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APPLICATIOA FOR CONSTRUCT�ON PERMIT/��� <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f� DEMOUTION �l COMBINATION �l BUILDING I� MECHANICAL �' PLUMBING f 1 SIGN <br />PROJECT ADDRESS <br />Mnn aooness <br />O�T�7 V.Ut�-M �. <br />drv 2ir <br />21P <br />cm rm m�.rve <br />cEnrnniCO�+tnncton Mnunooness � cnv :�r r�rove �inreucrr+,c� <br />LO Sr�r C,a+i*��+ct�s�1 M��Nn�_ �1y S$1I Co�U [Go17 AN <br />MELNRNICALCONTRACTOB M41lRDDRF.55 GiY lR` PIIONE �IATEUC[NSC• <br />P W MBING <br />PND! <br />_ � <br />rnoroseo use oc ouuoiruc <br />MAIL ADDRE55 <br />LEG�L OESCRtPTION OF PROPERTY �SHOWN BEIOW Oft FTTRGN T WO COPIES� <br />LOT BLOCN OF <br />GONStRUCT10N IORN LENDER ADDRE55. 1El EPIIONE NUMBER <br />WATER <br />SHOWER <br />KITCHEN SINK <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />�ACKFLOW PREVEN' <br />SINK (SERVICE — BA <br />IIP PHONE ST/1ELICENSE� <br />HEATING SYSTEM: I� GAS f 1 ELECTRIC ! l <br />co rrrnsor+nHovrwNrNo <br />1� J .11� J �� Z� I <br />I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7 ALL <br />PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLAT[ OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TV1E <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />x ��w�a,� �� �����r <br />SIGNPiURE �nTE <br />NO <br />OR ITEM FEE N. TVPE OF EOUIPMENT <br />� A/C—AMNDLGUNITS—H.P. <br />; FORCED AIR SYSTEMS — O.T.U. M E.A. <br />i HEAT PUMP <br />UNiT HEATERS — D.T.U. M <br />� CLOTHES DRVERS <br />VENTILATION FAN <br />� RANGEHOOD <br />WATER HEATER <br />� WOOD STOVE <br />METAL FIREPLACE (WOOD OURNMC,} <br />FIREPLACE INSERT (WOOD �URNING) <br />� GAS FIREPLACE <br />�.) GASRANGE <br />GAS PIPING <br />i EXHAUSTFAN <br />FOR OFFICE USE ONLY: <br />PRONTSGiA�CN RE��SF.TIIALN <br />USE ZONF <br />IIFIC+IIT LIMIIRTION <br />OCCUFANCV NO O4 Stl <br />Gnour <br />FIRE pUf1M REO� <br />fIPF. SPRINqFRRFOD <br />IOtAPE� <br />SUBTOTAL $ � <br />PERMIT 5 <br />TOTALFEE 5 � <br />sioe serencK ri��+ <br />NO OP f1WELUNG <br />IINII$ <br />UAIE <br />VACANt SITF <br />IiYES �� k0 <br />SIZE OF BLDGR 1 <br />OASEMENi <br />1`vE5 i� NO <br />CITY OF EVERETT <br />Lf�CAL SALES <br />TAX CODE IS 3105 <br />FEES <br />owioiac <br />PIUMpING <br />M[CIIANICAL <br />AOpI1�ONAl. PI AN CNECN <br />O1MER <br />SIAtE 0111t014G SI1Rp1�RC[ <br />rut+i ir, wonns <br />TOTAL <br />rFF <br />SUB TOTAL S <br />PFRMIT S <br />TOTALFEE $ <br />nrc cmt No <br />FEE <br />