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.-. <br />APPLICATION FOR CONSTRUCI _dN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f7 DEMOLITION fl COMBINATION I l BUILDING fjy{AECHANICAL r � pLUMBING fl SIGN <br />OWNER M�IL�OORESS CITY � Im PNON[ <br />�.@ED `?1lU/l�il� EiY/7_ LrJ[Ta'o•'C �820� 3S3-yo3o <br />TEN�NT MqL/�WRf.55 f.ITV 71P pHONE <br />11RCPoTECTORDESIGNEP M11II.MDRE55 �ITv 71P PNONE <br />GENER�LCONTR�CTdi MqL�DORE55 �IIY piP PHONf: StATEUCENSE• <br />MECHANIC�ICONTR�CTOR M�IUDDRE55 f.ITV IIP PIIONE SUTELICEN$Ei <br />CC>'2_ <br />CONTMGT PRICE OF WOi1K �� JO —� <br />J <br />OESCRIBE V/ORN �ND SIX1�RE FOOTAGE INVOIVED <br />ioT e�ax oF <br />P�ACEIT/JI I D. NUMBER <br />CONSIPUCTION tOAN LENOER, MpiE55. TELEP110NE NUMBER <br />� PLUTASIN6 <br />. � NO. TYPE OF FlIITURE OR ITEM <br />SUB TOTAL S <br />PERMIT S <br />FOR OFFIGE USE ONL1': <br />FRONT SFTP�CN PUR SF.TP�LK <br />115E20NE IOT�RE� <br />HEIGNI L'uiT�TiON NO OF OWELLING <br />UN175 <br />STATE LICENSE • <br />HEATING SVSTEM: f 1 GAS fl ELECTRIC fl <br />CONUCT PF.RSON AND PNONE N0. <br />I HEREAV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS 7F LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL dE COMPLIED WITH WHETHER SPECIFIED HEREIN O'i <br />cooiesl NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OH LOCAL LAW RE6ULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTIOk. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPEHTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTFACTORS LAW 1827 RCW AND 296200 WAC. <br />41 :�' ai�2lv� 7�e <br />51 � T ��" U�1E <br />CITY BVSME55 LICENSC NO. <br />SIOE SETBRCN <br />V�L�NT SItF. <br />f1VE5 fi NO <br />SIZE Of BLDGrt� <br />f1Vf.5 I1 NO <br />EpU1PMENT I FEE <br />A/C — AMNDI� UNITS — H.P. <br />FORCEb AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIt HEATERS — B.T.U. M <br />GLUTHES DRYERS <br />VENTILATION FAN <br />fiANGE HOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE S <br />PUN CII' CR NOM9[P � FEG � AECEIPT ND. <br />ammwr. <br />PLUMpI'JG <br />1A[CIIIINICAI <br />��Di11pNAL PIAG C�If.GK <br />onrzn <br />s*nie nmi omc sunr,��nnce <br />rrvecx'r,or+sr rinNsnrrnovenor CITYOFEVERETT runnr,wonK•. <br />LOCAL SALES - <br />,,.,� TAl( CODE IS 3105 TOTAL <br />