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� _ __� <br /> APPLICATI� .� FOR �t)�!S'rRUC'C DN Pr�P.N11Y <br /> GITY OF EVEFiETT •BUILCIING DIVISIQN � <br /> j 3200 CEDAR STREET•EVEREI'T,WA�920i �-259•8A10 <br /> /i <br /> Q DEMOUTION O COMBfNAiInN ❑ BUILDINL' t=': MECHANICAL ❑ PLUMBING O SIGN <br /> PROJECTADDRESS: /���, _��pi i�✓P -vc/etf <br /> � <br /> Ep Mu1.I�Wi1E55 [�tY lIP PHONE <br /> (��� tie �„de�:sor /g2C .��rer �✓P. `verP-�l- ;.�.�A 9�Zc�( i Zo�� 1 5�-�5`�� <br /> YUL�00HE55 citr z�P r�MNE <br /> /J1CN�CCTOROESIGNEf1 �����AE55 GITY 1'P �NONF <br /> I _ <br /> atNenK conm�cion µu�woness on r�r n��or+E <I�IE IICCNSE• <br /> MECN�NIGLLCONTNACI(M MNI�DONE55 dTY II� f'110NE cuTEUO'NSE• <br /> PLU4BW(�CONiR�LTOR MAILAWRE55 ptY I�P �NONE 57AfFl�CEHSl� <br /> ccwrn�^,rrwcEorwonK — HEATINGSYSTEM: ❑GAS ❑ EIECTRIC ❑ <br /> pE$LPoB�N�NDS� U�RE�Q7TA(lEWVOIKU / CON'ALTPERSd1�NOPIK1nEM0 <br /> .��� w.n �/�'�; SS� P�f��eT <br /> c r .- F� .S�C� z�� ��/U <br /> �- ' ///1 J 1 HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> "SOUGt�Q �teEi-( . _ APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT ALL <br /> P SEDUSE bi BlllldNO pROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �E�µp�Kp�pt�pNpppqppEqry�$IpWNpEIpNOt1�f1AG111VKICOPIE51 NOT. THE ORAMINO OF A PFRMIT DOES NOT PRESUTAE TO GIVE <br /> �aT B�aK a_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION Of ANY <br /> OTHER STATE OR LOCAL LAW RE6UUTINO CONSTRUCiION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFOFM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �}�� p CONTRACTORS LAW 10?7 RCW AND 2962U0 WAC. <br /> P`txs�f 3ioo 0�� �05"� / /- ', ` '` <br /> GONSTRVC7�ONlO�MlENOER.�Dd1E55.TF.LE1'N�MEMUMBEH �(_(p��G�✓ •��/---�-- <br /> S�GNAIURF D�TE <br /> GITY BUS�NESS IILEHSC NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF flXTURE OR IfEN. FEE NO. TYPE OF EOUIPMENT FEE <br /> T <br /> WATEHCLOSET(TOILET) � A/C—AIHNDLOUNR3 '_ <br /> BATHTUB ; FORCEDAIRSYSTEMS T_ <br /> UVATORY(WASH BASIN) � HEAT PUMP _�_ <br /> SHOWEH <br /> � UMIT HEATERS � <br /> KITCHEN SINK 8�ISP i CLOTNES DRVERS _�� <br /> DISHWASHER � RANGEHOOD � <br /> UUNDRY TRAY ; WA7ER HEATER � <br /> CIOTHES WASHER � WC�D STOVE � <br /> URINAL ' MEfAL FIREPLACE(WOOD BURNING) <br /> DRINNING FOUNTAIN � FIREPLACE INSLRG(WOOD BURNING) � <br /> FLOOR DRAIN GAS FIREPLACE � <br /> GASRANGE <br /> BACKROW PREVENTERS �_ �—' <br /> SINK(SERVICE—BAF.ETC.) GAS PIPIN6 <br /> P'(HAUST FAN _� <br /> � <br /> � ---�-- <br /> i <br /> ' '. � <br /> � <br /> _ � . � <br /> SUU TOTAL f ' SUB TOTAI f �_ <br /> PERMIT S � PERMIT S _ � <br /> TOTALFEE f ' TOTALFEE f ' <br /> FOR OFFICE USE ONLY: <br /> nrcnrr No <br /> iRd11RETPACN �EHISFTBnCN SIDESETB�CN �I�NG1EC�tMUM�1(n '.� fFf — <br /> ��3 .SJ <br /> USEIOMF. IOI�PF� V�CANT9IE <br /> FEES VALUATION FE. ET_ <br /> ❑YES ❑ � DUIII�IH6 � <br /> NEI6NT UMIi�TION NO Of DWEIIINb 92E W BIDOR� ' <br /> UNIf$ PIU40�NG __�.� <br /> __ ' <br /> OCCUPIINCY NO M SIM[5 OCCUVeNf IO�D B�SEMENf MFCNeHIC�I __ <br /> Gf10UP <br /> �YES ❑NO <br /> �DIN IION�I.M�X p�f GN ' <br /> FIRESPRiN1tLENRFO'D AF�Sd1 --- --�— <br /> ou�En <br /> fIRE/�iwRMREO'D AEASrW � <br /> SIAtEP1111��N6}�!fk111111iE — _ �� <br /> irrtnvr.or�sr vinNs�rvnov¢nar CITYOFGVERETT �IIPI�f.WOPMS _ _ <br /> LOCAL SALES ---— <br /> TAX CODE IS 3105 TOTAL <br /> �o•ie ---- . <br />