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APPLICATI�OnI FOR CO�ISTRUCT��+N PEFRMIT <br />CITY OF EVERETT • BUILDING DIV�SION <br />3200 CEDAR STREET • EVFRETT, WA 98201 •?59-8810 <br />fl DEMOLITION ��l'COMBINATION f�BUILDING �tiYfJIECHANICAL �1�PLUMBING fl SIGN <br />�ROJECT ADDRESS -� . i � <br />���_, 7 �� x� �� j� �,; i <br />OIYI,JJER MA4p��RE55 CITV ,t Z,_IP. �HONE <br />I l �) l U i/ . S c �� ��, (-� a� 7 I 7- 3G �� c......� �7 4� �1Ce-�- �.�.-.-�i %S ��:� G S.� - � 3 � Q- — <br />TENANi IAAII AO�RE55 L11Y ZIP '^'lIONE <br />ARCIIRFCTORDESIGNFR MNI.AD�R555 CITY IIP 'NONt <br />PLUMBING COMRAf,TOR <br />MFIL/ODR[55 CRY 71P °IIUN[ SIAIGLICEtJSF.� � <br />� r�� ����� L� r,�,,, N S� � 5-� � <br />!A LAODRF.SS Gtt 71P FIIONF. �ATF.UCFNSE� <br />IA.'IL4�OFE55 CI�Y ZIP PHONE .:T4IGLICENSE• <br />�ESGRIDE WORK ANp SOU4RE FOOTAGE IIlVOLVED <br />USE OF <br />LOT �� _ BLOCN <br />rnx <br />�ci� . <br />BELOW OR ARACH iy5_O <br />r-i <br />_ or� '`' `� <br />GONSTRUCiION LOAN LEN�EfI, AO�FESS. TEIEPHONE <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />BATHTUB <br />LAVATORY(WASH BAE <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNDFYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOGR DRAI�J <br />BACKFLOW PREVENTERS <br />CINK lRFRVICF — RAR F7 <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />FOA OFFICE USE ONLY: <br />FRONT SETMCN � REAR SETpFGN <br />20 2 U � <br />USEZONE� � LOiAFEF / <br />� cc� r � <br />HEIGIIT LIMI7AilON • NO OF D'NELLING <br />2� uwrs � <br />� <br />FlRF SPRINNLER <br />OY <br />FEE <br />� <br />� <br />� <br />5 ; <br />3 � <br />5 ' <br />SI�E SEi04CH <br />HEATING SYSTEM: h-1'GAS !�l ELECTRIC f l <br />.� <br />I HEREBY CERTIF� THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SP.ME'�O BF TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETH[R SPECIFIED HEFEIN OF <br />NOT. THE GRANTING OF A PEHMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PqOVISION OF AP;Y <br />OTHER STATE OR LOCAL LAK' REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUClION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROFERTY TO PERFORM THE WORK FOR WtifCH <br />APPLICNTION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />%-d-��/��[���. �� �S-%S <br />SIGNFTURF. OAiE <br />CI7Y BUSINE55 LICENSC NO. <br />MECHANICAL <br />NO. TYPE9FEOUIPMENT FEE <br />A/C — A/HNDLCi UNITS — H.P. <br />� FORCED AIR S'lSTEMS — B.T.U. M E.A. ; <br />�— <br />HEAT PUMP � <br />� <br />UNIT HEATERS — B.T.U. M ; <br />CLnTHES DRYFRS i <br />--�— <br />VENTILATION FAN � <br />RANGEHOOD � <br />WATcR HEATtFl � <br />WOOD STOVE ' <br />METAL FIREPLACE (�VOOD BURNING) i <br />FIREPLACE INSER7 (WOOD BUANING) � <br />GAS FIREPLACE � <br />GAS RANGE �— <br />GAS PIPING i <br />EXHAUSTfAN � <br />VnCaNr sr rtt� <br />. ES I I NO OUILOWG <br />)F BLD(:/�I <br />J $ ' UJnvC� } rwn�oiNG <br />5 F 4a�uc � <br />�nsEmENr � MECHnnIcnL <br />IIVES WFO <br />ADpp10N4L PLAN CHf.GH <br />OiMFR <br />STNE OUILOING SIIRCIIMGE <br />CITY OF EVERETT ruo�.icwonKs <br />LOCALSALES — <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE S <br />FE[ I �ECEIPTNO. <br />7/i / <br />