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APPLICAT14.i FOR CONSTRUCT.aa:+l PERMIT /��� <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl DEMOUTION �l COMBINATION fl BUILDING I-1 MECHANICAL � l PLUMBING f l SIGN <br />PROJECT ADDRESS , i _, , „ �` , � , , <br />oYMER MRILaooRE55 Clrv z�r r11o6[ <br />�j •, ��' S�7/o .5...,.c s�i� •r� c.Er�_. �y wa �Fzo 3 2�'S'- } 0 3 G <br />TFNANT MRILApD�E55 GLY 214` PNONF <br />pRCNIT[LTORUESIGNER MPII <br />i'LUMBINGCON7PAf,TOR MAIL <br />CONTR�CT PRICE OF WOfIN <br />DESCRIBE WORK AND SOUARE FOOTRGE INVOLVED <br />�al�� -, ,c� -_.� Se � /-.. �• . _ <br />,�jQw,.� /vti 4 f'I. <br />PROPo,S�ED USE OF BUILD:NG <br />%�G 5 / c:i.. < <- <br />LEG�L DESCPIPTION OF 1'ROPEFTY (SIIOWN BELOW OR FTfACM <br />LOT BIOCN Cf <br />PARCELTA%I.U.NUMBER <br />CONSTqlICT10N LOAN 1 GNDER �DDf1E55, TEIEPHONE NUMFEP <br />PLUMBING <br />NO. TYPE OF FlKTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASM BASIN) <br />SHOWER <br />KITCHEN SINK 3 DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENiERS <br />SINK ISERVICE — BAR, ET <br />tu• r•rvrn: oin�iui.croc. <br />j�P PI10NE STATE LICENSE • <br />21P PHONE STRiELICENSE� <br />HEATING SYSTEM: f� GAS f 1 ELECTRIC I l. <br />f.ONTRCi �[R>ON ANp PIIONf. NO <br />I HcREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUF AND CORRECT ALL <br />PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WNETHER SPECIFIED 11EREIN OR <br />TwocoriEsi NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOh OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TNE <br />OWNER OF TNIS PROPERTY TO PEFF�)RM THE WORK FOR WHICH <br />APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br />CONTHACTORS LAW iQ27 (iCW AND 296.200 WAC. <br />X � %" /�— -r'1S' <br />SIG RLU E DAI[ <br />CIIY OUSIN[55lICENSL NO <br />OR ITEM FEE NO. TYPE OF EOUIPMEHT FEE <br />A/C — A/HMDLG UNITS — H.P. ; <br />� FORCED AIR SVSTEMS — B.T.U. M E.A. � <br />i HEAT PUMP � <br />. <br />� UNITHEATERS—B.T.U. M <br />� CLOTHES ORVERS <br />� VENTILATION FAN � <br />� RANGEHOOD i <br />i VJATER HEATER <br />WOODSTOVE <br />METAL FIFlEPLACE (WOOD BURNING) i <br />� FIREPLACE INSEFT (WOOD OURNING) � <br />� GAS FIREPLACE � <br />C.) GAS RANGE _ <br />GAS PIPING <br />, EXHAUSTFAN � <br />SUD TOTAL 5 <br />PERMIT S <br />TOTAIFEE 5 <br />FOR OFFICE USE ONLY: <br />�RONT fiFTPPf.k RF.AR $RORCK <br />USE 20NE <br />❑EiGllt UMIIRTION <br />OGGUP�NCY NO Of <br />GROUP <br />�IRE �LMM REO� <br />r�RF crR�NNI [ R PE( <br />irre oF r,or+sr <br />1 Oi MEA <br />NO OF DW[IUNG <br />CNIIS <br />uniL <br />SIDE SETP4CN <br />VACRNi SILF. <br />IIYES f'� NU <br />SIZE 0� OLU(:rt I <br />SUB TO' <br />PERMIT <br />TOTALf <br />ri nu cnccK r+un+nrn � rer � ner.nrr eo <br />�UIl01NG <br />PLIIMOING <br />�SFMENL MECi1RNICAI. <br />IlYES !1 NO <br />' ADpI11pNA1.PL�NCHF.CK <br />on�cn <br />STAi[ 01➢LOING SUIICIIARf+E <br />GTYOFEVERETT runi�cwonKs <br />LOCALSALES ---- <br />TAX CODE IS 3105 707AL <br />