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APPLICATIL.J FOR CONSTRUCZ.JN PERMITr " <br /> CITY OF EVERETf•BUILDING DIVISION FC���� <br /> 3200 CEDAR STREET•EVERETT,WA 9820: •259•8810 <br /> ❑ DEMOUTION �COMBINATION ❑ BUILDING ❑ MECNANICAL.y�❑ PLUMBINO ❑ 81(iq <br /> PROJECTADDRE88: r�� 1 S /—YUC.�� c��il�// <br /> � <br /> p b12� �a\ la�^ OR. �,r�X; �v, :,P��1 q8a1S a� ��9a� lys�� — <br /> °��.�a..�� <br /> TE1WlT �MR 3$ CITV iIP iRONE <br /> MGWIECTOR0E51CaNER AWl�0pRE55 GITY ZIP PNONF <br /> OENEMICONTMCiO11/.^ WIL�0011ES5 CITV TI� P110NE SI�TELILENSE• <br /> `/ 1�� <br /> LIECMY11CI1lC�R R�ON7 IWLADdiE55 pTY ZIP GHONE ST�TEUCENSE• <br /> qUilIH6CONTMCTOR MWL�OORES$ CIIY 21V P11pNE STATEIICEMSE� <br /> CONTIMCT P1110E OF YqRI( <br /> HEATING SYSTEM: GAS O ELECTRIC ❑ _ <br /> pEgGIMEWp111INID5dMilEF00iAGEMlVOWED CONT�CT RSONNIDPMQ�pyt L /q� )J�, <br /> L �� iADI� �L�_�__ <br /> 5�' ��.93 s� ,���(� blc <br /> � 1 HEi:c�N GERTIfY THAT I HAVE READ AND EXAMINED THIS <br /> APPI.ICRTION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL � <br /> P^OPO�o�� pROViS10NS OF UWS ANQ OfiO1NANCES GOVERNING THIS TVPE OF <br /> WORK WItL BE COMPIIED WITH WHFTHfR 5'1'EGFIED HEREIN QR <br /> iEfw,oe'9c,av,i�w'�OsrrorEnrrlS�bwr�e�ow^n�n�cHnvocov�E 1 \ NpT. THE ORANTING OF A PERMIT fJ6)ES NOT PFIESINAE TO GNE <br /> �pT�xp�K a _ 1 J AUTHORITV TO VIQUTE OR CJ1NCEl THE PRpVI$tON OF ANV <br /> OTHER STAT€OR LOCAL LAW REGULATIN(i CONSTR4fCTK2M OR TME <br /> �, oaa- - a PEHFORMANCE 0F CONSIAUGTION.THAT I AM AUTtN)RIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICFi <br /> APPUCATION IS MADE AND I . COMPLV 'WITH TW�. STATE <br /> MRCB TIJI AD.MM.MER CONTRACTORS UW 18.27 RCW ANQ 296200 WAC. <br /> 5ti5o -a�a- oat -oo - o - P r ' o�' ^ � ,�� <br /> CONS1NULl10N IOAN lENOEN.l100RE53.TEIERI(M1E NIIMlER x � <br /> SIONATURE U E <br /> CITY BUSINESS IICENSE NO. <br /> p�,�p A�CHAt11CAL _.-.' <br /> NO. T11PE OF RXTURE d11SEM FEE KO. TVP@ OF FEE <br /> T� <br /> WATERCLOSET(TOILET) � NC-AMNDL6UWT�.� <br /> gp7��g � � FORCED AIR SVST€fA$ ' `_ <br /> � <br /> UVATORV(WASH BASIN) HEAT PUMP <br /> �►pyyEq � UNIT HEAT€RS <br /> KRCHEN SINK 3 DISV ; CL0111ES ORVEiSS <br /> DISHWASHER � HI'N6E H(?DD <br /> IAUNDRV TRAV ; �+6ATER HEATER r---�— <br /> CLOTHES WASHER � �� WOOD STOVfc <br /> Up�ry� MEfAL FIREPkACE(M/WD BURNING) , <br /> DRMMCING FOUNTAIN FIREPLACE INSER7(YVOOD BURNIN(3) , i <br /> FLOOR DMM � GAS FIREPIAGE .— <br /> � &ICKFLOW PREVENTERS ; GASNA.NGE ' <br /> SINK(SERV�CE-BAR.ETC.) ,2 GAS?IPING _ <br /> � � IXHoIUST FAN <br /> � ' <br /> i �- ' <br /> � <br /> SUB TOTAL f � ' SUB TOTAL S <br /> PERMIT f PERMIT S <br /> � TOTAIfEE f � YOF�Ii.FEE S <br /> �o�ce use oN�r: <br /> F/IONT SETB�CIt REAf1 SEiMCN . SIOE SET&1CN %�N CHECI(NUMBER �EF HECEWT MO <br /> 2� 2G' � - � i , <br /> � us¢ ior�� vMcu�rs�re fEES VALUATION FEE <br /> -2 o.E� o� r-- ---T-- <br /> � ��a� 0 35� _ <br /> ��r TATay ,,, w a oweiunc saE or x�r i - -- <br /> LCY uNrts / S� .3kf. CA�4 � rwrreiric 3� <br /> 3. __--. <br /> pCGUP�NCY M Of$1[MbFS OCC11P/VIT 1p�0 B�SEAENT ME(;Hti4!C11L <br /> IC-3 J'I /l� il ❑res d'l ---` <br /> m <br /> FIRESPRINKLEfiNEQ'D RE�Sp1 �DD�tlOrvkt PL�NCHF.CK _— __ <br /> OTHEN <br /> FMIENARMflEdD RFASON � <br /> STREBUILUINC SIWCNR�F. �,/ <br /> 1YPEUff,ONST %I1NS�P%10VEDeY CRYOFEV��'� PlIB1�f.WORNS --� _ <br /> �I F LOCA�SALES -- ---— ��'— <br /> �� oere Z 22 (v TAX CQDE 1&9105 tOtAL � � �� � ; I <br />