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APPLICAT�N FOR GONSTRU�ION ���MIT� <br /> CITY OF EVERETT•BUILDING DIVISION , <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ri DEMOLITION fl COMBINATION rl BUILDING MECHANiCAL '� PLUMBING fl SIOp <br /> PROJECTAODRESS 3 t i�' � ve. l,�) � <br /> owrren u.n.00ness cirv :m viwue <br /> �-lrFto k1vV���,lU', �4�1���I�r�eAQ-`cutvciE l�un1.� l"L (2cYe��lU -�alnl <br /> 1FNANt qlA�l. pp0(5$ CIIY iV p1�01iE <br /> nnLNICC�Of10E5�Gn[0 uY�M,ppE55 Ulv )m mqNE <br /> Th��Fsk.u,�le�; 1lvran�kec. . ko �Ald.u.v 4�1.,Sie ac�Lcaa,un.'L� 9�pa� , (2U1p1���s��3c� <br /> K.��c� �n��a� L�C �C��v-ne c�� (��DJP 11�TC0\i�O�IC�I <br /> NECII�NiCRICONI0�C1011� MA' AOpf1E55 f.lry IiP PIIONE Lt�tEUCENSE� <br /> �'Uc'�11e�:.. ' �.o � � �0� �t�y, 9��3 Cw��\3�i-�r�� �f rN��o�r8� <br /> PIUA1011tiL01110�C10n IA�ItAIXIP 5 LIIT Ilv PNONE SI�IEIICENSE <br /> va�� ' � � .�3��,��savn c�o�o\��-iN9� wn�-r���ioa� <br /> � cwnn�crrmceawonx <br /> HEAT�NG SYSTEM: f�IGAS ELECTRIC fl <br /> DESCOIBEKVBKANpS U�11EF IAG NVOWEO � IPEf15011 0 IIONENO^ n�A <br /> �' ,� / � l <br /> � �m��.t -i- � f,�(A " � � ?� -oa�o � � dos .a s��t ,al,� <br /> I I{ERE�Y CERTIFV THAT I HAVE RFA� AND E%AMINED THIS <br /> rnoroseouse ov emioinc APPIICATION ANO KNOY/THE SAME TO IfE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TYPE OF <br /> �7— S . WORH WIIL DE COMPUED WITH WHETHEfl SPEQFIED HEREIN OR <br /> � LEaloes �ioNovVn [nrv�9�avm -iowalert�c�nwocowE51 NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or�eioc. � or AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> ' (� r OTNER STATE OR LOCAL LAW REGULATINC�CONSTRUCTION OR THE <br /> � � 5 1�.' �A K_ ' ��S FERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEO BY THE <br /> — OWNER OF THIS PROPERN TO PERFORM THE V�JRN FOR WHICH <br /> � L ( � ��� �� APPLICATION IS MADE AND' I COMPLY WITH THE SiATE <br /> - ru¢ ii o.Huu'' CONTRAC OFlS LAW 1827 RCW AND 206200 WAC. <br /> covsmucnoniou1ieuocn�oonsss.�Ei[r��oxe� x ,�Vl1C �. � <br /> sr,�.�une w�E <br /> GYIY BV9uE551¢ENSE NO <br /> , PLUMBING MEGHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. IYPE OF EOUIPMENT FEE <br /> WATER CLOSET(�OILET) A/C—MiNDlO UNRS—H.P. <br /> OttfHTUe FORCEDAIRSYSTEM¢—B.LU. M E.A. <br /> LAVdTOflV(WASH PASIN) HEAT PUMP <br /> — SHOWER UNITMEATERS—B.T.U. M <br /> KITCHEN SINN 8 DISP CL07HE5 URYEflS <br /> DISHWASHER VENTIIATIJN FAN <br /> I.AUN�flY TRAY � RANGE MODD <br /> _ CLOTIIESWASHER � r— WATERHEATER <br /> UflI;IAL —� — WOODSTOVE <br /> ORINNING FOUNTAIN METAL FIREPLACE(WOOD BURNING) <br /> FIOOR URAIN — FIfiEPLACE INSERT(WOO�BURNING� <br /> OFCRFIOW PREVENTEflS GAS FIREPLRCE <br /> SINK(SERVICE—DAR.ETC.) <br /> � / GASFlFNGE <br /> . GAS PIPING <br /> EXNAUSTFAN <br /> i <br /> SUBTOTAL, 5 SUOTUTAL S <br /> PERh11T 5 PERMIT f <br /> TOTAIFEE 5 TOTALFEE E 3 <br /> FOR OFFICE USE ONLY: � <br /> rnartseru�cK ne.nse�e.cK soese�o.cn rur�, �n Fce �eccm�Ho <br /> / <br /> WEI011E IONPEA V�CANI$IIE VALUATION FEE <br /> I IYFS II x0 �� <br /> IIEIGIIILMIf�110N NOOfUWfIIINO 51lEOiBLWIII � <br /> UNII$ �I111.101x0 � <br /> �'� <br /> OCCIIGI.NCY tqOfSlMu[5 OCCUvuIIl0e0 OeSEPEN� u����µ���� <br /> cnouv <br /> , I i ncs n xo <br /> . nn¢�unuacon nE.soH �ow�iwu.n•nc�rtcn <br /> on�en -- <br /> nncsrniuKiEnncoo nc�sov <br /> surt o�mmr�c sunc�unct <br /> nreamr�si rinrvserrnov[oor CITYOFEVERETT rumir.vmnKs <br /> LOCALSALES � <br /> ,,,,� TAX CODE IS 7105 toinL � <br /> _. ... .. .. . ._. ... ._ _ . . _. . i <br />