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.� - <br /> APPLICATIO�I FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259•@B10 <br /> ❑ DEMOLITION O COMBINATION O BUILDING �I ME NICAL O PLUMBINIi ❑ SION <br /> PROJECT ADDRESS: �,��,?�, ,� ��- �3� ���� p�.`_ <br /> �,.. � L3�st ��.� ��«.G� 9�zu l <br /> OM0/ M�R�DDf1E55 LIT�' IiP PNOME <br /> �� �1��� <br /> t¢Niwt uui�nonrss crtr ri> PIqNE <br /> 11RLMTECT qi DESIONER MMt MIXIESS GITY )iP PNpNE <br /> L:'v�ANnFAY s�4�Es � SFOiv�cL- E�.�. /.���1 olS9�,I4/ yuMN3:I'ay2NZ <br /> OENE Gq11RA�TOR NULA0pRE55 CI Y I�P PIqNE Sf�TE IICENSE� <br /> �AECHAN�C�I CONTRA�Tp1 MA1L�ODRf 55 pltt TIP OIqNF 3T11TE II�ENSE� <br /> PlUMN1000NTN�CTOR N�IIMpIE55 CIIY IIP P/qNE Si�TEL10ENSE� <br /> LdITMGT IRILE Of WORN <br /> HEATING SYSTEM: ❑OAS ❑ELECTRIC O <br /> DESCR1�E Wp11I Mq Sd1�RE Fpp1I1pE WVOlVEO Cp1T�CT PERSON�NO VHONE NO <br /> �1� I <br /> I HEREBY CERTIFV THAT 1 HAVE READ AND EIfAMINED THIS <br /> �i��p����a� APPUCATION AND KNOW THE SAME TO BE 1RUE AND CORRECT ALL <br /> PROVISIONS OF UWS AND ORDINANCES 60VERNIN6 THIS TYPE OF <br /> WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEOKOE1CNWilOM0iP110PERtt�51qWNlELOWp1ATT/iCNtWpWNE9� NOT. THE ORANTIN(i Of A PEFMIT DOES NOT PRESUME TO OIVE <br /> �oT uocK a AUTHORITV TO VIOLATE OR CANCEL THE PpOV1610N OF ANY <br /> OTHER STATE OR LOCAL lAW REODUTIN(i CONSTRUCTION OR TME <br /> PERFORMANCE OF CONSTHUCTION.THAT I AM AUTMORIZED BV TME <br /> OWNER OF THIS PqOPEHTY TO PERFORM TME WORIt FOR WHICH <br /> APPLICATION IS MADE ANO I COMPLY WITH TME BTATE <br /> /NICfL TM I.D.MIANER CONTRAC?ORS LAW 18.27 RCW ANO 296.200 WAC. <br /> CON6TRUCiqN IO/W lENOER.A0011E53.fELFP110NE MNNER x y _ �I '�C �C <br /> � D�TE <br /> CIIY/UyNE88 UCENSE <br /> K�� MECMAINCAI <br /> NO. TY/E OF fllITU11E OR ITEM FEE 110. TYR OR tQINMiLIR FEE <br /> WATER CLOSET(TOILEn � �_�Q�� , <br /> �T�� ' FORCED AIR SVSTEMS ' <br /> LAVATORY�MASH BA31N) � HEAT PUMP , <br /> ���R ' UNIT HEATEHS � <br /> KITCHEN SINK 6 OISP ; CLO�HEB DRVERS � <br /> D16HWASHER � RANdE HWD � <br /> LAUNORY TRAV ; WATER HEATER � <br /> � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL � MEfAL FIREPLACE(W000 BURNINO) � <br /> DRINKIN6 fOUNTAIN � FIREPIACE IN3ERT(INOOD BURNINO) , <br /> FLOOR DRAIN � CiAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; (3A3 HANdE � <br /> BINK(SERVICE—BAR,ETCJ � CiAS PIPINO � <br /> ' EXHAUST FAN ' <br /> � i <br /> i � <br /> � � <br /> SUB TOTAL f ' SUB TOTAL f ' <br /> PERMIT f � PERMIT � <br /> TOTALFEE t � TOTALFEE f <br /> FOR OFFICE USE ONLY: - <br /> i110NT!IETlALII REAR SETlACN SIOE SFTl�CII �IAN CIIECK HU11BF11 iFF AFEEIPf NO <br /> � � <br /> usimhe 10111REA V�C�NfSRE fEEB VALUATION FEE <br /> ❑res o No ouinwn <br /> i <br /> IIEIONTUMT�TION .roaowcwno S�IEOFlIDOrtI <br /> r <br /> UNIfS P111M01N6 i <br /> OCCVPANC'I IqOffIMYFf OLLUPANIIO�U lI15EMENT `'7 ' l i \ <br /> O�OUr MFCII�NIGM �v � pv <br /> ❑YES O�M � <br /> i1RE8PRIIMLERREO'D BE�SON �DpIIpN�LPI�NLrIf.CN i <br /> ��•_ <br /> 071�E11 � <br /> FIREMMMREO'D AE�SpN <br /> i <br /> S7Ak BUIl01N(7 SU11C11�11(tF i <br /> �" �.� <br /> rrv[ar.or�sr vinNs�vrrrovcoer CRYOFEVERETT ruanr.won�s � <br /> LOCAL SALES --;— <br /> o�iE TAI(CODE IS�105 TotAL i <br />