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�� <br />-, <br />.. , <br />- APPLICATION FOR CONSTRUCTrON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />i 1 DEMOUTION COMBINATION I i gUILDING � I MECHANICAL � 1 pLUMBING I I SIGN <br />PROJECT ADDRESS r V�� � � �` � / <br />/020 /V . �road�� � <br />en Mui eonness r.n� CO �,vun .a,i n�%niia �C.'�%'% //�% <br />M�N �ti' � �l,l�cHc�.l� I.��.✓,� <br />�� <br />r/.����.���iKa� ` Nan��rss _//`t �(n(oy /cnr rir rHONr <br />�� l M ti)ii. <br />ctr+en�icorurn�cton M.n.�nnncSs � i,nv �ir r�wNe sureur.rHSF. <br />MECN�NICAI CONiR4CT0f1 MRtL �DD[1F.55 ,.ITv 21P PIIONE STRF LICf.NSE � <br />PWMBINOCONTR�CTOR A1MLpU0RE5S Cliv 71P p110NE SGIEUCENSE� <br />CONTR�GT PRICE Of WOAI( <br />11ESCRIFE WOPN �hU 501URE FOOiA4F INVOIVED <br />�J- �,.aa — <br />vrro�roseo use r�F euapNo <br />LEO�L OESCRIP110N OF {'qpPERTV �SHUWN BELOW Oq �T1ACM TWO COPIE51 <br />�m __ eioca or . <br />PANCELT�XID NUMBER - <br />CONSTRULTION IO�N LENOER. �IXME55. TBIEPNONE NUMBER <br />PLUMBINO <br />NO. TYPE OF Fl%TURE <br />WATER CLOSET ITOILETI <br />SHOWER <br />KITCHEN SINK <br />DISrIWASHER <br />LAUNORV TRA' <br />CLOTHES WAS <br />URINhL <br />DRINKINO FOU <br />FLOOR ORAIN <br />FEE <br />HEATING SYSTEM: f I GAS f" 1 ELECTRIC �l <br />f.ONi�Ci 1'FRSON �Np PIIONF NO <br />1 HEREBV CERTIPV THAt I HAVE READ AND E%AMINED 7HIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES 60VEFNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE OR^NTINO OF A PEfiM1T DOES NOT PRESUME TO OIVE <br />AUTHORITV 1� V'('LATE OR CANCEL THE PqOVI510N OF ANV <br />OTHEP STATE JR LOCAL LAW �IEOULATINO CONSTRUCTION OR THE <br />PERFnqMhNCE O O TRUCTION. THAT I AM AUTHORI2E0 BY THE <br />OWNER OF THI PROP TV TO PE THE WORK FOR WHICH <br />APPLICATIO . IS MA AiVD OMPL WITH THE STATE <br />CONTRACT 5 LAW 1 27 ypCW D 29 200 C. <br />� � Sl / �A <br />CITY 9USMEoS LIf,ENSE KU <br />TYPE OF FIifTURE OR ITEM <br />A�C —AMNDLG UNITS — HP. <br />FOFCED AIR SVSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />RANCF <br />FAN <br />� FIREPLACEINSERT <br />=VENTERS i GASFIREPLACE <br />— BAR, ETC.) OAS RANGE <br />OAS PIPINO <br />� EXHAUSTFAN <br />SUBTOTAL 5 <br />PGRMIT S <br />TOTALFEE S <br />FOSi OFFiCE USE ONLY: <br />LRONfSF1P1C�: HF�115FTP�CN <br />USF20NF 101/RE� <br />HEIOH7 LIMITMION No a owewrw <br />UNIIS <br />OCCUP�NCY NO p[StrW1E5 OCCUP�NiL0�0 <br />OF CONST <br />aEon <br />nnq <br />G Pv <br />SIDE SETBACN <br />V�C�NI SITE <br />I IYB It NO <br />PL�N CIIECN NUMOFP <br />nminiva <br />SI?E Of pLU(irtI — <br />PLIiMPiNC <br />B�SEMENf <br />Mff,lUNlf.q <br />f1YE5 f1N0 — <br />�ODIfIONQ PLFN CIIECN <br />� oni[n <br />fi�lE 6UILDING S�IRCNAq(iE <br />CITY OF EVERETT runnc wonKs <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />FEE <br />i <br />T— <br />� <br />!__ <br />SUB TOTAL S <br />PEFMIT S � <br />TO?AL FEE S ' <br />fEE RECFII'TNO <br />VALUATION FEE <br />�� � <br />• <br />