOER fEE <br /> fPONTSETBACK PERR SETlfAGK 9UESETBACN �� <br /> USE ZONE LOT ARER <br /> vnCnr+*sn[ FEE VALUATION PEE <br /> IlYES (� t�0 (fUIIDINQ ' <br /> SIZE OF BLOGRI � <br /> NEIOMT IIMITATiON NO OF UWEWNO � <br /> UNIiS PLVMFlING <br /> OCCUPANG� t10 JF SiDFIES OGCUP�NT lOAO BRSEMENT <br /> MECNRNILAL � <br /> GROUP r7YE5 fl NO � <br /> AOUITION�LPUNCNECK i . <br /> FIFE AL�RM RE00 fiEA50N I <br /> OTNER � <br /> FIfiESPRINI4ERRE0'D fiEA50N SiPfE0l11L01N65VRG11AACE <br /> S <br /> � <br /> i <br /> 1YPEOFCONST. P�NSRPI'iiOVE�BY CITYOFEVERETT �'��A��CWORKS : <br /> LOCAL SALES TOTAL ' <br /> oAtE TAX CODE IS 3105 — <br />