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,�+�/ cpeyum� ��7�9.r <br /> APPLICATIt��! FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259•8810 <br /> f-1 DEMOLITION f l COMBINATION KI BUILDINO I"1 MECNANICAL �1 PLUMBINO f 1 SI(iN <br /> PROJECT ADDRESS <br /> owrrta M�IL�OORESS citt zm rNonc <br /> C y�Rc' �T �.f'KS � `iLL, vfPi , 802 01Ulf/iTE'D BG�{'o �=✓C/,a�T 9&�3 zs z -b376 <br /> tENANT / NAII�D011E55 4 arr tir r� NE �R �-o-5ov <br /> I.CC�'IC/d LYD(/I` COUf�i'i�' ,9 I /�JI�h/�� UlGll' O/C.' �'-✓G`�i'tf Tr�j E':d/ <br /> u+e�rteronoes�n R M�III1DOqE55 citv rm rMONe <br /> �GU.P/�� - <br /> �6E CONj11ACT�n MIJL�Od1E55 /� CIIY JIP PiqNf: SIATEIICENSF.� <br /> re. o�-t1C.YA �C. /��'PJOa�inA+� � � /793/7 ��in4N� �/�soZ <br /> MECN�NIG1Lf.�'�q��C70R �MAIL�ODRE55 ' CITY T�� TPIIONE STATEIICENSE� <br /> fj9irs�i �o�o c7��- 3 -9-910 �1o9-3�dv <br /> PLUMlINOCON7RACTOR MML�OORE59 qTY ZIP PNONE SUTELILENSE� <br /> CONTRACT MMCE Of <br /> ppp _ HEATINO 8V8TEM: I 1 QAS fl ELECTRIC f-1 <br /> OEBCRIlE �NO SpUAqE FOOTAOE INVOIVEU CONT�CT PERSON�N�P E NO <br /> �9 - m 2 -03cd <br /> GC�'1c1+� l a�iC fo✓RSi, 7 F/�'DUIa.� l't7a �/i D�v <br /> ' D � ' CJ � HEREBY CEFTIFV THAT I HAVE READ AND E%AMINED THIS <br /> Crnonw¢o use a euiano APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �N � L`� PROVISIONS OF LAWS ANO ORDINANCE6 OOVERNINO THIS TYPE OP <br /> v WOflK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN Ofl <br /> �auoeseawria+araovenrvisawHeeiowoa�rt�cnTvrc�covi¢si rypT. THE ORANTING OF A PERMIT DOE6 NOT PREBUME TO aIVE <br /> �or s�oac a AUTHORITY TO VIOLATE OR CANCEL THE PFOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW qE6ULATINO CONSIRUCTION OR THE <br /> ° ' GVD. -� E � PERFORMANCE OF CONSTfiUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THI9 PPOPERTY TO PERFORM TME WORK FOR WHICH <br /> i APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> � t��-525 3[1 � _ CONTRA TORS LA iB.27 RCW AND 288200 WAC. <br /> C�81�K'iD9NLOANIENDE �0011ESSTELEPIIONEMI4BEH � Z /(�/`1� L'���/G'�"^" SI�G'/�5' _ <br /> —"� SN3N U OATE <br /> CITY BUSINE55 LICENSE NO <br /> KUYMN6 MECMANICAL <br /> NO. TY►E Oi ftlRIME 0111TEM FEE NO. TYP[Of�QIN�AAfNT 1'�E <br /> WATERCIOSET�TOILEn ' NC—AMNOIAUNRB—H.P. � <br /> BATHTUB ' FOFCED AIR SVSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> BMOWER ' UNIT HEATERS—B.T.U. M ; <br /> KITCHEN 61NK 6 DISP i CLOTHES DRVERS i <br /> DIBHWASHER � VENTILATION FAN � <br /> UUNDRV TRAV ; RANQE HOOD ; <br /> CIOTHEB WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE ' <br /> DRINI(INf3 FOUNTAIN � METAL FIREPLACE(WOOD BURNINQ) � <br /> FLOOR DRAIN � FIHEPLACE INSERT(WOOD BURNINO) ; <br /> BACKFLOW PREVENiERS ; f3AS FIREPLACE � <br /> SINK(SERVICE—BAR.ETC.) � QAS RANOE � <br /> � UAS PIPINO ' <br /> � EXHAUST FAN � <br /> i � <br /> i � <br /> � � <br /> � � <br /> SUB TOTAL S SUB TOTAL S ' <br /> PERMIT S i PEFMIT S � <br /> l'OTAL FEE S ' TOTAL t�EE S ' <br /> FOR OFFICE USE ONLV: <br /> i11d1T5ET8ACM RE�RSETB�CN S�DESETOACR PUNCI NIIMflFR �FF �Ff.EIPTNO <br /> � <br /> us¢ior� IOTAPFA veceNrsne � EE VALUATION FEE _ <br /> I IYES I I HO OUILDINO � �5�� I J I CIC� <br /> � <br /> HEIONT LIIMUTIdI NO OF OWELUNO SIZE O�BlDO/�I I i <br /> UNIfS /.(J�(�}� PlVMOINO — _ � <br /> (l/��l'I.�V <br /> a�IMPANCY NO Ot SIMIES OLCUP�NT LO�U BASEMENf MFCII�NIf.0 � <br /> � <br /> fIVES 11 NO � �- <br /> FIREIKMMREOD PFAS �l](A�ION�I PIANCUF.GN --�—_ <br /> on�en ; <br /> FIRFSMiINKIERRE0�11 REI150N i <br /> $TAiE BUIIUINO51IfIf,11�Rf,k i G <br /> i..)�/ <br /> __ _ �._ <br /> TYPE OF�' ST PUNS APPROV(D IIY CITY OF EVERETT ����I If,WnpNS ' <br /> ��M LOCAL SALES — --- <br /> —�-- <br /> o�.E 8 yr ` TAIf CODE IS 9105 TOTAL � <br />