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APPLICATIO.� FOR CONSTRUCT�ON PERMIZ�w�� <br /> CI7Y OF EVERETT•BUILDING OIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 99201 •259-8810 <br /> ❑ DEMOUTION ❑ COMBIN�ApTION� / [�f BUILDMIG �MECMANICAL Q PLUMBIN(i D 81(iN <br /> PROJECTADORESS: :�d H�.lv� rr <br /> I owpFn uw�oollEss c�rv !m vHONE <br /> �,yi.IF�E4� �ow�s I�o.Q,nx 3zco9 �ir�«.>.�p vvra q6o83 (2� �8�-9vo6 <br />� IENWt Wul�00f1E55 Glr i�o VIq�4 <br /> NIGNRGi OR pE51fi�ER 1MM�0011E55 CIIY 71P PIpNE . . <br /> Tw�. c,�.a���� �o �-'v� �z�9 Kr2K�+�+a�J w'� 96o6z (2.oc.) �{e3-9t,o6 <br /> aFnFwICONm�G�an wuL�o0nE55 d�r 7�r wqN•. C��IEIICENSE. <br /> T,«�. c�a.�F�,su� cr�sr. L.��. � �� � �� �, ,� -r�.,�.,�tor,-b.�, <br /> ME4M�NLNCONIMCMR MM�OOI�ESS CAfY 11V P�10NE Ff�7ElICEMSE� <br /> R1NMl6CONTMC70R YMLAOOIIE55 Cltt 21P PIqNE ST�IEUCEMSE• <br /> GONiMCiM110EOF W01111 <br /> HEATING SYSTEM: GAS ❑ELECTHIC ❑ <br /> OElCMEMqMtNq50U11REFOO�MEMVOIVED CONTI�CTPERSONANOPIqNENp HM+C1�. <br /> � N i�. � ,e..�� , ctaN�,�e zcc. 46z-qc.o <br /> PteR (�tno) 995—'7'7 <br /> 1 922 S.F Z �A� A2A � w� zcto) ^!i - <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINEO THIS <br /> �p���*� APVLICATIOM AND KNOW THE SAME TO BE TRUE AND CORRECT AlL <br /> PROVIS�ONS OF UWS AND ORDINANCES OOVERNIN6 THIS TYPE OF <br /> WORK WILI BE COMPLIED WITH WMETHER SPECIFIED HEREMI OR <br /> lEp�l0E4Cpq11pNOFPIqPENTY�5110Wp�lOWplAiViGNiMqCOPffS) NpT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �m '3 w� a AUTHOHITV TO VIOUTE OR CANCEL THE PROVISION OF ANV <br /> OTNER STATE OR LOCAL UW REGULATIN6 CONSTRUCTION OR THE <br /> p 5 � �� PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTIIORIZED BY THE <br /> OWNEH OF THIS PROVERTV TO PERFORM THE WORK FOR WNICN <br /> 28 M�-��� ST. APPLICATION IS MADE AND 1 COMPIV WITH THE 6TATE <br /> IMCEl711M lD. R CONTRACTORS LAW 18.27 RCW AND 2BB.200 WAC. <br /> SS2 - 000 - 00) � �� I . <br /> CONSIRUG710N IOM�lEMOER MDRESS.TElER10HE NUMBER X 9 29•�Ice <br /> C.1�11'j3�MJ{� — � 9N717�71MIE OA1E <br /> CAY BU4NESS IICENSE NO. <br /> pLUA1BINp AAECHANICAL <br /> NO. TYVE OF FlXTURE OR REM fEE NO. TYPE Oi EWIIMiAENT FEE <br /> 's WATER CLOSET(TOIIEn � A/C—AMNpLp U►NTS ' <br /> 2 BATMTUB ; '� FORCED AIR SVSTEMS ' <br /> UWATORY(NMSH BA91N) � HEAT PUMP <br /> � SHOWER � UNIT HEATERS ' <br /> KITCMEN SINK 8 DISP i CLOTHES DRYERS i <br /> � q&NYASHER � RAN6E HOOD � <br /> IAVNDHY TMY � WATEN HFATER <br /> CLOTNES WASHER � WO00 STOVE � <br /> UpINAL � MEFAL FIREPLACE(WOOD BURNING) <br /> ORINKNKi FOUNTAIN i FIi�PLACE INSERT(YYOW BURNING) � <br /> FLppp pqA1N � � GAS FIREPLACE � <br /> BACNFLOW PREVENTERS � (iAS RANGE i <br /> SMIK(SERVICE—BAR,ETC.) � 'S (iAS PIPoN(i <br /> IXHAU3T FAN ' <br /> � � <br /> � � <br /> SUB TOTAI S ' SUB TOTAL f <br /> PERMIT f � PERMIT f � <br /> TOTALFEE S ' TOTAIfEE S ' <br /> FOR OFFICE USE ONLY: <br /> i110N7lE1MCIf / 11EMSEiMCk S�OEBETMCIt / Vl�MC11E �R FE�D � IIECFqTMO <br /> / r <br /> � <br /> uee zd� ioi�e V�GINt SItE FEES VALUATON FEE <br /> �- � ❑.E5 ❑� a,,,,o»,,, 106 � i .:U <br /> MEIOMTIIMT�110N �T�OWEllIN6 SREOF S.F..IL1JM1t(i � <br /> 19i'' �F. a G au.�e.«� 9'/ � O!� <br /> �cr iaaf�a�ts occuww�iaw s�se�Nt ,,,Ec,,,,r�:�, O 10c� <br /> _ V Z oves 0�� ; <br /> FNE9VMI¢ERIIEO'D RE�90N �Od110N�LR�NGNF.Ck <br /> OIHEP <br /> fIRFNAIM�REO'D RE�56M <br /> STME BUIOM(S S�IRGN11116E i �"l <br /> _� �� <br /> TwEorr,orisr . vuNs�vvnovc�sr CRYOFEVERETT ru�rwo�s �7 ".J Oc� <br /> � l9i:A�SALES <br /> o�Te 5 L8 9L TpX CODE t8�105 toT�� p'1 I 'v� <br />