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APPLICAT04rd FOFU COI�ISTRU�CTrON PERilA1T <br />CITY OF EVEFETT • BUILDING DIVISION <br />3200 CEDA!i STREET • EVERETT, WA 98201 • 259•8810 <br />fl DEMOLITION _f I COMBINATIOk f 1 BUILDING f� MECHRNICAL � I PLUMBING <br />ownen � Mn nD6nEss / . tm <br />�I���; v��` ����y �.��� ti� <br />7[NANi IApILA�DOF:55 CITY <br />�?_�,�1�,f��v_ 5���, h 9'z � ; <br />� �� � m�orve %�%� <br />,,, %n J�r-� AG / -lJ`� �/ <br />zir <br />� . ... rnync pIPIt UGLNtih � <br />PLUMBINGCONIPAf,TOR MAIL�ODRE55 GIIV ZIP PHONE STA7GIJCF.NSE� <br />wonk r,�ro <br />iot <br />o�ocH <br />wvo�veo n <br />OR ATiACH <br />CONSTHUCTIONIOANLENDER.RUDR[SS.TELEPHONENUMBER <br />516� ��" �/ <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOStT(TOILET) <br />B�STHTUB <br />LAVATORY (WASH 3ASIN) <br />SHOWER <br />KITCHEN SINY. 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CIOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />FLOOq DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. ETC.1 <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONTSETIIACK PEMSF.TBACK <br />USE20NE L07AHE/. <br />IIEIGIIT LI�TION NO OF DY/ELLING <br />❑NII$ <br />No o� S�cnEs <br />�f-A504 <br />uare <br />SIDE SEiBRCN <br />VALAHi51IE <br />fIYES fl NO <br />szE or oi�m <br />IIYES 11 NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />HEATING SYSTEM: I l GAS f-1 ELECTRIC f I <br />cor�rnerrensoNnrio� orveNo /� ��1n / <br />�. /lY'I,'M L/ � � /.o // l�, i"- <br />� s�o -iis^v <br />I REBY CERTIFY THAT I HAVE READ AND EXAAIINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH 6YHETHER SPECIFIED H[REIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br />AUTHORITY TO VIOLATE OR CANCEL THE PFOVISION OF ANY <br />OTHER STATE OR LOCAL LAV! REGULATING CONSTRUCTION OR THE <br />PERFOflMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED OY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1027 RCW AND 296200 WAC. <br />X �?-�y�7, �e,�%�j� /� 22� 1� <br />9Q+41UPE OnT[ <br />CITY DUSRlESS UCENSE NO. <br />MECHANICAL <br />NO. TYPE OF EqUIPMENT FEE <br />A/C — AMNDLG UNITS — H.P. � <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br />HEAT PUMP , <br />UN�T HEATERS — B.T.U. M � <br />CLOTHES ORVERS ; <br />VENTILATION FAN r <br />RANGEHOOD � <br />WATER HEATER , <br />WOODSTOVE � <br />METAL FIFEPLACE (WOOD BURNING) ; <br />FIREPLACE INSERT (WOOD BURNING) ! <br />GAS FIREPLACE ' <br />GAS RANGE � <br />GAS PIPING � <br />EXHAUSTFAN , <br />PLAN CIIELK HUTAfiffl <br />owimnc <br />SUB TOTAL 5 <br />FERMIT S <br />T07AL FEE S <br />fEE RECFIPiNO <br />==� ?S. /J <br />PWh!OMG <br />MECIInNICIII <br />ApDIIIONAL PL�N C��F.LK <br />Oi11Ef1 <br />ST�7[ �UIlOR1G SUf1C.11PfiGE <br />runi ic t•;nnKs <br />TOTAL <br />