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APPLICATI�i�! FOR CONSTRUCT�ON PERMIT/ <br /> CITY OF EVERETT• BUILDING DIVISION L�C� <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259•8810 � <br /> fl DEMOLITION fl COMBINATION fl BUILDING I 1 MECHANICAL �1 PLUMBING 1 l SI(:N <br /> PROJECT ADDRESS . � � �p�z 7 � <br /> � 5 t��`UL ���L1 G'�� '�^� �1/� � `c��„e, ��' u'!�' <br /> owr+En Mut•q�ess cirv m rr�or+ <br /> M�u�� t" C:.(��. �� �'s��:��, G.v;R- �y�—�5 C!r � <br /> TENIINT M�IUfH1RE55 �� CI1Y � IIP i'110NE <br /> f � � /I i <br /> /v I � '��/� .�= /-rJ-< i'c . _�� ��%�)":. —_ <br /> �RCHITCCT OH OESIGN[R MMI�D[1RE55 GiTY 71P PNONF <br /> �v�l.�.q �'���� /y '�/ �' 22� L� ��. ��'c"�c� Ci��.� <br /> GEN[ML CONIfIRCiOq MMLFWRESS GtV ]IP P��04[ SiRif.11CENSE• <br /> _) ann�5 L �iC� ov� c':lsc�n ��'z� ��Y1�, <br /> MELHnNIC�L CONTRAf,TOR M�II�DbHF.55 CITY LIP PIIONG 5T4TF I ILGNSE� <br /> t'IUMBMGCONTR�CTOR M41LqDDRE55 LIiY IIP VIIGNE STAiFtICENSE• <br /> cor+rruc*rmc oF won� T� . <br /> ��'�?�;�j HEATING SYSTEM: I 1 GAS f 1 ELECTRIC p _ <br /> OESCRIBE W(�RK�ND SOUARE FOOTAGE IN�OLVED � CONiACT PfR50N RN�i�110N[NO <br /> �, l � I�j � (/ _ <br /> �c � � G.xv� � .l�'m cs� C��s� 7 a -2�� <br /> DO � � I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE T'iUE AND CORRECT ALL <br /> vnoroseo use eundr+c PROVISIONS OF LAWS AND ORDINANCES GG FRNING THIS TVPE OF ' <br /> WORK V/ILL BE COMPLIED WITH WHETHEP 'ECIFIED f1EREIN Ofi <br /> LEG�LOESCRIPTIONOfPROPEPTY�SHOWNOEIOWOt1�TTRCNTWOCOPIES� NOT. TF1E GHINTING OF A PERMIT DOES NO� PRESUME TO GIVE <br /> iot BLOCK_.. _OF AUTHOFiITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEU BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WJRK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STPTE <br /> PARLELTIV(ID. BER CONTHA RS LAW 1827 RCW AND 296200 WAC. <br /> G n ; � �O � 7;' :� ����I�*`C/�'� � <br /> CONSTRUCTIONIO�NIENDER'�ppRE55.TELE1'NONENUMPF.R X L (�J <br /> SICaN RE U�IE 'J <br /> CITY AUS�NESS UCENS[NO <br /> PLUMSIN6 MECHANICAL <br /> NO. TYPE OF flf(TUHE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. . <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.i.. � <br /> UVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER UNIT HEATERS—B.T.U. M <br /> KITCHEPI SINK d D P i CLOTHES DRYERS i <br /> UISHWARHER VENTILATION FAN � <br /> LAUNDRY TRAY � RANGE HOOD <br /> CLOTHES WASHf� WATEH HEATER <br /> URINA� WOOD STOVE <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSEHT(WOOD BURNING) <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> T <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> GAS PIPING <br /> i EXHAUSTFAN � <br /> ; � _ <br /> SUB TOTAL $ � SUB TOTAI $ <br /> PERMIT $ PERMIT 8 _ � <br /> TOTALFEE 5 TOTALFEE E ' <br /> FOR OFFICE USE ONLY: <br /> �RONT SETPRCK RF.�R SFTPRCN SIpE SE7A4CN �UNCHECN NUM9fR If[ AFf.FIPi NO <br /> � ���� <br /> Use zoNe i.oi n,r,p vacnvt Srte FEES VALUATION FEE <br /> i�res �; rvo ounnwc 9 ; �Jv <br /> NEIGNTLIMIiRTION NOOFUWftLING 512EOfFLIXirt1 <br /> UNi15 II� n /���5 PIUMOMG — i <br /> �T� <br /> OCQIP�NCV NO OI SfMU[5 OCCUPRNt LORD BASFMENI MFC�InNIf.M. � <br /> GROUP �_ <br /> 1 2 ND G!�- �,�FS D��� — - <br /> fIPERURMRFOD t1lASON <br /> aooiuor+ni.m na cuccK I <br /> ---i-_ <br /> 1I i <br /> N� OiNFR i <br /> FIPFSPRINqFRREO'0 �FA�ON <br /> '��V SiAifl0U11U14G511Rf.11�qf.f � � r� <br /> �V <br /> irreorr.or+sr rinNsnrrnovFnnv I—CITYOFEVERETT rnnncwnnec I <br /> � JA1, LOCAL SALES -- -- —---?��— <br /> � oAtE ti (� �J� TAX CODE IS 3105 TOTAL � (� ' � <br />