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._ ^ <br />APPLICATION F�1R CONSTRUCTIVN PERMIT <br />CITY OF EVERETT • BUI�DING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />fl DEMOLITION f 1 COMBINATION �l BUILDINO I 1 MECHANICAL i 1 PLUMBING :so[ SIGN <br />PROJECT ADDRCSS <br />MAII �DO(1E55 <br />�/ T ,5 � <br />CItt <br />�/�.vik��0% �i <br />f,liY <br />� <br />CrtY <br />rir <br />71P PnONE <br />3yv aGs � <br />�m r�wNF <br />/1c� •[ �'�• 1 N" /-6 �J � o( 7n fil _ 7 J�al / S� J 7 <br />OENEf1AL C(R1III�CTIX1 M�II UN/11F55 (IIY )IP PIIONF. SI�1E I ICENSE • <br />MFCIIANIGL CONiR�CTOB M�4 �DORE55 (;IiV 7iP FIIONE StAfF I ICENSE � <br />f'LUM9INOCONiR�f,TIX1 M�IL�DDRESS CIiY ZIP P110NF S7�IEIICF.NSE� <br />/L'T.r. � <br />OESCRIBE YqRN ANU SOU�RE FOOT�OF INVIXVED <br />LEOQDESCRIPTIONOfPROPERtt�5NOWNPEIOWd 1Tl�CNTWOCd'IES� <br />ioT e�ocK or <br />CONSTRlICT10N IO�N LENOEII. �DIXIESS. iftEPNONE NUMBER <br />TYPE OF fll(TURE OR ITEM <br />WATER CLOSET�TOILET) <br />BATHTUB <br />LAVATORVIWASH BASINI <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />BACKFLOW PHEVENTEHS <br />SINK ISERVICE — BAR, E7 <br />SUBTOTAL E <br />PERMIT S <br />HEATING SYSTEM: f�GAS �IELECTRIC fl <br />CONI�CI PFRSON �NO PIIpNF NO ^ <br />//77 . � <br />I HEREBV CEFTIFV THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF ONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS fiOP TO PERFORM THE WORK FOR WHICH <br />APPLICATION S M AND I COMPLY WITH THE STATE <br />CONTRACT SLt RCW AND 296200 WAC. <br />N7 <br />fEE NO. TVPE OP EOUIPMENT <br />wa. — rvnnuw urvn a— n. <br />FORCED AIR SVSTEMS — � <br />HEAT PUMP <br />UNIT HEATERS — O.T.U. M <br />CLOTNES DRYERS <br />VENTILATION FAN <br />RAN6EHOOD <br />WATER HEATER <br />METAL FIREPLACE (WOOD <br />FIREPLACEINSERT�WOOC <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />FOR OFFICE USE ONLY: <br />fI1tMIT5FTP�CN� f1E��5FTP�CN SIDFSEifl�f.N PI�NCIIFf.I( <br />'rJ � O� <br />u5F7oN� �� S1 IIE� � I�� v�C,�Nt�I� � _ <br />C>wJ <br />nun rnNc: <br />IIEIOIII UMIT�TION NO Of 11WF.lLINO SIZE Of PlU(:�I <br />S IINrtS / Pl11MOMti <br />r inr srnw�i Fi� nro n <br />n.�� r - <br />N�SFAIFNL MPf�1�NICG1. <br />IIVFS �� NO �-- <br />Af101IIpNA� PI �N I:IIf CM <br />nn�rn <br />sreie nmioiaa simc�una: <br />�� CITY OF EVERETT runi ic wanKs <br />LOCAL SALES -- <br />.� _ q V TAX CODE IS 3105 tOinL <br />O�tf. <br />PERMIT E <br />TOTALFEE E <br />rrF InrcnrrNn <br />FEE <br />� <br />