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� � <br />� <br />APPLICATIGrI FOR CONSTRUCT �ON PERMIT <br />C'TY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />f-1 DEMOLITIJN fl COMBINATION �BUILDINf+ i l MECHANICAL � 1 PLUMBING f l SIGN <br />PROJECT ADDRESS -y�— <br />- � <br />� .5 1 `1 `� �� � � `�- <br />Vrm�en ��r, n�qn. �uu��ess cin ',r rMONE <br />i � <br />��„�a� I�tc.�C�r o2c�i�i 5} � r_�- �a 9Q�vi s.�-l'I�� <br />TEN�NT MAILppORC55 GTY 71P PIIONE <br />11RGNITECTORDESIGNER MRIL�ODRE55 �Itt ]iP pHONF. <br />GENEtiPLCONTR�Ciqi MAILApDP[55 .❑Y TiP PIION[ StATE110ENSf.• <br />Ou�,�7�r S��a��. as a vJ� <br />MECNRNICIIL LONTRACTOR MAIL �DDRE55 (;IiY 7ip PHONE STATF UCF.NSE � <br />OLUMBINGCONiRAf,iOR MRILAD�RE55 CItY ZIP PIIONE SiA1[�ICENSE• <br />PRICE OF WOtiK <br />SD D �,� <br />NORN�NOSOUARE <br />0 <br />LEGq. pESCRIPTION Of PROPF <br />LOT BLOCN <br />CONSIRUCTION LOAN IENDER. �UDRESS. TEIEPHONE NUMBEO <br />PLUMBIN6 <br />NO. TVI�E OF flXTI <br />WATER CLOSET (TOILI <br />BATHTUB <br />LAVATORY(WASH BA: <br />SHOWER <br />KITCHEN SINK E DISP <br />SINK <br />SUBTOTAL S <br />PERMIT 5 <br />FOR OFFICE USE ONLY: <br />fRONiSFTPACN PF.RRSF.TORCN <br />USE20NE IOTRRF� <br />NEIGIIT LIMITATION NO Of fIWFLLING <br />IINIIS <br />OCIXIPRNCY NO Oi S10Pi[5 OCCUPRNi LOAO <br />i.ROUP <br />FR PF.O'D <br />PLANSAPPROVEOOY <br />CJPIES� <br />FEE <br />SIOE SEiBACN <br />V4C�Ni SIiF <br />IIY[5 I' NO <br />HEATING SYSTEM: f 1 GAS I-1 ELECTRIC f l <br />CONiRCT PERSON AND PIIONE N0. <br />1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. 7�HAT I AM AUTHOR12ED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE PND I COMPLY WITH THE STATE <br />CONTRACT RS LAW 10.27 RCW AND 296200 WAC. <br />x ���v�7�f" � � � i i �i � <br />51 iORE � O�TE <br />Citt BUSINE55I ICGNS@ NO <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />A/C — A/HNDLG UNfTS — H.P. ' <br />FOFCEDAIRSYSTEMS—B.T.U. M E.A. ; <br />HEAT PUMP �— <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRVERS i <br />VENTILATION FAN � <br />RANGE HOOD ' <br />WATER HEATER <br />\YOOD STOVE ' <br />�9ETAL FIREPLACE (WOOD BURNING) i <br />FIREPLACE INSERT (WOOD BURNING) � <br />GAS FIREPLACE I <br />SUB TOTAL $ <br />PERMIT 5 <br />TOTALFEE 5 <br />rinricuecKHumnen Ircr �necrirrNo. <br />ONIOMG <br />SIZE OI' BLDOR 1 <br />PI IINOMG <br />BRSEMENI M�p�pMCnt <br />It\ES ��NO <br />ADU1110NN. PI.�N CNf.CN <br />OIHER <br />Sinlf. IiUR01vG s1Inr1URC.c <br />CITY OF EVERETT riiruc won�c <br />LOCALSALES <br />TAX CODE IS 3105 TO7AL <br />