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ApPLi�ATIV�I �OR CONS'TRUCT �ON �ERl1111T <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVEqETT, WA 98201 • 259-8810 <br />rl DEMOLITION I�YCOMBINATION ��YBUILDING I�YIdECHANICAL <<=�PLUMBING f l� <br />PROJECTADDRESS //�/� /��— �J/ U � <br />r <br />Mna nvuness <br />�a7 /7-3(�Xl,o.�. <br />IAAIL AD�RF55 <br />5, b�wv�r..-� C(//i <br />� <br />CIIY [iv <br />rNor+E <br />P� �:.� <br />G-S� -�30 <br />ARCIIIfF.CT OR �ESIGNEF �Ap�� p��RtSS ""' '�� <br />GENEt1�LWNTRRG R1 MAIL/•DURE�S Cli� ZiP PHONL Si�TFIICENSE� <br />I��r //')., s,..,w �, «.G-.._,_.� If A1uHS'c o�S � > <br />� L' 1 l3_e-`S'1�...✓!."'t-' _ <br />MECHANI ALCONTN�CTOR MAI�AUGHESS Cltt 71P P�10NE ST4iF.LICENSE� <br />PLUMBIYG CON7FnCTOR r�:.U4 ODRESS CIN 21P PNONE STAiE LICF.NSE � <br />CONTRA7TPPICEOF WOPK � HEATIIJG SYSTEM: �GAS f 1 ELEC? RIC I I_ <br />DESCRI�'c WORK PNO SOUARE FOOTAGE INVOIVED n ^ CONTACT 'EqSGN A� PI�N[ 1j0 O �� !� a�� 3� <br />'1 // <br />PROPOSED USE OF UURUING /� 1 <br />c�.(.,�.lr L„n7w4 0?J'-� . <br />LEGAL UES/C-RIPSAN OF PaOPERtt (SH�M BELOW OR ATTAS�� T4 <br />l� BLOCK or�,�_�� <br />�or -- <br />C�j�— _ ( /.0 .-u u .� � � <br />PANCEL7AXI.D.NUMBER <br />CONSTRUCTION LOAN LEN9Efi. ADDPESS. TE�EPd01lE NUMBER <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />^,L WATER CLOSET (TOILET) _ <br />BATHTUB <br />�_ LAVATORY (WASH BASIN) <br />SHOWER _ <br />( KITCHEN SINK 8 DISP <br />� DISHWASHER <br />LAUPlDRY TRAY <br />CLOTHES WASHER <br />URINAI <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TqTAL S <br />PERMIT 5 <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />fRONTSF.TPFCK �E�R SFTDACN <br />USE Z NE lOT PREA <br />%� -3 <br />❑EI[HT LINNATION NOI OF DWELLING <br />ii <br />OGCUPANCY I NO OP Si0RC5 UGcurwrvi u <br />on ur � <br />iREALAR/�A REOD 9FASON <br />J`{'D <br />; IPF SFfiIN I FR REOD tiFn50N <br />D <br />Fvreorco�+sr ninr�snrrn� <br />���� ,...��/1 <br />FEE <br />SIOE SETBnCN <br />I HE�[6Y CERTIFY TFiAT I HAVE READ AND EXAMINED THIS <br />APPUC�fION AND KNOW THE SAME TO BE TRUE AND CORRECT AlL <br />PROVISIONS UF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK NJILL OE COMPLIED WITH WHEIHER SPECIFIED HEREIN OR <br />NO�. THE GRANTI�� OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TU VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OF LOCAL LAV/ REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OVJNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />�'' � 1 1 D �a- �-� s- <br />x — --�-� <br />SIGNATUPE / OAtL <br />CITV BUSINE55 LIGENSC NO <br />MECHANICAL <br />NO. TYPEOFE�UIPMENT FEE <br />A/C — A/HNDLG UNITS — H.P. ' <br />FORCED AIR SYSTEMS — B.T.U. M E.A. ; <br />HEAT PUMP ' <br />UNIT HEATERS — B.T.U. M <br />� CLOTHES DRYdHS ' <br />j VENTILATION Ff�N � — <br />� RANGEHOOD � <br />_L WATER HEATER ; <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) � <br />�¢_ FIREPLACE INSERT (WOOD BURNING) ' <br />� ' <br />GAS FIFiFPIACE � <br />GAS RA� ` <br />GAS PIPIN(i � <br />� EXHAUST FAN _ ' <br />SU8 TOTAL 5 <br />---r <br />PERMIT S <br />TOTAI FEE S , <br />r�nr�aiFr.Krtuusrn rrF I�+eccirT��o <br />VACANf SRE -_— <br />�i�ES i, N� DU����N� <br />sae or, .o S� � v R s <br />/O S � rwr.+nivc <br />/ S t�f� <br />BOSEMENi IdEC11RNIGAL <br />(IVES D 'O — <br />ADp1110NA1_ PIAN G�f;CN <br />O1MER <br />STATE Ol➢L�IN6 SURCIIMGF <br />°Y CITYOFEVERETT r��A����•��""s <br />LOCAL SALES - <br />�/�S TAX CODE IS 3105 TOTAL _ <br />oa <br />d17 <br />