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APPLICATIOt FOR CONSTRUCTIMIN PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETTI WA 9 01-259•5910 4ff <br />0DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:"�Oa I,QCI:fI<157ELLA i�IT-4`6�oI <br />nrcM[ 54tE LICEx5E1 <br />_gf�L�9 T n1aQ IA(N a <br />MqN[ SATELICENSE lI e <br />PHOM STATE LCENSEI <br />COHIRAC1 rRKf W WDIII( /1 �� =- <br />IQ('i <br />—�-- <br />HEATING SYSTEM: GAS ❑ELECTRIC Cl <br />Ii5CI11av MONX AND SQUARE FO01AGf MVOLKn <br />rFPITII. I PFRSINI AM) rybRF NO ,^ <br />\ � <br />U�G�IK��l�cr= <br />IA-[1ILfGLiC- <br />114EVIE13Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BF. COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT, TIIE GRANTING OF A PEFIF41T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING 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 MAD D I COMPLY WITH THE STATE <br />DONTRA, TO LA AND 296.200 WAC, <br />7 <br />X <br />SINIAII If DATE <br />PMVOSEO RSf OF SOLOING <br />_ <br />EEGAI GESCRIWIpY W M1p'EIIIF ISIgWI1 SHONORATIACN 1NOCp'IF51 <br />LOT BLDGK Or <br />PA ELTAX I D. WYBER <br />l./LORESS.IEI o-5 <br />U��O <br />CONSrIIRCrldIIO.W'fM NUMBER <br />_ <br />CIIY BIISI.E55110ENSC NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE CA ITEM <br />FEE <br />NO. <br />TYPE OF EOHIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />— MINDLG UNITS <br />BATHTUB <br />_ <br />_A/C <br />AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />—� <br />_FORCED <br />IILAT PUMP <br />�— <br />SHOWER <br />UNIT HEATERS <br />—'KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATEH I (EATER <br />CLOTHES WASHER <br />URINAL <br />WOOU STOVE <br />MGIAL FIREPLACE OVGOO BURNING) <br />—'— <br />DRINKING FOUNTAIN <br />FIREPLACE INSEHT (WOOD BURNING) <br />_ <br />FLOOR DRAIN <br />GAS TTnr:P1ACE <br />BACKFLOW PREVENTERS <br />_ <br />GAS RANGE <br />SINK(SERVICE — BAR, ETC. <br />--i— <br />GAS PIPING <br />EXI MUST FAN <br />SUB TOTAL f <br />SUB TOTAL f <br />PEFIMIT S <br />PERMIT f <br />_ <br />TOTAL FEE $ <br />I <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />IRONT SETT K <br />R(TR Sf IBACx <br />SM Sf IBACK <br />PI AN CHECK MIWIfR <br />JI1�� <br />HI <br />MCFIPT NO <br />USE LONE <br />101 AREA <br />VACANT SITE <br />CITIES ONO <br />FEES <br />VALUATION <br />FEE <br />MALuuKI <br />-- <br />_ <br />—�— <br />HEIGHT LIWfARON <br />OCCUPANCY BO M SllwiS <br />GRgB' <br />NO V GNELVNO SREOT8UxV I <br />UNITS <br />DC CUPANT WNT AU BASEME <br />DIES O NO <br />ry11MBNG <br />4f^.TIAMf:AI <br />—+ <br />.0311"1.1 AANIIBCK <br />— <br />"HI BPWNALLRNAG 'D <br />NFAIGN <br />D111[R <br />FIRE ALA94 RE0'D <br />nF ASryI <br />STATE mKHnKt 51KKNAm[ <br />rrrca Dove <br />PIANIAPTIIOvm OT <br />OAIE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nmlE VAans <br />TOTAL <br />