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APPLICATIO"1 FOR CONSTRUCTI� N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �EATING SYSTEM: GAS ❑ ELECTRIC ❑ <br />259-8810 <br />❑ DEMOLITION f_1 COMBINATION I I BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />HOUSING AUTHORITY10F�THE CITY OF EVLRETT 1401PPOPLAR EVERETT,98201 (206) 258-9222 <br />TEWWT M/JLI100RE5g CITV LP PlqNE � <br />�n�crano�sa�R ruawonEss c�r 98201 (20b) 259-3161 <br />THE DTKEMAN 1602 HEWITT AVE EVERETT, �• <br />6ENE11/�CONTMCTON WJLADDRESS CITY ZIP � ST�IE <br />YUN S CO3 INC 1600 S. GRAHAM ST SEATTLE, 98108 (200,�64-0170 YUT�S��*09�/C9 <br />MECNANICIILCONTMCTOA WLAODfiESS CffY ZIP PHONE STATELICEq9E1 <br />SAME AS ABOVE <br />rt�uwarroeornw�emn rnnww�oaEss cm zir rHa+e sr�re��nse� <br />SAME AS ABOVE •, <br />�cuss aF vyowc , <br />� ❑ NEW f.l AODITION I�J ALTERATION I�I REPAIR I I UEMOLITION I I WOODSTOVE/FRPL INSERT CI BUILDING RELOCATION <br />u <br />[W`%�'�11:�3 <br />t . <br />e <br />�wt oescnrna+oF rravEm �s�awn oe�ow on nttncH w�m cor�es� <br />toT e�ot�t <br />E�:•i L�1 <br />DISHWASHER <br />BACKFLOW PREVENTERS <br />FOR OFFlCE USE ONLY: <br />use zaert <br />Fti73: 3:n: q <br />�or�n <br />� <br />TOTAL FEE S I 2� <br />sroe seie�eu <br />VACANT SITE <br />:tWL acwcr YanoveUwcw�s <br />Wr • <br />NO.OF ST0111ES <br />FIRE SPFWNLEqS <br />CITY OF EVERETT <br />LOCALSALES <br />7AX COOE IS 3105 <br />CONTACT PEli50N AND PIIONE NO. <br />t HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES f30VERNMO THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOL THE GRANTINO OF A PERMIT DOES NOT PRESi1ME TO CiIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER S7ATE OR IOCAL LAW REGULATIN(i CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZEO BY THE <br />OWNER OF THIS PROPERTY TO PERFOflM THE WORK FOR WHICH <br />APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br />CONTPACTORS LAW 1827 RCW AND 296.200 WAC. <br />��1���--1 ����•�2 <br />sp�uiue ah <br />SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS--B.T.U. M <br />VENTILATION FAN <br />WOOD STOVE <br />HEATPUMP <br />GAS PIPING <br />BUIIDINa <br />PUIMBINCi <br />MECHANICAL <br />ADDITIONAI FLAN CHECK <br />SPRINKLER <br />STATE BUILDW6 SURCHARGE <br />PUOLIC WORKS <br />TOTAI <br />TOTAL FEE <br />