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APPLICATION FOR CONSTRUCTION PERMIT��}�. <br /> CITY OF EVERETT•BUILDIN(3 OIVISION �%��,�. <br /> 3200 CEDAR STREET•EVERETT,WA B820i •259•8910 `C <br /> ❑ DEMOlIT10N �COMBINATION ❑ BWLDIN(i ❑ MECHANICAL ❑ PLUMBIN(i ❑ SIfiN <br /> PROJECT ADDRESS: �7� ���'�� �� I <br /> SETl-I �t-15Tf2U[.Ti� I r�L I��" s'�A'l"� f�V V MPfZY��V l LUE GL `�LZIJ _ <br /> OYMER yyL�ppqEu CITY ZIP P O f i <br /> TEIMNT YML�E55 CITY/ Z� PHONE <br /> ra�� P��zs�Y-I-1 �H� ( �i5'�1 - �0 34� ►0�o2/�i, <br /> •qfj111ECTOR0E5qNER YNIMONE55 Citt IIP P��O�+F � <br /> p,zal2�iETF-a �nr..►ST2�•1l�tllx-1 Ir-1 C� ��✓L� 1�/o12St'L�d'77 M IL <br /> pENEf4l CONTf4tipl MIJI�OM1E55 CIIY II� PIIONE SI�TE 110ENSE� '2/'�/ I <br /> I� G �56-T11�C� L����� v�,/A �i�'7�'1�91 J�HL,4�055`IZ� <br /> ���y������ y��ppqES$ G�TY ZIV PNONE STATE IICENSE <br /> �a1ZT'� �LU1�13il.JL� SIJo4�loM15t-1 YNA 'Srap�`}-237 .a�Z'1�t11Z313D <br /> PlU CONTNGiOR MAII/�WFE55�� ' CIiY � ZIP PNONE STATELILENSE <br /> ��7 O[�^j� ^ <br /> °ONi""0T°"�0FW0P1 HEATING SYSTEM: GAS �ELECTRIC ❑ <br /> 5 �,o�l St' <br /> oESUME wa�uq wuu�E rooT�fiE wvotvEo LON711CT PER90N�NO PHONE NO <br /> �-oCD 3aTLs�TJ-� lv 4 <br /> I HEREBV CERTIFY THAT I HAVE READ AND�£%AMINED THIS <br /> ��r APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CARRECT ALL <br /> vnovoseo usE ov auwaua PROVISIONS OF UWS AND ORDINANCES GOVERNINCi THIS TVPE OF <br /> WORK WILL BE COMPIIED WITH WHETHER SPECIfIEO HEREIN OH <br /> ��u��qr���or�mv�sqwr�eE�owon�n�cNrnocovi[si NpT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO (iIVE <br /> `aT d v �� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REOULATINp CONSTRUCTION OR TME <br /> OY' dPA�2..IGS)D E �I�ST PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTMONIZED BV THE <br /> OWN OF THIS PROPER7V TO PERFORM THE VYORIf FOR WHICH <br /> Q�G/LL} — O�j) —O�� '� D O � � C ION S I 1A 27 RCW AND 288200`WAC.ITH THE STATE <br /> PNCELTA%LD.Ml�lER _ <br /> GOMS1RUCt10N IWII lENOEN.IDDRE55.TEi EP1qHE MMBER x <br /> y0N E <br /> piV BU91NE89 LILENS[NU <br /> PLUYBiN6 MECHANICAL <br /> NO. TYPE OF Fl1fTURE 011 fTEM FEE NO. TYPE OF ECUIPMENT FEE <br /> WATER CLOSET(TOI�En I NC—MiNDLG UNITS ' <br /> BATHTUB � 1 FORCED AIR SYSTEMS i <br /> UVATORV(WASH BASIN) J. � � HEAT PUMP ' <br /> SHOWER � — UNIT HEATERS <br /> KITCHEN SINK 8 DISP i � CLOTHES DRVERS <br /> . DISHWASHER R4NGEHOOD <br /> UUNDRY TMY � WATER HEATER T__ <br /> CLOTHES WASHER � r WOODSTOVE <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) <br /> DRINKINO FOUNTAIN i r FlREPLACE INSERT(WOOD BURNING) � <br /> FIOOR OFMN � CiAS FIREP4ACE ' <br /> � <br /> — BACKROWPREVENTERS ; � CiASRM1GE <br /> SINK(SERVICE—8M.ETC.) OAS PIPING ' <br /> DQiAUST FAN <br /> i <br /> � <br /> � � <br /> i <br /> SUBTOTAL f SUBTOTAL f � <br /> PERMIT S PERMIT t � <br /> TOTAIFEE S � TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> fRtlNiSETBKAt NEUISET R $IpESETB�CN OI�NCNECKNUMBEP FEF ���T�. <br /> � �' s � no �� , 53 <br /> use loue I / lOT ARE����J V�G�NT SITE FEES VALUATION FEE <br /> ,¢ � <br /> L. ❑vEs o r+o eu�owc �o�/�-"C7 � <br /> NEMaHT UMIT�tIp! � NO Of OWEL4NG S�ZE OF BIDGR � <br /> "7Q UNIiS �ZOO SF Gq�'cEf pLIIMBING <br /> «i , <br /> ��NiCV NOOfSIOqES OCCW�NtLO�O BASEMENi MECN�HIG�I _ � <br /> as u-� o•ES � �j <br /> ADDITqNlILPI/�MCHF.CK J'�,J� <br /> FIRESPRINKIERPEO'D RE�SON .- <br /> OT11ER <br /> FlRENMMiiEO'0 RE�SOu �O <br /> STAIE BUIIDINO SIIPCN�RGE <br /> *ro¢orr,onsr PUNSMFMOVEOBY CRYOFEVEAE7T PIIB11f.W011N5 �/�' � <br /> 'a�'� i_ <br /> LOCAL SALES <br /> _/f, o�rt TAX CODE IS 3105 TOTAL ' <br />