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—W' f� <br /> � APPLICATI�N FOR CONSTRUCI �ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 '��" <br /> f] DEMOLITION �l COMBINATION I°f BUILDIN(i f-1 MECHANICAL �� PLUMBIN(i fl SION <br /> PROJECT ADDRESS/qD �E J� �VE2� 9 ?0 <br /> / <br /> � ss cn zm v'wne l��D.���� <br /> �� �F�FT �I NE SPA����.�J ar SNTr�nio�n cd� �l P3�L � <br /> j�NT MNL11Dp1E55 / CITY PNONE <br /> �31�:-�- F�0 130X �f I � � 9zi�G'OJ,6 -�r- �,,,/1--'�G�7'� <br /> �qderccr oesar�n M�IL1100RE55 cm zm rHor+e �_/��_�_ <br /> YNO EFA► <br /> pEMLGONTMGTqi MNL 55 CIIY 21f` P110NE STATEUCENSE � <br /> O ' �S <br /> MEf.NMMC11lCONTR�Ctt1H MIJL��ORESS I7V ZIP ///� F110NE 5 TEUCENSE� <br /> � MQ �-CJ� �/ � Q <br /> %UI.lRH3 CON �GTOR M �Dp1ESS ITY P PHONE ST�TE LICENSE/ <br /> CTP /�O <br /> UV ' YSTEM: I l GAS fl ELECTRIC�— <br /> OE$CpllE RK�DSOU�REFOOTMiEMVOLVEU CTPERSON� P �NO. <br /> E�T61 L <br /> ,,,� -t- — -/7S <br /> I HEREBY CERTIFY THAT I HAVE READ AND�.EXAMINED THIS <br /> �� r APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT.ALL <br /> �o °;�0�0 PROVISIONS OF LAWS AND ORDINANCES CiOVERNINC THIS TVPE OF <br /> � l.- WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ��p¢sp�rtqNpFRqv¢my� 1 � EELpWp111TfACNTVqCORES) NpT. THE �RANTINa OF A PERMIT DOES NOT PRESUME TO OIVE <br /> wr t i2 e�odc�1�oF''�� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> - OTHER STATE OR LOCAL LAW REQUUTINQ C�NISTRUCTION OR 1ME <br /> � (�� ��, � PERFORMANCE OF CONSTRUCTION.TMAT I AM;AUTHORIZED BV THE <br /> OWNER r THIS PROPERTY TO PERFORM TNe WORK WR WHICH <br /> � APPLIC ION IS MADE AND I COMPLV WITM THE STATE <br /> '. t�i.o.Mnwe CONTR TORS LAW 1B. RCW AND 298200 WAC. <br /> `�q -. f�� -oz� - o� - o " <br /> CpNSTIN1CT10N lWN LENOER.�Op�E53.TELEPIIOlIE MlMBER <br /> SpMA711pE D�TE I <br /> , CITV BUSINE55 LICENSE N0. � <br /> ���� MECMANICAL <br /> . N0. TYPE OF FlXTUIIE OR ITEM FEE NO. TYPE OF EOUIPMIElIT FEE <br /> WATERClOSET(TOILE� � A/C—MHNDLOUNRS—H.P. ' <br /> � �T�Ug ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) � EAT PUMP � <br /> SrypyyEq � l! T HEATERS—B.T.U. M ' <br /> ITCMEN SINK 6 DISP i CLO ES DRYERS � <br /> � HWASHER � VENTIL TION FAN ' <br /> LA RY TRAV ; RANGE H D � <br /> CLOTH WASHER i WATER HEA R ' <br /> � URINAL WOOD STOVE ' <br /> DRINKINO F MAIN � METAL FIREPLAC D BUfiNING) �_, <br /> ROOR DRAIN � FIREPLACE INSERT D BURNINO) _ ; <br /> BACKFLOW PREV ERS ; GAS FIREPLACE � <br /> SINK(SERV�rc—9A ,ETC.) 6AS RANGE ' <br /> GAS PIPIN6 � <br /> i EXHAUSTFAN � <br /> � ' <br /> i <br /> � <br /> � <br /> � <br /> SUB TOTAL � SUB TOTAL E ; <br /> PERMIT S � PERMIT E � <br /> TOTAIFEE S ' 1 TOTALFEE ' _ <br /> FOR OFFICE USE ONLY: l/ - 2�y� <br /> pppNt$E7BACK PE�R SEtB�CN SIDE SETB�CK PUN GIIE NUMflF � iE�r^/�' AECEIPT NO <br /> / / <br /> USEZONE LOTIIRE� V�C�Nf51TE FEES VALUIITION �E <br /> fIYES ft NO � � <br /> eunniNr, <br /> NEI6HTLIMIUTION NO.OFOWELLING SIZEOFdIOGRI � <br /> UNIiS � <br /> .� 7 3 ��,�M�,N� � - <br /> OCCUPANLY NO M SIMiES OCCUP�NT lOAD B/�SEMEN ' <br /> M[CM4NICRl <br /> �� N q. I a o - — <br /> YES I i NO <br /> FI �URMREO'D RE�SON RDDI110NRL^LANP�[GK <br /> /�o �,���� i <br /> FIRF.SPRINNLFRREO'f1 FF��M+ i�/� <br /> STRI[OUIIDI4(;SURCNFRCE �� <br /> N� <br /> TVPe or cor+sr v�nNs oven er CITY OF EVERETT runnc wonKs <br /> � � �S – G TA1(CODE SL3 OS TO7AL , <br /> o�iE z1 -9 � <br />