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---, , . <br />APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION �/ <br />3200 CEDAR STqEET • EVERETT, WA 982U1 • 259•8810 <br />�l DEMOLITtON ( 1 COMBINATION (l BUILDING MECHANICAL i 1 pLUMBING f I SIGN <br />PROJECT ADDRESS I, /- 1j. p �� <br />y v� `l A � � � �'16 a0� <br />OWNFp MI1IL�DIXiE55 CITY 7iP nHONF. <br />GLEuti1 SER�_ �1b�� S 3� l�u� Gvc�� �� , wa. �t�ao3 a5a o��5 <br />1FN1Ni unii�none55 nrv nn ruor+E <br />SAMc <br />�xrm[cT on o6sicNen M�II Af�RE55 att nr rnoNe - <br />r,e�nn�ccr+mncron MAl1.ADD0E55 cirv nr nnoNr surrucrrxe. <br />MECN�NICnLCON7R�CtOf1 MAIL�IJbf1E55 CITV 7iP PIIONF STNFUGFNSF• <br />� L- I� <br />PLV48�NGCONIR�CTqi MML�ODRE55 CIIV 71P PIIONE Si�IEUCFNSE� <br />coranecr <br />,. NST RI.L <br />Iuslqu <br />�ROPOSFO U[E OF p111L01N0 <br />� 55�oi • 4� <br />FOOTIIGE INVOLVED <br />NwT (GraS <br />iec•i oescmrnon or rnorem isirowr� ee�owon <br />lOT BLOCK —_ nr <br />__--._..._.._...._.. Sao� - 004 - oo�- o00 <br />CONSTtil1CT10N �O�N 1 ENDER, AOOf1E55. TELEMIONE NUMPEO <br />PLUMBINO <br />NO. <br />WATER <br />OR <br />DISP <br />�G FOUNTAIN <br />DRqIN <br />FEE <br />SVBTOiAL $ <br />PERMIT E <br />TOTALFEE 3 <br />FOR OFFICE USE ONIY: <br />rn�rcF*nacK nFnnsetnncK <br />USE20NF <br />i�E�mir uMrt�nov <br />OCGIIPANCY NO M 51 <br />cnour <br />fIRF. RLAOM PEOO <br />fIRF SPf11NNIERRE00 <br />1 Ul R1FA <br />ruo or owEiur+n <br />IiN1iS <br />OCCUP�NiIO�U <br />DAiE <br />soE sernncx <br />V�CRII� $IIF. <br />IiY[S Iit�U <br />SIIE O� 9LD(:R I <br />IIYES II NO <br />CITY OF EVERETT <br />LOCAISALES <br />TAX CODE IS 3105 <br />HEATING SYSTEM: � GAS f I ELECTHIC f I <br />coNincrrrnsounHnruoueuo , , <br />— � i7- a��� <br />I HEREBV CERTIFY TNAT I HAVE READ AND EXAMINED TfiIS <br />APPUCATION AND KNOW THE SAME 70 BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING iHIS TVPE O(' <br />WORK WI�L BE COMPLIED WITH WHETHER SPEGFIED HF.REIN OR <br />NOT. THE OqANtING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTNORITY TO VIOLATE OR CAiJCEI THE PROVISION OF ANV <br />OTHER SiATE OF LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUiHORIZED BY THE <br />OWNER OF THIS PROPERTV TQ PERFORM iHE WORK FOR WHICH <br />APPUCATION IS MADE AND I COMPIY WITH THE STATE <br />CONiRA TORS LAW 18�.2` RCN AND 296.200 WAC. <br />x� � I� Q'- 5 - %b <br />SICNRIIIRE –�— p�IG <br />CItV BUSINESS LIGf.NSf. NU <br />TVPE OF EOUIPMENT <br />A/C — AMNDLO UNITS — H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />liEAT PUMA <br />UNIT HEATENS — �.T.U. M <br />CLOTHES DRVERS <br />VENTILAiION FAN <br />RANGEHOOD <br />WATER NEATER <br />WOODSTOVE <br />METALFIREPLACE <br />FIqEPLACE INSE(i" <br />GAS FIREPLACE <br />GASRAN6E <br />GAS PIPING <br />rl nN Crl[CK <br />eunnwr, <br />PU11.IpMC <br />IlfC1l�Nlf.�l -- <br />�f�U�11N1M PI �N CNf f.N <br />murn <br />SiNE DI/IIbVlG SIIOCINpf,E <br />PIIpIIf.NMf1RS <br />TOtAL <br />rrr <br />nrcnriHo <br />