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APPLICATIOA FOR CONSTRUCT�dN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl DEMOLITION COMBINATION �� BUILDING ' i MECHANICAL ' PWMBING i' SIGN <br />PROJECT ADDRESS � <br />I� �? - �����''' � ' <br />f-�.�5�, <br />�F��� �, M3�,��e ti��� la�; �.. muk;i+er� Ji4°„�����5 � <br />,L , �`'I� -l� � E: <br />�FN�!it uui enonrss rnc nr rnoNF <br />`cti <br />N � <br />;'__ <br />r,ewfnucoairn[:tan � w�ixounrss �i�v ------�-�r--�= __ . <br />7m rv�nvr 5urnicrNSF. <br />MFCN�N�CR�.U`N1R�f.LGR M�IIADpRF55 CITV )IP PIiONf STATFI�[FNGE� <br />PIIIMPINC CON1Mf.1(N! MA1� AppRE55 (11IY jIP PIIpNF Si�I( IICFNSf � <br />CONfMCT PAICE Of WpOK <br />UESC91pF. WONY �N� SOII�PE FOOT�QE INVOIVED <br />I, <br />i eu�� oEsc�r vnorenn is�rovm nFiow or� <br />io. nia:K or_ <br />�,� � ��ba -�s � <br />PARLEIU%ID MIMPER <br />�ga8as-3 -oog-a6c�9 <br />CONSItR1CilONIOAHIfNDFq �DpI1FS5. iFLfM10NE � <br />PLUMBIN6 <br />N'1. TYPE OF <br />� <br />WATER CLOSET <br />SHOWFR <br />KITCHEN SINK 6 D�SP _ <br />DISHWASHER <br />LAUNDRYTPAV <br />CLOTHES WASHER <br />URIPJAL <br />DRINKING FOUNTAIN <br />FLOOR DRA�N <br />BACFFLOW PREVENTERS <br />SINN (SERVICE — BAq, El <br />SUB TOTAL E <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONL�: <br />rnoNr suirer� � nr m s <br />mysvme <br />B[ICHI I IMIi�110N <br />HEATING SYSTEM: �AS '' ELECTRIC I 1 <br />COHt�Ci PG�SON �Nfl PIIONf NO <br />KI / '^ �. !Y, s 1 1 � i. <br />I 1' �� � U� 1 7� iC.' <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />�� APPIIf;ATInN AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />�� PPOVISIONS OF IAWS AND ORDINANCES GOVERNING Th11S TYPE OF <br />WORK WILL BE COMP;.IED WITN WHETHER SPECIFIED tiEREIN OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUiHORITV TO VIO�ATE OP CANCEL TNE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCiION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUiHORIZED BY THE <br />OWNER OF THIS PROPER7V TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH TNE STATE <br />CONTR CTORS LAW 1827 W AND 296200 WAC. <br />X ��� � �� qS <br />SiGNATURE p�IF <br />q1tY0USMF.55110ENSf NU <br />FEE NO. TYPE Of EOUIPMENT FEE <br />-� <br />A/C — NFiNDLO UNITS — H.P. <br />� FORCED AIR SVSTEMS — D.T.U. M E.A. � <br />T- HEAT PUMP � <br />' UNIT HEATERS — B.T.U. M <br />i (:LOTHES DFVERS � <br />VENTILATION FAN i <br />� RANGE HOOD � <br />i WATERHEAIEH� � <br />WOOD STOVE � <br />—: <br />METAL FIREPLACE (WOOD BURNING) ; <br />� FIREPLACEINSEFT(WOOD OURNING) � <br />; GA i FIREPLACE ' <br />GNS RANGE �— <br />GAS PIPING <br />i ;� EXHAUST FAN � <br />PERMIT <br />TOTAL FEE <br />