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APPLICATIO�� fOR CONSTRUCTIG.+1 PERMIT e��� <br />tneewrynsn TO BE COMPLETED IN INK PLEASE PRINT � <br />CITV OF <br />everett HEATING SYSTEM• � �ns ❑ ELECT IC ❑ <br />BUILDING DEPARTMENT ' <br />259-8810 <br />I7 DEMOLITION I I COMBINATION I I BUILDING <br />�OWNE M�ILAUDRE55 CITY <br />in.y �t.[-F' � ll� --��r-l�� �u�.� <br />TENAN� MAIL AUDRESS � ��7y <br />� <br />uir <br />I MEC�f HANICAL <br />IIP <br />PMONE <br />i I PLUMBING -� f I SIGN <br />� <br />PWMBINQCONTNACTOR MqILADURE55 CITV ZIP PNONE IICENSEI <br />/w <br />LlASS OF WORK <br />❑ NEW ❑ ADDITION <br />� PROPOBEDUSEOFBUILDING <br />Sf.� <br />'� LE(3AL DESCRIPTqN OF PflOPI <br />ior e�ocrc <br />PROJECT <br />TYPE OF <br />WATER CLOSET� <br />BATHTUB <br />UVATORY (WAS! <br />SHOWER <br />KITCHEN SINK 6 <br />IATIO�� R�EPA R I. I DEMOLITION I 1 WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />A(� CONTACTPERSONANDPNONENO. /� ` ` /� �^� <br />��� AO <br />BELOW OB �RACH FOIIR <br />OF <br />SUB <br />FOR OFFICE USE ONLY: <br />FflONT5E78�CK RE�RSETBACK <br />USE20NE LOTAREA <br />lYPEOiCONTS.�IIOWABIE iVP[OFCONSI.ACIURL <br />SIZEOFBLOf]. NO.OFS70RIE5 <br />OGCUPNICVLOA� <br />INTAKEBV I P�ANSAPPROVEDBY <br />FEE <br />S <br />SIDE SETBRCN <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT. ALL � <br />PROVISIONS OF LAWS AND OflDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR ' <br />NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONS7qUCTION OR THE � <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY THE � <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH � <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. �/// � <br />SIGN�TUREOFCONTMCTOqOR�UTMORIZEDAGENT DATE �(_ l - -�j/ � <br />(/ O / <br />X `T� ��� � <br />APPLIC�NTSLITYBUSINESSIICENSE .A USINESSNAME <br />MECHANICAL <br />J0. TYPE OF EOUIPMENT FFF <br />FORGED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M -;— <br />CLOTHES DRYERS � i <br />VENTILATION FAN � � <br />� <br />RANGEHOOD , . <br />WATEH HEATER � <br />WOOD STOVE ' ` <br />METAL fIREPLACE 8 CHIMNEY � <br />FIREPLACE INSERT � " <br />HEAT PUMP , ' <br />GAS PIPING � � <br />EXHAUST FAN , ' <br />PLAN CHEGN NUMBER <br />BUILDING <br />O[LUwNCY MOOiUNi11iNGUMi15 <br />°RW' PLUM8ING <br />BeSEMENT MECHANICAL <br />HEIGIITLIMI7FTION ADDITIONALPUNCHECN <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVEflETT pUBLIC WORNS <br />LOCAL SALES <br />TAX CODE IS 3105 ror�� <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />RECEIPT NO. <br />