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,.� <br />APPLICATII..� F�R CONSTRUC1.Oi�1 PERMIT <br />CITY OF EVERETT • E3UILDING DIVISION � <br />32D0 CEDl1R STREET • EVERETT, WA 98201 • 259�A°'0 <br />i i DEMOLII'ION iI� COMBINATION BUILDING i MECHANICAL PLUMBING f I SIGN <br />PROJECTADDRESS { _ _ <br />� —' <br />ow�+r� rleii nni�n� �.� ni� �,r runar <br />GYr,�'CC ,d,��i✓�=�.m,f��_xaa�G- - r-�.� �,'`f-_ ���.3- —�c� --.�'�-y'y�" <br />�,���.�r ,,,������„��-�- �„ ,,, - „��,�,� — <br />----- -- -- --- -- - -- -- — -- — <br />/nna�a'rf�r,t"onntci,��rn uqn nnui�rss ..iv �in mwt+E <br />�' /i`3 _ �C Lfl'17PJ" <br />�_r•�Ncnnicmmnr.rai Men.nnnnrss cnv nr rucNe sureuceNse. <br />1.'iU1ANIC�L'1CNiRAC70R MAIL �ObRF.55 f.l1Y )IP PIIONE S7ALE IICFNSE � <br />�IUMPINGCOtlinnf,lOR NNl�IN1PE55 CI�1 )IP PIIpNF. SIALEL�CFNSF.� <br />r.oN�nncrrmr.eorvmnn -- — --- — <br />HEATING SYSTEM: I i GAS � ELECTRIC f-I, <br />oescmaewo��tinr�o_ rnn cb�� �rvoivrn caNincrnensoHu+nr�ror+r�+o <br />/oao ��r�'�.,.�6/�- — <br />��--�-<<: ��- ,�/�-? --- <br />leau o�_scnin�rl%pr� or rr+oni <br />lot " fll.(N:N <br />__ or <br />� 1�� .') ..-�_:�� <br />�;oNsrnucnor� i o�N i.rr+ocn. nooness. ie� cr��aie uuunen <br />NO. TYPE OF <br />WATER CLOSET <br />BATHTUB <br />� LAVATORV(WAS <br />SHOW[R <br />LAUNORYTRAY <br />CLOTHES WASHER <br />UPINAL <br />DRINY,ING FOUNIAIN <br />1'LOOR DRAIN <br />DACKFLOW PREVEN7ERS <br />SU�TOTAL 5 <br />PEFMIT S <br />__�__ TOTAL FEE 5 � <br />FOR OFFICE USE ONLY: <br />fRONi5fi0FCN f1�Af15fTMCN 9pE5FLAACk <br />/ C) � ZO `� � / C � <br />ucp 1oN[ � � o� nne� vncn^+� �nr <br />�-� 7_/G`� y,r� N�� <br />❑[IGIIT IIMIT�iION � '10 (K 11WRLING <br />2 �i iiNits � <br />OGGUP�NGY NOOt5i0��iE5 OCCU�4N110AU <br />anour <br />e�3 �_i 1 _�rJ_� <br />IIR[�U�A�fI[Op Pf4SP: <br />N, � <br />r�ne svaiNKi.rn neo�n nra rn+ <br />��� <br />tvae oF coNsi ri eNs �rrno eq <br />� �', <br />�'� f`nIL �'1 �Z�/ <br />Sllf UI ItI1H:l1 <br />�02 S`.F���iRA[:,�+ <br />P�SIMf.Ni � � <br />Ilv[5 {/NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />I HER[�V CERTIFV THAT I HAVE READ AND E%AMINED THIS <br />APPLICqTIOh AND KNOW THE SAME TO �E TPUE AND CORFECT. ALl <br />PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIFD WITH 1NHETHEF7 SPECIFIED HERE�N OR <br />NOT. THE GRANTING OF A PERAIIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR IOCAL L�W FECUi.ATING CONSTHUGTION OR THL <br />PERFORMANCE OP CONSiRUCTIOy. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS 'ROPEIiTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADP ANO I COMPLV WITH THE 'iIATE <br />CONTHAC70R5 LAW 18.77 RCW AND 296.200 WAC. <br />f.�Y pll?CIF�ti IICEN<[ NO <br />MECMANICAL <br />N0. TVPE OF FIXTURE OR IiEM <br />A/C — A/HNDLG UNITS — H,P. <br />FOACED AIR SVSTEMS — �.T.U. M <br />HEAT PUMP <br />l UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VFNTILATION FAN <br />T RANGENOOD <br />WATEH HEATER <br />WOOD STOVE <br />METAL FIREPIACE (WOOD BURNING <br />FIREPLACEINSERT�WOOU BURNINC <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />„L EXHAUSTFAN <br />ri�N cr�ECKNUMnrn <br />�`�` �` , <br />nunon+r. <br />ri uMni�+ , <br />F�CCIUNIC�L <br />�DO17i0N�11'LAN G��ECR <br />on�en <br />siae nmioiNc sunc��nnce <br />rum r. woSKS <br />TOTAL <br />'.1' <br />❑nIF <br />FEE <br />F <br />SUBTOTAL $ � <br />PERMIT S � <br />TOTALFEE S ' <br />rrF necFmrr+o <br />VALUATION FEE <br />56 3F.£3 �' - � "' <br />1 <br />�/J 'l'' <br />/rri t� <br />I <br />-----r' � <br />� <br />' � <br />�r y�� ! Ir 7 <br />