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APPLICA'�IL�� FOR �ONSTRUCti .aN PERMIT <br /> CITY OF EVEHETT•BUILDING OIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ C—O7�MBINATION ❑ BUILDINO ECHANIC�Ar d ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS Z T�� ��LI� �� �L L�� ��-\�D E U ��J=�-,i <br /> pyA�q MIUL�00RE55 ptt � I'��I P E <br /> �: r l-1 o I.AS CaA��y.E���---�-F IF=��c�l�Fa.,l �i,��� �v-`=1�"�C�i > >��-13�.1C <br /> TEN�MT M1uL�[55 A�Y IIP P110NE <br /> MLMTECTpIDESIGNEP MNI�DU�E55� Gltt 71P PnONE <br /> G NE C MGTOR M/JL�ODfiE55 CIIY � 7�P PBONE iUTEIILENSE� <br /> (�ti� 1�.��j�� aAnn Tlla.en�;��k� �� `7�/%°/ a���-��,� �n�e-rN vtl�lLt�j <br /> yE�,µ�pN7p��7pq M/uI�ODRE55 'T Gtt T�P PNONE STATEUCENSE� f� � <br /> PLUL6NGCONTRACTOR MIJt�ODRE55 CITY ZIP PHONE STALEIIGENSE� <br /> `°"T""°T°"�°Fwa� � �' HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br /> ��P <br /> pE$CqlE MppK�N:1 Sq1�PE f00T110E MVOlVEO CONTACT VERSd��ND PIqNE NO � <br /> r � �� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TQ BE TRUE AND CARRECT ALL <br /> rnopos¢o use eutdra PROVISIONS OF UWS AND ORUINANCES GOVERNINC THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> tEOKpex,-qvnarocprqrepn�sNowr+eE�owa+�n�cNrwoea�es� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LO7 �� � AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL lAW RE�ULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAQE AND COMPLY WITN TI�E STATE <br /> CANTRACTORS AN 296200 WAC. <br /> MIILELTiVI1.D.M/GBER � <br /> � `\ � <br /> CONSIRUCTqNL LENOER.�0011ESS.TElEP110NEMUMBFR X v <br /> SIGNA �� <br /> CITY BUSINESS I�CENSE NO <br /> ���� MECHANICAL <br /> NO. TYPE OF R)fTURE 0111TEM FEE NO. TYPE OF ECUIPMENT FEE <br /> WATER CLOSET(TOILE� � MC—AMNOLO UNfiS ' <br /> �TM� � FORCED AIR SVSTEMS � <br /> UVATORV(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATERS � <br /> KRCHEN SINK 8 DISP ; CLOTHES DRVERS � <br /> DISHWASHER <br /> � RANGEHOOD ' <br /> LAUNDRY TRAY ; WATER HEATER i <br /> CLOTNES WASHER � WOODSTOVE ' <br /> URINAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKIN6 FOUNTAIN � FIREPIACE INSEFiT(WOOD BURNING) � <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR.ETC.) GAS PIPING ' <br /> EXHAUSTFAN <br /> � <br /> i � <br /> � <br /> � <br /> � <br /> � <br /> SUB TOTAL f ; SUB TOTAL S � <br /> PERMIT S i PERMIT f � <br /> TOTALFEE f � TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> PUN C11EGK NUMAFR FEF pEf.EIPi NO <br /> FIIONT SETBACI( AE�N SF.iB�CK SI�E SETB�CK � ��� <br /> u5E ia+E l01�REA V�GAhT S�TE FEES VALUATION FEE _T_. <br /> ❑YES ❑ � pWIDING � <br /> HEIGNTLtM1T11TION UNIfaOWEIIING 512EOiBlDGRI � <br /> P1U1181NG <br /> T <br /> i <br /> pCq1P�NCY Iq d 51(M8F5 OLCUP�NT 10�U BASEMENT MECNeNICH � <br /> OROIR � <br /> ❑YES ❑MO � <br /> �DD�IION�I�L�N C�ICCM _ <br /> fIRESPRINKLEflREO'0 RF.ASON <br /> i <br /> 01HER <br /> flPE AURM REO'D AEASON � <br /> SI�IE OUIl01N6$UtICHMiGE � <br /> -- �� <br /> TY7E Of f,pNST �1�N5�PPFOVED BY CITY OF EVERETT PUPI If.WORNS _ _ <br /> IOCAL SALES J— <br /> ��,E TAX CODE IS 3105 TOTAL '_ <br />