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APPLI�A'�'i�_1N FOR COIdS'�RIiC . ION PERMO`� <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />� DEMOU710N ❑ COMBINATION p BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />PHOJECT ADDR�SS:I. 829 Lombard Everett, WA 98201 <br />tiveretC Communi.tv Colle�e 801 [Jetmore Gver.etL WA 98201 388-9513 <br />owrr¢n MVL�00{1E55 an —� nr r�wr+c — <br />IENANT IA�II. /u)Of1F.55 CIIY IIP PIIONF <br />AOGIIITECiORDE51GNf.❑ MAIIADpRE55 CITY 7�P PIIONF <br />OWIICL' <br />—___ ___— ___ .. _. __ _._._. _._.. __— _ _ <br />GCHFlUlCON711�G1(Nl MAllA01)I1E55 CrtY lil` IYIOI�Ii SI�TEIICFNSE• <br />AIECB�NICAI CONTRAC7011 Mul �DDf1E55 CIIY IIP PI101�F. STATE UCENSE � <br />PIIIAIHINGf.O11IP�f.1011 I.I�ItAI)ORE55 CIIY ZII' PIION[ $TATEIICENSE� <br />GONIMGI PRIf.E OF WOfiK <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ , <br />DESGRIBE WORH ANU SOUAPE FOOTn4E INVOWE� LONTAC� MfiSON �ND 1'110NE NO <br />Mark Stewart 388-9513 <br />tEGAL OESCIIIPTIDN Of POOPER7Y �SHOWN BGLOW IX1 ATTALII TWO GOPIES) <br />�or mocK _or <br />5938 163 015 0005 <br />PMGEl7A% I.D. HUTABER <br />CONSiHIILTION IO�N LENOER, AOORESS. TELEI'110NE IlUMBEfi <br />PLUMBING <br />NO. TYPE Of FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH DASIN) <br />SHOWER <br />KITGNEN SINK 8 OISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />iRONTSEID�CK REMSFi0AC1( <br />USE 20NE <br />MEIGIR LIM'T�TION <br />OCCUPANCY NO Of 5 <br />GIIOUP <br />FIflE SPflINNI ER REO'D <br />SUB TOTAL S <br />PERMI7 S <br />TOTAL FEE S <br />SIPE SE'iB�CN <br />101 MEA <br />1�0 OF bWEILING <br />UNIIS <br />O(:CIIPANI lOAO <br />ri <br />UAI! <br />I VACAI.! S�IE <br />❑VES ❑ NO <br />site or e�ocrt i <br />❑YES ❑ NO <br />'E0°Y CITY OP EVERETT <br />LOCALSALES <br />__ _ TAX CODE IS 3105 <br />I HEREBY CERTIFY THAT 1 kiAVE READ ANO E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PHOVISIONS 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 />AUTiIORITY TO VIOLATE OR CANCEL THE YROVISION OF ANY <br />OTHER SlATE OP LOCAL LAW REGULATING CONSTRUCTION Ofl THE <br />PEFlFURMANCE OF CONSTflUCTiON. THAT I AM AUTHOflIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfl WHICH <br />APPLICATION IS MADE AND I COMPL'! WITH THE STATE <br />CONTRACTORS LAW 1B. CVV'AN 296.200 WAC. <br />x _�l�l/2 � �, � .l' l�h� 5/16/97 <br />SIfiNATURE DATE <br />CITY BUSINE55 LiGGNSC NO <br />MECHANICAL <br />NO. TYPEOFEQUIPMENT FEE <br />A/C — A/fiNOLG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT IIEATERS <br />CLOTHES ORYERS <br />RANGEHOOD <br />WATER FIEATEN <br />WOOD STOVc' <br />METAL FIREPLACE �WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL S <br />� PERMIT f <br />TOTAL FEE f <br />PIANCIICCNNUMOfR / fEF 11ECEIPINO <br />��` _ <br />owinwa <br />P111A1WNG <br />MECIInNIGI <br />AUU11101U1 1`I �N f.111:f.N <br />pO�[II <br />tilAl l OIIII IlRlli SI IIIf.11MIGl <br />Punnt wo�a5 <br />-- ��----- .. <br />TOTAL <br />