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APPLIC�4T10.� FOR Cf�NSTRUCi�JN PERIIAIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f� DEMOLITION ( I COMBINATIOY 1 1 BUIL.DING i 1 MECHANICAL � 1 PLUMBING I I SIGN <br />PROJECT ACDRESS <br />8i0� %i�i' ff VE S� <br />owNEn <br />1F.NANT <br />A(iCHRF.G70R �CSIGN[R MAII ApORF55 <br />cin zir <br />_ VE.PE7T l�t//-� � <br />( IiV 21P <br />CIIY Tlp <br />CItY yIP <br />1 / _ /i ) . (�-I-.. _� <br />0 G �Z %0 - %��z/ <br />CHONE <br />SIAT[ UCffJSE + <br />U •...• ��� rrwr� StATE� <br />PLpMURlGCONTRPt;TOR MnILAU0FE55 QTY ZIP VHpNF �STAiFIICF�lSE� <br />CGNTRACTpRICEO(j OqH� — <br />-y �� HERTING SYSTEM: I I GAS f; ELECTRIC f l_ <br />DESGRIOE WORK AH� SOUARF FOOTpGE INVOLVE� CONTACT PfR50N AND PIIONF NO. <br />Wi0PO5ED USE OF BUILDING <br />LEGAL OESCRIPiION OP PROPERtt <br />LOi OLpCK _ <br />PARCELTAXI.D.NUMBER <br />CONSTRUCTIONtOANLENpFR,p�ORESS.TElEPt10NE NUNBEB <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET(TOILET) <br />BATHTUB <br />LAVATOFY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNORYTRAY <br />CLOTHES WASHEFi <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEPITE <br />SINK (SERVICE — BAR, <br />TVlC WPIES� <br />FEE <br />SUB TOTAL 5 <br />PERMIT S <br />TOTAL FEE 5 <br />FOR OFFICE USE ONLY: <br />FPONiSFTPnCN RF.AR SFTp�CK <br />❑SF.20NF. IOiaPEA <br />❑EIGHTLIMIiATION :JOOFUYIC.UING <br />IINIiS <br />OCCUPANCV NU OfS�ORiFS OCCUPANiLOAD <br />Gf1�l1P <br />FIqEALARMqEOP RFASON <br />FIRFSPRINKIf-RRfO-D RE4FON <br />tvae ar coNsr ri nNs nrr�noveo ov <br />untE <br />SIDE SETPACn <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNON THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS 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 VIULATE OR C;_h+'Fl. THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION �R THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY 7HE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOI7S LAW 182'I RCW AND 296200 WAC. <br />X���`;—�;,-;.� �s J <br />SI ATUFE D�TE <br />CIiY pU$ING55 LIGENSL N0. <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />A/C — A/HNDLG UNITS — H.P. r— <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PUMP —T— <br />UNI? HEATERS — B.T.U. M � <br />CLOTHES DRYERS <br />VENTILATION FAN r— <br />RANGE HOOD � <br />WATER HEATFR —i— <br />WOODSTOVE � <br />METAL FIREPLAGE (WOOD BURNING) i <br />FIFEPLACE INSERT (WOOD BURNING) � <br />GAS FIRFPLACE ; <br />GAS RANGE �— <br />GAS PIPING <br />EXHAUSTFAN , <br />SUB TOTAL 5 ; <br />PERMIT S <br />TOTAL FEE 5 R� ! — <br />PLNJCHGCNNUM9[(i � FFf I RFCFIPTNO <br />V�CRNI SRF FEES <br />fiyES il NO <br />OIIILDWG <br />SIZE OP ALOG/TI <br />PIUMOWf. <br />P�SEMENt 6�fC11�NICAt <br />I rvE5 � I NO — <br />MUI I IONN. PI AN G��GCK <br />OillEl\ <br />SiNE OUIL[)I4G SIIRCHnpGE <br />CITY OF EVERETT rimi �c wonKs <br />LOCAL SAIES <br />TAX CODE IS 3105 TOTAL <br />