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APPL,ICATION FOR CONSTRUC?�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, 1NA 98201 • 259-8810 <br />fl DEMOLITION fl COMFiINATION fl BUILDING fX MECHANICAL f� pLUMBING �l SIGN <br />�PROJECT ADDRESS 1. _ ., � <br />cin <br />CITV ZIP <br />GENERALCONiMCi011 MAILAD�RE55 Cllv zIp <br />PIIONG $iql@LIC[NSE• <br />AAFPWm�u r�mn�n�.... ..... . _ . <br />WORK AND SOUARE FOOiAGE <br />rno <br />� IOT� BLOCK <br />PMCEL TN( I.D. NUMBER <br />_ G,o�3 - oo�- oag - <br />CONSTRUCTIONLOANIENDER.�DORESS.TELEPHONENUM�ER <br />PLUMBIN6 <br />NO. TYPE 7F flX <br />WATER CLOSET (TOI <br />BATHTUB <br />LAVATORY (WASH BP <br />SHOWER <br />KITCHEN SINK 8 �ISI <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />Fi70NT5EiAACK REAlISF.TPACK <br />USE20NE (.OTAqEA <br />OR ITEM <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE S <br />�I�[NSE � <br />HEATING SYSTEM: T1�GAS f-1 ELECTRIC I l <br />CONTACTPERSONANpPHONENO. � _ <br />I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED 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 WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />XONT__��R / V W^27 RCW AND 296.200 WAC. <br />� �� �'�- �L� <br />SIGNIiUFE OATE <br />CItV �USiNESS LICENSE N0. <br />FEE NO. 7YPE OF EpUIPMENT FEE <br />' A/C—AMNDLGUNITS—H.P. � <br />; � FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />� HEAT PUMP <br />_ ; UNIT HEATERS — B.T.U. M <br />SIDE SETB�CN <br />VACAN7 SIIE <br />IIYES fi NO <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />ME?AL FIREPLACE <br />FIREPLACE INSEf7 <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />SUB TOTAL S <br />PERMIT $ <br />TOTALFEE 5 <br />PLANq1ECNNUMBER I FE[ I qECEIPTNO. <br />EfUILf1MG <br />NEIGNT�IMIiRTION NOOFUWELLING S12EOFBLDGRI <br />UN17S <br />PLUMOING <br />OCCUPANCV NO pt SfOPiES pCCUPANT LOAD BASF.MENT MBC114NIC41. <br />GROUP <br />fIYES II NO <br />FIRE �LARM NEO'0 q[ASON �DDIIION�I. PLAN CNf.GN <br />on�En <br />FlRFSPqINR1.ERf1E00 REASON <br />STATC OU4DING SIIRCN4116E <br />TYPEOFCON51 P�ANSAPPROVEOAV CITYOFEVERETT rueur,wunKs <br />LOCALSALES <br />oate TAX CODE IS 3105 TOTAL <br />