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APPLICATIt�N FOR CONSTRUCI �ON PERMIT <br /> CITY OF EVEFETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETi;WA 9g201 • (425)257-8810 <br /> � DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL O PIUMBING ❑ SIGN <br /> PROJECT ADDRESS: f�fY/J' - 3,.q g.,r JE Fv..r.a_Zfi �„s� Y � 1 vo-+ <br /> T� �i lY,i�/`Ina.� �3r����w�Sc C--�c�� (,.�A S� zo� .�.�'3�S� Z <br /> O�Ep M�R�ODRE55 CIiY Zm PNON[ <br /> TENANT MAII�DORE$$ [ITY ]iP P��ONE <br /> �RCNITF.Ct OR SIGNER M1111�DDPESS CIfY �IP PHONF <br /> GFNERA�CONi LTpR M�IUDDRES$ �IjV )iP PIIp4[ Gf�LCII�FNSE• <br /> MF.GHANIC�LCO� iR�C10R MA���ppqE55 f.itt jiP PnDNC STSTFUCENSE� <br /> PIUMBIN��OM �CTpR M�ILAppqE55 CITY ZIP PHONE $T�TF LIGENSE i <br /> CONIMCf PRILE Of WpqN <br /> HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br /> DESCRiBF.NpRB AND SOU�RE FppTAGE INVOLVED CONUCi PCRSON�ND PHONF NO <br /> ��l <br /> � �' <br /> . I HEREBY CERT�FV THAT 1 HAVE READ AND EICAMINEO THIS <br /> PROPOSFD USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECI ALL <br /> J PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRiPT10NOFPROPE TV�SN WNBELOWpqATTAGNTWpCOPoE51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> wi �h' eiocK�or � �--�� �� � AU7HORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> ( P�+Y��w �'� OTHER ST4TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIY WITH Tl,e STATE <br /> PMCEL lAX I D.MIMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> :�aa 3 000 o��a o�� os ,_� `�—�--- q �1 97 <br /> CONSiRUCTION LO�N IENDEN,�DOqE55.iElEl'NONE NVMBER <br /> , SIGN�TV p��� <br /> 1 <br /> • ' <br /> CITY BUSINE55 UCENSC NO <br /> � PLUMBING MECHANICAL <br /> ' NO. TYPE OF FlI(TUqE OR ITEM FEE NO. TYPE OF EQUtPMENT FEE <br /> WATEH CLOSET(TOILET) A/C—AMNDLG UNITS <br /> BATHTUB ; FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP , <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 OISP CLOTHES DRVERS <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ' WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL � METALFIFEPLACE(WOOOBURNIt:3) <br /> DRINKINCa FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> _ FLOOR DFAIN � GAS FIREPLACE <br /> BACKFLOW PREVENTERS GASFPNGE ; <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> EXHAUSTFAN <br /> � � <br /> i � <br /> i <br /> SUB TOTAL E � SUB TOTAL <br /> PERMIT a � PERMIT 3 <br /> TOTALFEE S � TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> fqpNTSFTpRCK RFRRSFTA�C% SIDESFiB�CN PI�NCII[CNNNfifR �� � ffF. , 1,1 ^ RFf.PPTNO <br /> Ol(� 7i) <br /> usE zo^+F 101�RFA v�c�rvt srt� FEES VALVATION FEE <br /> ❑VES ❑ N� �— <br /> nunnwr. <br /> NEIG�Q IM�I�IION NO Of UW[LLING S�ZE Of 6lDGR1 — <br /> 11NI1 V PI UMpING <br /> _.—_ __—_ __l__ <br /> OCCUPANf.v q0 0�c�puik5 IX:CUP4M LO�p A�SFMENI <br /> GROUP MFCII�YIf.µ <br /> ❑YES ❑NO -- - '—" <br /> 1 iqF.SPRtK�..'ER REO'D fIfASO!! ADDIIIpNAI.PI�N CM(.CK <br /> _ _ �_ <br /> 011lE� <br /> liq[FIARMFEO'0 RF4cpV <br /> 51�1F AUilUlrvb SUf1CHpRFC <br /> �rreorcovsr rinr�serraovrnnr CITYOFEVERETT runiir.wonns <br /> LOCAL SALES -' -- — �— ------ - <br /> �q�E TAX CODE IS 3105 TO7AL <br />