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APPLICATII��I FOR CONSiRUCl� .ON PEFtN11T /�' <br />CITY OF EVERETT • BUII.DING DIVISIOfJ �+CA�!� <br />3200 CEDAR STREET • EVERETf, N/A 98201 • 259-8810 � �irrr <br />� DE�AOUTION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ pLUMBING ❑ SIGN <br />PROJECT /:�DREuS:I� 819 Lombard Everett, WA 98201 <br />Everett Community Colle�e 801 [Jetmore Gverett ldA 98201 388-9513 <br />owr+en M�I1�0011E55 arv ZIP —�. PIIONE <br />TENAN7 M�II.AUDflF.55 CIIY 11P {`IIONE <br />AfiCMRECT Oq DESIGNGR MAl AOORE55 LIIY 7iP PIIONE <br />�wner <br />GENEOet CON10eL100 MAIL RDUf1E55 CIIY !i1` � pupqf SMTE lIC[NSE • <br />COMRACIOR MAILMURESS <br />PI111AB:NGf.ON7RM.I011 M�ILApDRESS CI1Y [II' <br />OESCRIBE WOpY ANO SOUARE FOOTAGE INVOLV[O <br />1 CGAL DESLNIPTION OF POOPE <br />LOT p�p�N <br />CONSiflUCTION 1 O�N lENOEP. A�DRESS. IEl EPHONE NUMBEIi <br />ND• � TYPE OF FIXTURE OR ITEM <br />I WATER CLOSEi (TOILET) <br />LAVATORY (WASN DASIN) <br />SNOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BnCKFLOW PFEVENTERS <br />SINK fCFGVII:f- _ PGR FT <br />SUB TOTAL S <br />PERMIT S <br />HEA7ING SYSTEM: ❑ GAS <br />LOtITACT P[f150N AND PNONF. NO <br />Mark Stewart 388-9513 <br />SIQE LICENSE � <br />STATE 410ENSE � <br />❑ ELECTRIC ❑ <br />1 IIEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINAIJCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHEA SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEqM1T DOES NOT PRE.,UME TO GIVE <br />AUTFiORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTh1ER STATE OR LOCAL LAW REGULATING CONSTRUC'i ION OR THE <br />PERFORMA�ICE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPI.ICATION IS MADE AND I COMPLY WITIi T{tE STATE <br />CONTRACTORS LAW 1B. N 296200 WAC. <br />x�l�l/ � l'���t/ 5/16/97 <br />SIfNATUPE O�TE <br />Q7Y BUSMESS IICENSE NO <br />►IECNANICAL <br />FEE NO. TYPE OFEOU <br />�— A/C—lvHNDLGUNITS <br />; FORCED AIR SYSTEMS <br />�— HEAT PUMP <br />—�— — <br />� UNIT fiEATERS <br />� CLOTfiES DRYERS <br />T� MNGE HOOD <br />.� TOTALFEE S � <br />FOR OFFICE USE UNLY: <br />iHONTSETMLN PEMSFTBACR SIDESETBALN <br />❑SE IONE 1 Ol AREA VAC�NI SIIE <br />❑YES � NO <br />HEIGIIf IIMITLTION NO OF DWEIIING SIZc OF 9LDGRI <br />UNIi$ <br />NO 0( $IDN[5 � OCCIII'AM 10�� <br />fIRE <br />IYPEO(f.(11lSi IPIA�lSAPI'110V1'OOV <br />u•u <br />OY[S ❑ NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 9105 <br />WATER hIEATER <br />WOOD STOVE <br />MEfAL FIREPIACE (WO( <br />FIREPLACE INSERT (N/0 <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXI IAUST FAN <br />PI �H CIIGCN f�11MqfR <br />p1111DIN1: <br />PIUAIUIN(i <br />MECIUNIChI --- <br />FD0111011AI PI�Nf.11(CN <br />OII�EB <br />til�ll OIIIl1�l1!(i tillllfll�llCl <br />i'1I111�I:wOIU: �'�� <br />TOTAL <br />fFf <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE S <br />iiECEIPI NO <br />