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APPLICATIf 1 FOR CO�liS7RUCT 'N P�RIiA17 �}�. <br />CITY OF EVEFlETT �• BUILDING DIVISION �/� _ <br />3200 CEDAR STflEET • E�%ERETT, WA 98201 • 259-8810 �C�rr <br />❑ DEMOLITION ❑ COM8INATION ❑ BUILDING � MECHANICAL �PLUMBING ❑ SIGN <br />PROJECTADDRESS: �-z �", � �-(, `j � �-\� '��--G� �� I <br />c <br />-iryv�.cJ � i_i �.-r.�t�L lu i� r\1L— <br />TEHAHT MNLApDHE55 ���Y <br />� `)�n'�� __ <br />�nc�a*r.cronoesieHEn u�n�ooness cnr <br />G[NER�ICONIMLIO{i MNI�DDRE55 ���Y � <br />�ECIIANICAL <br />DESCRIBE NC%iN ANO SOUAfiE <br />LO1 9LOCK <br />P�ViCEL LV( I O. NUMBER <br />L <br />CONSIf1UCilON lOM! LENDF <br />.AD�PE55 ❑n <br />c\ /'1/��{�. <br />.AUORESS � Clh' <br />� �%l i- <br />���� <br />=� — <br />E MVOLVED <br />�����i If ' ' -i <br />.�r�i� F-�1`��("_-21i ( <br />�wr+ eEiow rn Arv.cr� two coriEsi <br />TElEM10NE NUMOEO <br />PLUMBING <br />NO. TYPE OF Fl%TURE <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />LAUNDRYTFAY <br />CIOTHES WASHER <br />UriINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLON' PfiEVEN' <br />AINK fSFi]VICF _ RA <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />f00Nt 5[TIUCN PE�P SfTl1iLN <br />use zoHe im enc� <br />nurur uurtnnor+ NO Of OWRLIN(: <br />UN115 <br />pCCOP�NLv NO (N SI(%X6 OCCUPANI LOAO <br />F!!:i5!'BiNKLEFREOD ��fetiUrv <br />fltiC.lUfIMl1E0'� AEASON <br />0 <br />�m <br />nr <br />C'�- � .� C�-?� G `� <br />P1�OHE <br />rr�o�+F <br />PiIONf SIRC IICENSE � <br />I � �r� ' /�1�2-rN,;��f �n.3���" ; <br />I�IONf Si�LE UCENSE � <br />1la rHON[ ' s1�lE UclMst • <br />NEATING SYSTEM: p GAS � ELECTRIC O <br />cor�ur.rr[n5o�+�Nne��a�cNo / ���I <br />l.. "� �6(�C�1-- <br />��.�,���� <br />I IIEREBY CERTIFY THAT I I�AVE 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 WITIi WHETIIEF SPECIFIEO HEREIN OR <br />NOT. THE GFiANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTFiER STATE OR LOCAL LAW REGULATING CONSTflUCT10N OR THE <br />PC-FlFORMANCE OF CONSTfiUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TNIS Pfi TY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS ADE OMPLY WITH THE STATE <br />CONTRACTOR AW 1 D 96.200 WAC. <br />x �� 7�2� � �- <br />SIGNAIpfIE O�IE <br />CI1Y OI151NE$$ l ICENSC NO <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />- —T- <br />A/C - MiNDLG UNRS ' <br />fORCE� AIF SYSTEMS � <br />_—�_ <br />HEAT PUMP <br />UNIT HEATEfiS � _ <br />WATER HGTER <br />WOOD Sl OVE <br />MEfAL FIREPLACE (WOOD OUFNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS PIPING <br />EXHAUST FF <br />SIOE SElO�LN PI �N CI I f.M' N'I^III� <br />/ " <br />v.ca+r snr FEES <br />oves ❑ uu nunnwr. <br />sirr or oi urn i —�-_ _. -" <br />�'Il1u0iFL <br />BASEMENI MFC�I�MGI <br />❑Y[5 ❑ NO --- <br />•OUI IIOMq PI AN Cn! CN <br />Oil�ffl <br />SiAiE OUIl01Nf. SIIRCII�qGE <br />S I ', b <br />PERMIT <br />TOTAL F <br />rr� � nrcim� do <br />vinNS�nvnovEoor CITY OF EVERETT rumi�won+s <br />LOCAL SALES - - �--- -- -"-� <br />���rt . --_ - --_- ._TAX CODE IS 3105 _ TOTAL -- -_-_--- . -- .- _ .----- - - -- <br />