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APPLICATION FOR CONSTRUCT�ON PERMIT� <br /> CITY OF EVERE7T•BUILDIN�OIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-6810 <br /> ❑ DEMOL�TION �COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBINti ❑ SION <br /> PROJECT ADORESS: �7 � ' � ��- <br /> 13o¢sE77-1 Go/-15Tf2U! T��.! �r�c, �2q- `.1�'A?� ,4�1L�' MPIZ`t�'V l l,uF. Gl�d'�i'7ZU <br /> ONMER MIJL�OOf1E55 CITV 21P PMONE <br /> 1E14Mi VNIMOPE55 CITV ZIV PNONE <br /> r�� ���zs��--� �.�� � ��, - �v 34� <br /> u1Cw�ECi0R0E9�ONEN uul�0onE55 � i�v r���r�F . 'O�O��i/� <br /> .f�t�l?5�1"1-a lins-PST���tl�x-I 1i--1li SAr�I� 13q2S�LId77MlL <br /> GEMEIWCONTMGTOR M/JIADDRE55 GTY ZIP P�IONE Sf�TEUCENSE• 17�'�!wr� <br /> � � G �C�'71F�d1� kv�tzETTt V�,/A �i4'7-7'1�lI J�HL,a,�OSS`rL. I <br /> uEcwe,�cKco'+m�cron wu��ooness cm nv G110NE sureucEweE. <br /> ,�rT� �LU1.�113i�1C� SN�4�IoM15N YNA 'S�P�"23' sSgz�Y'IIZ� 73b <br /> Ky�CONTIUCTOP MYLADORE55 - ptt + 21P PNONE $UTELICENSEI <br /> �i a, �,a.� /� <br /> CON�R�CTP"�E0FM1ORN �n,;��5� HEATINOSVSTEM: �GAS ❑EIECTRIC ❑ <br /> 5 <br /> pEy�1Y0E Nq�y(,V1p Sq�ARE FOOTMfiE INVOWEO CONT�CT PERBONMq PIqNE NO <br /> rodP Fsaras�r�a 35�I1v3d <br /> I HEREBY CERTIFY THAT I HAVE READ AND�£XAMINHO THIS <br /> '��Y'I�'<—+ � — APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> ��o����'� PROVISION$OF IAWS AND ORDINANCES 80VERNIN(i THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPEdFIED HEREIN OR <br /> t��ruo�scnrtio�oFrnoa�mr�5�qwpee�owon�nncNrwocovies� NpT. THE ORANTING OF A PERMIT DOES NOT PREBUME TO a1VE <br /> �oi `v ��K � AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR IOCAL lAW REQUUTINp CONBTRUCTION OR TME <br /> OY'� �PdZ.IG-S)D E �/�� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTSIORIZEO BV TME <br /> OWN OF THIS PAOPERTV TO PERFORM THE WOfYf FOiI�WHICH <br /> _ �� � � MP C ION I ADE AND I COMPLY WITH THE STATE <br /> ' z7 acw nND 298R00 W�C. <br /> MpCELTAXI.D.MI4BER _ <br /> GpN,qTRUGTION LW11lEN0EP.�DORE55.1ELEA10NE MM�BER x _ . <br /> gpM f <br /> G7Y BU&NE88 LICENSC NO <br /> v�u�►Ks MECMANICAL <br /> NO. TVPE OF Fl%TURE ON REM FEE NO. � TYPE OF E�UIPMENT FEE <br /> WATER CIOSET(TOILEn / ' NC—AMN066 UNRS ' <br /> BATHTUB � � 1 FOFCEOAIRSYSTEPAB ' <br /> UYATORV(WASH BAStN) ). i HEAT PUMP � <br /> � SHOWER � — UNITMEATERS <br /> KITCHEN SINK 6 DISP i CLOTHES DRVERS � <br /> DISHWA3HER � RANGE HOOD ' <br /> IAUNDRY TRAY ' WATEH HEATER i <br /> CLOTNES WASHER � r WOOD STOVE � <br /> URINAL � � MEfAL FIflEPLACE(WOOD BURNIN6) ' � <br /> DRINKINO FOUNTAIN i r FIREPLACE INSENT(WOOD BURNINCa) � � <br /> i <br /> — FIOOR DRAIN � Ci11S FIREPLACE ' ' <br /> — BACKFLOW PREVENTERS i f�5�NOE � I <br /> SM1K(SERVICE—BAR.ET:) CiAS PIPING ' �. <br /> � D(HAUST FAN ! <br /> � ' <br /> � <br /> v <br /> � I <br /> � <br /> SUB TOTQ S SUB TpTK f ' '�, <br /> PEAMIT S PERMIT f � I <br /> TOTALFEE S TOTALFEE f ��i <br /> Fi7H OFFICE USE ONLY: I� <br /> F110NTSETBACN REMSET N 51DESETB�CK PL�NCIIECKMIM6ER FEF ����� <br /> — -2�� �� S � C> 3 .53 <br /> USE Id1E I /. ioT�r+���Z�� VAC�NT SITE FEES VALUATON FEE <br /> ��ES 0 !!O 68�` , <br /> BUIIDING <br /> 11ENiHTLI1.nTAT10N_ � �ITOFW/ELLING SREOFBIOGrt` � <br /> �% IZOO S.f. LIV./✓G �' PLUMBINC <br /> SF GnRncE <br /> ��up.r+cr raas«wcs occw�NTio.o e.sene�t � � ���,W�u ,. ; <br /> R3 v-� ❑res U'F+o <br /> FIRESPRINNLERREO'D AE�Sd1 �OO�iION�LPI�NCHF.GN 3�? <br /> OTNER <br /> FIFlEMMMPEO'0 AE�SON � <br /> ST��E BUIIDPK:S�MCH�RGE J�J <br /> TWEOif,pNST pUNSAPPFOVEDBY CRVOFEVERETT PUBLKWOPI(5 � �j y_ <br /> � IOCAL SALES ��Z ��Z <br /> �-/�{ o�re TAX CODE IS 3105 TOTAL i <br /> I <br />