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'.2.,r�.' . . <br /> 'T�Kn�r. ` <br /> � , � <br /> APPLICATI ". FOR CONSTRUC7.J1� �ERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> � 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> � ❑ DEMOLJTION ❑ COMBINATION ❑ BUILDINO �/ ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> PROJECT�EBS: �C ��� 'E'���"" �7 <br /> '�-��i ' � t..cJ/�- iSZ/ /-S—?�5�1� �� S�. �r���i�i�r� �.� ��� <br /> � wu��oonEss an nr v (2�� /�—��Z�_ <br /> O <br /> t�r ��ooness an ziv vHor�e <br /> �qp�i[CTq10ESIGNER LWI�ODRE55 CITY 21P PMONE <br /> � ��pµ ��T�plp IW��pppEu CRY ZIP PNONE SfATE LICENSE� <br /> ��pp y�Ul�pppE55 CITY ZIP PHONE STATE LICENSE� , <br /> �. p��yaNGCONTp�C1pp MAIl�Dp1E55 CIfV Z�P PHONE STATELICENSE� <br /> CONiR"OiPR1�OFM�` HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> � p�9�rypE W0111��MD SOU�FOOT/�GE wVOLVED GONTACT PERSON AND PIqNE NO <br /> � _ <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINEC 7HIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND rARRECT ALL <br /> rnorosEo euinw�a PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> oc mv�S�pwNee�awor��n�cHiwocoriesi ry�T. THE 6RANTINCi OF A PERMIT DOES NOT PRESUME TO GIVE <br /> i� �� � AUTHORITY TO VIOLATE OR CANCEL THE PHOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6ULAT�N6 CONSTRl1CTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW iB27 RCW AND 200 WAC. <br /> p�� o.ti5�9 Da/ a/oz ol/S" /� /L/ /� <br /> CONS71NK.fIONLOANlENOER.A00NE55.iELEP110r/ENINMER X J �7 `7� <br /> SION�TURE Dl1TE � <br /> CITV BUSINESS IICENSE NO. <br /> ���� MECHANICAL <br /> N0. TYPE OF FlXTURE 0111TEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILEn ' NC—AMNDLG UNfTS ' <br /> ' �T�� � FORCED AIR SYSTEMS _� <br /> UIVATORV(WASH BASIN) � HEAT PUMP ' ' <br /> ��R � UNIT HEATERS ' <br /> KRCHEN SINK 6 DISP � CLOTHES DRVERS � <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRV TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' - . <br /> UAINAL � METAL FIREPLACE(WOOD BURNING) � <br /> DRIWKING FWNTAIN i FIREPUICE INSERT(WOOD BURNING) � <br /> FLOOR DRAIN � GAS FlREPLACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR.ETC.) � GAS PIPING ' <br /> � IXHAUSTfAN � <br /> i ' <br /> i <br /> i <br /> � i <br /> � <br /> i <br /> � <br /> SUB TOTAL S � SUB TOTAL S � <br /> PERMIT S i _ PERMIT S � <br /> TOTAL FEE f ' __ _,_ TOTAL FEE S <br /> FOR OFFlCE USE ONLY: <br /> Fpp�{{$EiB�CK REMSETB�CK S�OESETBACIt PlANC11ECKNUAIBER FEF PECEIPTNO <br /> �j�c� � — <br /> use za+E �ot eae� VAC/UIT$ITE FEES VALUATION FEE <br /> � <br /> ❑ves ❑ rio ern�on+c I <br /> NEI6HT UMIT�TION MO.OF��ME�UNG SIZE OF BlD6R.l � <br /> I�NlTS Pl11MBiNG j _ <br /> -T <br /> 1 <br /> OCCUP�NCY NO(%SfMES U:CUV/�NT IO�D B/SEMENT MECH�NICM � <br /> 61qIN — ' <br /> ❑YES ❑ NO <br /> �DDITION�I PL�N CNf.CN � <br /> FlRESPHINKLERREO'D RE�SON _ T-' <br /> OTHER � <br /> FIFEMARMPC-0'D RE�SOM i�' <br /> STATE BUIlDINO SIIRCHRqf.E ��� <br /> TVVE OF f,pJST PLANS APPR11\'ED BY CITY OF EVEREIT ���Bl lf.WORNS � <br /> �OCAL SALES J— <br /> DATE TAX CODE IS 3105 TOTAL ' <br />