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APPLICATIOrI FOR CONSTRUCT�ON PERMIT �}J. <br />CITY OF EVERETT • BUII_DING DIVISION �/ �� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 �Q` ��"" <br />rl DEMOUTION fl COMBINATION f i BUILDING f� MECHANICAL � 1 PLUMBING ( � SIGN <br />oym¢n uait�ooness citt zm r��o�+r. <br />`'�v • �7v,inct S[hel�i- 3C�3_�;_� <br />IEN�NT MAILRDORCSS CIIY l�P f��OM <br />IIRCHRECT OR DES�GNEP M�IL ADORE55 GTV liP PHON[ <br />GENEP�LCONTMCT(Ni MRIlAODR[55 CII1' :U` P�104[ SIATEIIC[NSE� <br />MECHANIL6LGONTRnCTOfi MAIIAD�RF55 CITV 71P PIIONF. St�TEIiCEN<E• <br />PLUMBINGCONiRAf,TOR MAILADURESS CITY IIP PHONE STAIEIICENSE� <br />pE$CRIBE WORR �NO 50U�RE FOOT�GE INV01AE0 <br />PYo�Gne ���5'�,I�u{�o <br />, i <br />RttnCN TWO GOPIES) <br />LOT BLOLN <br />fpN57RUCPON LOAN LENDER, �DDRE55. TELFPNONE NUMBER <br />PLUMBINO <br />NO, TVPE OF FlXTURE OR ITEM I <br />WATER CLOSET�TOILET) <br />BATIitUB <br />UVATORY (WASH BASIN) <br />;.HOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRV TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKtNG FOUNTAIN <br />FLOOR DRAIN <br />DACKFLOW PREVENTERS <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />ff10NT SETP�CK RF:�R SFTAACN ilOE SGTpRCN <br />USE ZONE <br />IIEIGNi LIMIT�tION <br />OCCUPANCY NO 0� 54 <br />cnour <br />FlRE AL�RM �iEO P <br />fIRF' SPRINKI FP REO-D <br />HEATING SYSTEM: I i GAS ! 1 ELECTRIC � l <br />CONiPCi PF.RSON AND PIIONF. NO <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIICAT10N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER 5?ECIFIEO HEREIN OR <br />NOT. THE GRANTIN(i OF A PERMIT �OES NOT PRESUME TO GIV[ <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 I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOP WNICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.2) RCW AND 296200 WAC. <br />x I 9 Y�.11 S� �l lti'U/�' ��/�l �� � _ <br />SIGNPTl1RE �A�� <br />CITV BUSINE55 UC[NSC NO <br />MECHANICAL _ <br />NO, TYPE OF EOUIPMENT FEE <br />FORCED AIR SYSTEMS — B.7.U. M E.A. <br />HEAT PUMP <br />IINiT HEATERS — B.T.U. M <br />GLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOC <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIfiEPLACE INSERT (WOOD BURNING) <br />GAS <br />FAN <br />SUBTOTAL 5 <br />PERMIT S <br />TOIALFEE $ <br />rinr�cn�eKbyromyn�, ree Inrcrirrno <br />tpTRRFq VACRNt 9iF <br />� ��ES � � ���� OWL�iNG <br />NOOPUWCLLING SIZEO(BICG/tl <br />UNIiG SLIINOING <br />OCCU�ANILOAD PASEMENI MEC�I4NILRL <br />nvEs � Hn <br />nooiuoNn� ri.nv crmc� <br />fifAGON _�.— <br />ovien <br />Rf�FON <br />STI.iE fl11ilOMG SUfICM�PCE <br />r�nvsnrrnovcnov CITY OF EVERETT rum�r,wcnKc <br />LOCAL SALES - � <br />,.... TAX CODE IS 3105 70iAL <br />