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APPLICATIG.� FOR CONSTRUCT.JN PERMIT <br /> CITY OF EVERETT•BUIL�,VG DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> O DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MECMANICAL <br /> ❑ PLUMBING p SIGN <br /> PROJECT ADDRESS:� 2 z 2 � CRA�� '��/s �..QTe� <br /> XnioSecr� P. .6ox �ssz �„�,�// �sz�G <br /> 3`3 ts->-� <br /> ��� � M�IADpf1E55 CITY Z�P PHONE <br /> TEHNJT MM111[IOR[55 CITY IiV PI�pNE <br /> NiGMTCtT OR DESiGNER Y�It I�OOi1E55 Citt 7m PIqNE <br /> GENER/�lCpNfM�TOR MMLMOIiE55 CrtY I�P PnONE 5l�lElICFNSE� <br /> /�///YJP� <br /> MECMAMiCALCONTR�CTOR MnIUDIX1E55 f.ltt 7�P P11pNE SraEL1LEN5E• <br /> PLN.lM6CONTRA�TOii MAtLA00HE55 GI1Y IIn P1qNE STATEL�CENSE• <br /> CONTMGT VItlGE OF YIORK <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> DEURIlE YIORK AND$qJ�RE FOOi/iGE MIVOlVEO CONT�GT PERSdI AND PHpNQ NO. <br /> I HEREBY CERTIFY THAT I HAVE REAp AND EXAMINED THIS <br /> pqpPp�o����q,p APPLICATION AND KNOW THE SAME TO AE TRUE AND CORRECT ALL <br /> PROVISIONS OF UWS AND ORGiNANCES GOVERNIN6 THIS TYPE OF <br /> WORK Wlll BE CAMPLIED WIrH YVFIETHEH SPECIFIEO HEREIN OR <br /> lEWL0E5CtqPT10NaP�lOPEp1Y(S�QMMlEl0�40R�TTl�LN1MpCpP1E5) NOT. THE aRANTINp OF A PERMR DOES NOT PRESUME TO GIVE <br /> �ot e�oac � . AUTHORITV TO VIOLATE OR CANCEL TH£ PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6UUTN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTqUCTION.THAT I AM AUTHORIZED 8Y TNE <br /> OWNER OF TMIS PROPERTY TO PEHFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ►NIGEL TI1R I.D.MIMBER CANTRACT/OR�S lAW 18.27 RCW AND 296200 WAC. <br /> CONSTIIIILiION ldW IENDER.11Dp11E55.TElfP110NE M1�1lER I�� •"'"� � /I ' �{'f� <br /> �'n� � / D�TE <br /> ✓ <br /> CIT'EU9MESS LILENSE Np <br /> K��� MECHANICAL <br /> NO. TYPE OF FlIITURE OR ITEM FEE NO. TYI+E OF EpU1PMENT FEE <br /> WATER CIOSET(TOILEn � NC—AIHNpLp UNfTS � <br /> �TNT� ' FORCED AIR 3YSTEMS � <br /> VNATORY(WASH BASIN) � HtAT PUMP , <br /> SHOWER ' UNIT HEATERS � <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS ; <br /> DISHWASHER � RANGEHOOD , <br /> UUNDRY TRAV ' WATER HEATER <br /> i � <br /> CLOTHES WASHER � WOODSTOVE , <br /> UFlINAL � METAL FIREPLACE(WOOD BURNING) � <br /> DRIVKIN(i FOUNTAIN ; FIREPLACE INSERT(1NOOD BUHNIN6) ; <br /> FLOCIR DRAIN � GAS FIREPLACE � <br /> 6!1(:icFLOW PREVENTERS ; GAS RANGE ` <br /> SINK(SERVICE—BAR,ETC.) � GAS pIPIN6 ;— <br /> ' IXHAUST FAN <br /> � <br /> � � <br /> � � <br /> � � <br /> � , <br /> SUB TOTAL S ' SUB TOT�.L f ' <br /> PERMIT f � PERMIT f � <br /> TOTALFEE f � TOTALFEE f � <br /> FOR OFFICE USE ONLY: <br /> FAOMT SEtlApt RE�R SETl�CN SIDE SEilACk 1'l�N�IIECN NUAyER iEF RECEIPT NO <br /> �sE ta+¢ l07�REA V�C�Nf S�fE FEES VALUATION FEE <br /> ❑res ❑ �o nunnwr. O� <br /> � <br /> ��aNruwunoa rro ovowe�ur.a St2EOFllWff.l , <br /> UNITS PtUMpINC j <br /> T <br /> OLQMANCY M Oi SI(11tlE5 OCCUP�NT IO�D E�SEA1E111 <br /> ORqB MECN�NIC�L i <br /> OYliS ❑ NO � <br /> i <br /> FlRESPRINKtEHREO'0 RE�SON �D�IiION�L�R�NGnf.GK � <br /> i _ <br /> 011�En � <br /> flRENAIiMREO'D RE�SpI <br /> ST�lEOUIlbwD51111GN�OGE L � /rT <br /> �..aLl1 <br /> trvE or r.or�sr PLANS�PPROVE�9Y CITY OF EVERETT �IIq11(;WO�KS <br /> LOCAL SALES —�— <br /> o.rc TAX COOE IS 3105 7oT�L � ;� <br />