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APPLICATIO.d FOEi CONSTRUCT■aN PERMIT( <br />CITY OF EVERETT • BUILDING DIVISION L�� <br />3200 CFDAR STREET • EVEFETT, WA 98201 • 259-8810 � <br />-0 DEMOLITiON fl CQMBINATION t',(BUILDING f 1 MECHANICAL � 1 PLUMBING f l SIGN <br />PROJECT ADDRESS <br />y` z s fi�o <br />owNEn <br />i <br />�� �✓E'�-�-.T <br />=_ss cin <br />Y6z; <br />2�,,3 �f� 6"7y�a <br />r��oNe <br />�1u3 2 � 9 [7y_'-y <br />PIIONE <br />..n�n��...,�vn ncm m���nwnenn cnr ]in PHONE <br />QE�ir-+ �s�o,✓ 1i�1a� 9Z,�a pz�w �eG.-s�N.l� �iSnzc oG �7'/ S�'� <br />cEruenntcor�rnncron Mni�nooness cnr zir rnone — srnieucervse. <br />` K�n,w.a.�J_� !�r J�uv`w--r,55 /t31qo .`�.n 6�8 Z*'r.o �6 .-���RoL6/�/� <br />;%a�2 r n.�sr,-.�� n�.� /o / o i � <br />MECHANICALCONTR4CTOP MAIL�ppRESS Cltt 7iP PIIOY,f SiR[LIC[NSE• <br />NA <br />PWMBINGCOHiRACTOR MnILADDPESS Clil' IIP PHONE STATELICF.NSE� <br />CONiBRCTPRICEOPWOlM � <br />�zo�o Cn�a�- <br />DESCPIBE WOPN AN� SOUARE FOOTAGE INVOLVEO <br />%�'�seL.r4 ..L.( !' .�. _ <br />J <br />vn�oro"seo use oF euitoirvc <br />�r n L <br />LEGALOESC IPTIDNOFPFOPERTV�.';MOWNBELOWORATTAGN <br />LOT _ __ BLOCK or <br />w <br />PAURCELTAp%I.O.NUMBER <br />7U%O.'O�D� bZ%— 00�% <br />CONSTf. 1C�ION LC V L[N�[li, ADpRESS, TELEFHJNE NUMBER <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER GLOSET ITOILETI <br />8 DISP <br />CLOTHES WASHE� <br />URINAL —� <br />DRINKING fOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />SINK (SERVICE — BA <br />FOR OFFICE USE ONLY: <br />fpONiSFTBALK RE�R SF704CN <br />- - -- <br />Ucp JOrvF <br />� <br />IILIGII� LIMIiA <br />2i' <br />occurnNcv <br />r.n[iim <br />� U�� <br />�i(i[ Al�f1M R <br />�iPF S�t11NKll <br />lYP�01 CON: <br />SUB TOTAL 5 <br />PERMIT S <br />TOTALFEE S <br />IOiARF� <br />7l /z,�� <br />NO OF OWELIING <br />UNIiS , <br />RFOU � �F�GON <br />HEATING SYSTEM: IIGAS I"IELECTRIC fI <br />CONiACi PFRSON �Np PIIUNF NO <br />� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S <br />� APPLICATION AN� KNOW THE 3AME TO OE TRUE AND CORRECT ALL <br />PROVISIONS OF LA'NS AND ORDINANCES GOVERNING THIS l"YPE OF <br />WORK WILL DE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />'� NOT. THE GRANTING OF A PERMIT DOES NOT PP.ESUME TO GNE <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 PROP�RTY TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADF AND I COMPLY WITH THE STATE <br />CONTRq.CTORS LAW 1827 RCW AND 296.200 WAC. <br />� <br />CIiY DUSINESS IICENSC NO. <br />iyy�■�L'�w <br />�_QZ <br />�_����� <br />TYPE OF EOUIPMENT <br />HNC! G UNITS — H.P. <br />AIR SYSTEMS — B.T.U. M E.A. <br />— B.T.U. Id <br />RANGEHOOD <br />i WATER HEATER <br />WOOD STOVE <br />i METAL FIREPLACE (WO 0 BURNING) <br />� FIREPLACE INSERT (WOO BURNING) <br />; GAS FIREPLACE <br />GAS FANGE <br />� GAS PIPING <br />i EXHAUSTFAN _ <br />—_— <br />SUB TOTAL $ <br />i PERMIi $ <br />TOTAL FEE 5 <br />SIDESETfi4CK I�IAN <br />3. 9S '/� �`� �^^?� <br />VRCANI SILF hCC, <br />IIYES � �UIIDING <br />SIZE Of 9LDGrt I <br />-N ume ��24�`)S <br />o SF <br />�����v���� <br />15[M°Nf �� �,��f,u�NICM. <br />IIYES !rN0 <br />AD91110NN. PI AN OIF.CK <br />U111ER <br />Sinl G[1UII D W 0 SURCHAqGE <br />CITY OF EVERETT �'�muc�v�nKs <br />�oca�sa�es - <br />TAX CODE IS 3105 70TAL <br />FEE <br />F[F � I PECF.IPT NO <br />5��' �:' � <br />r"; <br />