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APPLICATII .� FQR CONSTRUC7 .JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259•8810 <br /> p DEMOUTION L7 COMBINATION [q BUILDING �MECHANICAL Q PLUMBING p SIGN <br /> pROJECT ADDRESS: �a� �� S <br /> WRlfp YNL�OOnE55 c1tt !m P1qNE <br /> �,s.=�E� �ow�s Po.f6ox 3�z.�e9 '_i21�v+ra� wra �10�63 �_�'�63-9406 <br /> 1FM�Ml WIl�00RE55 CIIY !IV PINN9E <br /> NiGWTEttq10E51GHFP Nul�OD/1E55 CITY JIP v1qNE <br /> —Tw�. c..e.N�=��� P o. �q.: �zco9 Ki2K.�✓��J W�a 9�BS ('c.c�.) �{93-9teo6 _ <br /> pENERµCONTMGT(IR AWLAOOIIESS C�tY 71P P�qNE SI�IELICENSE� <br /> Tw. GA�F15�L� W^�ST. ,[n1C.. d �� n �� 1r �� Ti..ne.Aeio'7'1oA <br /> IIFCN�WCALCON7MCTOf1 YMl�00RE5$ CI1Y ZIP VIIONE ATAIEIICENSE• <br /> MUYlllfi CONiMCT011 MM1110011E55 G11Y ZIF F1qNE SU�E IICENSE� <br /> Cp1TqllCi PpCE OF WONN <br /> HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> pE$CplEWpRMANO5011�REFOOTMEwVOlKO CONt�CTFERSp/MAPMONENO. N� 01S. <br /> � u� � r-.� i.. � ,ea� T cc�Nr.�eu� (zoc.149�s-�lceoe <br /> . (�ti �-r�oo} 995-'1'7 <br /> I q1? S.F. 2 c++2 4�►•t•+ � ! �"� �b) "�� - � <br /> I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COARECT ALL <br /> �D���� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN ON <br /> icw�oEscnvnpio�nrqv¢�rriyawmee�owa�n�cNiwocories� NOT. THE OMNTIN6 OF A PERMIT DOES NOT PRESUME TO (31VE <br /> ior 2 s�ou ov AUTHORITY TO VtOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTiiUCTION OH THE <br /> II 5 �� � �� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM TNE WORK FON WHICH <br /> .��Z �, ,�,g� S.�- APPLICATtON IS MADE AND I COMPIY WITH THE STATE <br /> ►MCEI TA%I.D. R CONTRACTORS lAW 1827 RCW AND 296200 WAC. <br /> 852 - o00 - o0't. / /� I . <br /> CONSIRIIC710NlON1lEN0ER.l10WES5.TELEPIqNEMIMlER 5 ATUPE �w�X �r9 <br /> 29•�Ico <br /> G.1�1"(SA�J�C - <br /> cin evs�r+ess��ceNse no. <br /> p�pyB��p MECHANICAI <br /> NO. TYPE OF FIXTURE Oq REM FEE NO. TYPE OF EOUIPMENT PEE <br /> 3 WATER CIOSET(TOILET) � NC-MHNDLG UNITS ' <br /> 2 BATHTUB ; FORCED AIH SYSTEMS i <br /> UVATORY(WASH BASIN) � HEAT PUMP <br /> � SFIOWER � UNITNEATERS <br /> � KITCHEN SINK 8 DISP i � CLOTHES DRVEHS � <br /> � DISHWASHER � � RANGE HOOD � <br /> UUNDRY TRAY ' WATEfl HFATER � <br /> CIOTHESWASHER � WOODSTOVE ' <br /> URINAL � MEfAI FIREPLICE(WOOD BURNING) <br /> DRINKING FOUNTAIN i FIREPLACE INSERT(VVOOD BURNING) � <br /> FLOOH DRAIN � GAS FIREPLACE ' <br /> BACKFLOW PRE\'ENTERS � CaAS RANGE i <br /> SINK(SEHVICE-BAR.ETC.) '�j GAS PIPING ' <br /> E7(HAUST FAN <br /> � <br /> r <br /> � <br /> � <br /> � � <br /> � <br /> � � <br /> SU8 TOTAI S ; SUB TOTAL f � <br /> PERMIT f � PERMIT S �� <br /> 10TAL FEE S � TOTAI FEE S ' _— <br /> FOR OFFICE USE ONLY: <br /> iIIONT 9ETeACN 11EM SETMICN SIOE BETB�CM Pll1M CIIECR NUMBER FEF�O � �EIPT NO <br /> 2� � �4� G � � � <br /> �gF=p� _ � ior�u�� v,�HiyrE FEES VALUATION FEE <br /> OYES ❑� BUIIDINA � C7 <br /> MEIOMUMIi�T10N � MO O�OWELUtq SREGf NOORI � <br /> urdte � s.L. t��fA 4c+e vwMeir+o / ' l' <br /> � <br /> GCCUVANGY NO Of SIMES OCCINIINT LOW S���NT MECN�MCM �O C ��C� <br /> 3 u-i Z ❑res � ' <br /> FIRF. PoNKiERllEO'0 AE�SOM �Dd110N�1Ml1NG�1F.CN � <br /> � <br /> OiHE11 <br /> FKENAIIMPEO'D ��� � <br /> STAIE BUIIDIN(151111CN�flbE '� <br /> r <br /> rroeacansr ilAN9�ORrn¢�v CITYOFEVfRETT rueur.woaKs �DyOC� <br /> �J LOGALSALES ' � <br /> �-/✓ oerf 5 LD f� TAX CODE IS J105 io7Al � '� i <br />