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APPLICATION FOR GONS4�tUCT10F". P�ERM6'� <br />CI1Y OP EVEP.GTT • BUILDING DIVISION �r���� <br />3200 CEDAR STREET • EVERETT, WA 88201 • 259•8810 <br />❑ D=MOLITION �OMBINATION BUILDING J�MECHANICAI �PLUMBING ❑ SION <br />PROJECT ADDRESS= �/ %�� -�f _--5� <br />�tzsETi--1 c�sT'R��]"� h M��vlt.C� � vu,� 9.G�Zo 3��► lo a� <br />OVIqFN MuI�ODRE55 Ott 7iP PNCW[ <br />SA1�.t� <br />TFNANT MULIiWRE55 CIfY 7�P DuONE <br />5�►t-�t� T �b P>c <br />•nciarzcranoesaNen 4MFOORF55 f cm nn PHONF -- <br />{�..i� �2Cl��C'L� �i0i..� 5�'iLl�l G:-�jh� c.�� W1f"r tZ.-r�cC'/�/�`iiAd/� <br />t�rr 7�r rnoNE <br />�wCYn�n�Yw��.Vnlllwylyn MuI�WH[]J j:IT'! <br />�P P��ONF iTFTELI�fNSF <br />�� <br />PLUWINOCONTR�CTOR M�II�WqE55 CIfV SiV P11pNE STAtEUGENSE� <br />oeecroee wd« �Ho sou• <br />� <br />4 / <br />PIIpPpyED USE OFlULdNO <br />iew�oesc PT10NOiM10Pl <br />ior �_ aiocK <br />�l <br />PNILELTAllI.D.NUMBER <br />COHSTRl/CT10N IOIJI lEN0ER,10pflE$9. IEIEI'NJNE NU4BER <br />PLUMBINO <br />Fl%TURE OR ITEM <br />LAVATORV <br />SHOWER <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) — <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE S <br />FOH OFFICE USE ONLY: <br />iRd/iSETBACk,� � PENISETB�GN <br />// Uf/ , <br />USE ZONE � � � <br />IIC 0� <br />rw a owewr+a <br />UHIfS <br />/(!''1 �'' <br />SIDE6FTB�Ck� <br />..� / <br />VI�C�NI S�tE <br />OrEs ❑ rw <br />�� e�oari <br />t7'vN4 <br />.. RAG <br />BASEMENT � � <br />% ❑rEs �Tio <br />HEATING SYSTE:M: �I <br />COHr�ct vensa+�Ho v��onE rro <br />❑ ELECTRIC ❑ <br />1 NEREBV CERTIFV THAT 1 HAVE RF.AD AND E%AMINED THIS <br />PPi`LICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS fiF LAWS A�:D OROINANCES 60VEFNING 7HI i TYrE OF <br />WORK WILL dE COMPLIED WITH WHEThIER SPECIFIF.C� HEREIN OR <br />1•t1T. THE GRANTINO OF A PERMIT DOES NOT PREFJME TO GIVE <br />�UTHORITY TO VIOLATE OR CANCEL THE PRO��SiJN OF ANY <br />OTHER S'AiE OR LOCAI LAW REOL'UTINO CONSTH�CTION OR THE <br />PERFO 1+'ANCE OF CONSTFlUCTION. THAT 1 AM AUTNOHIZED OY THE <br />OWN f TNIS PROPERTV TO PERFORM THE WORN FOR WHICH <br />APPL AT IS ADE I COMPLV WITH THE GTATE <br />CON A I. W NU�B6.200 WAC <br />' �y, '1� _ �? , <br />CITY BI ISINESS IICENSC NO <br />dECHANICAL <br />N0. TYPE OF EOUIPMENT <br />NC-NHNDLQ UNRS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HE4TER5 <br />CiOTHESDRVERS <br />PANGEH�OD <br />WATEN HGTER <br />WOOD STOVE <br />METAL FIP:'�IACE (VJOOD BURNING) <br />FIRcPLACE INSER7 (WOOD BUFNING) <br />GAS FIREPIACE <br />GAS RANGE <br />GAS PIPINO <br />EXHAUSTFAN - <br />SUB TOTAL <br />PERMIT <br />Pl �N CIIELR NWBER <br />�-'/.t� <br />eunnwa <br />vwuoiNo <br />MECN�NICII <br />�DD�IION�I M �N GNfi[K <br />O�NER <br />ST�IE BUIlDM6 SUf1LNA0(iE <br />f PL�NSAP�Bovqo v CITVOFEVERETT runncvron.s <br />�� LOCALSAIES <br />/1� o�rE �n ��//S(n TAX CODE IS �105 TOrAL <br />FEE <br />fFf �� RECEIPTNO <br />VALUATION �'f� EE <br />1�-- �T <br />� - <br />� <br />� � , _ <br />i.�. i <br />0 <br />