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APPLICATIf 'V IFOR CONS'TRUC'f Dt� PERWIIT� <br /> CITY OF EVERE�! = 3UILDING DIVISION <br /> 3200 CEDAR STREEl'• EVERETT, WA 98201 •259-8610 <br /> C7 DEMOUTION ❑ COMBINATION O 9UILDING ❑ MECHANICAL p PLUMBING ❑ SIfiN <br /> PROJECT ALIDRESS: �7� Q2Pi�Pa4 t-.ti1 _E. I`4Q•i,lT k1I� . �If�:��___ <br /> ravA2Ew [�. L'�y�£. 104 BA�,�42A 1�wJ _'cJ�2t1r r..,� qf5.1�3 Zvlo 3:�3 -��/O(o _ <br /> ea uui�ooaess an rir n��or�c <br /> ieruNt uuiwoness r.nr i�r r�aHc � � <br /> �RC111TCCTOi1DE516HER 4�APDUNE55 f.11Y '"'--�Ji� aJ4.���a+F L��`7 <br /> 5c-sliFr �As 5f2�iccs za�,o za��PG-_I,J�__�i42 �f3y�-v _ .��o�+�i'L— SWrFr - <br /> fNEn/�IGONtMGIOR MulMME55 cllv Jir rnONf ���1EIICENSE. <br /> I �C 1'111 11l CONTML70P MMl11DDRE55 atY 7�� P110NF 541F ULENSF� <br /> � M1000HTR�CiOR 4�I1A00NE55 CI�Y 2�P P110NE 51�LELICFNfiEr <br /> C� <br /> cor�nucT rwcE or w«� HEATING SYSTEM: �.GAS ❑ ELECTRIC ❑ <br /> oescrveE vnoau�No sou�r�voouae wvow¢o r.a'uc�rcnsa+�wn rrror��a <br /> L�S,au_ r��Pa�f r�a� ���,aN�c, F,�P -- <br /> I HEREOY CEFTIFY 71iAT I IIAVE REAO AND E%AMINED THIS <br /> - APPLICATION ANU KNO�'J TNE SAME TO BE TRUE AND CORRECT ALL <br /> rrqrosco us[a eu�nr�o PROVISIONS CF LAWS ANU GHDINANCES GOVEHNING THIS TVPE OF <br /> . WOPK WILL BE COMPLIED WITH WHETHER SPECIFIE� HEREIN OR <br /> ien�uoescwrrar�awavEnn�yavme��a�o^"n�c���wocorirsi NOT. THE 6RANTIN6 OF A PERMI7 DOES NOT PHESUME TO 61VE <br /> io� _��x a _ AUTHORITV 7G VIOLATE OH CANCEL 7HE PHOVI510N OF ANV <br /> — OTHER STATE OR LOCAI LAW REGULATINO CONSiHUCTION OR TME <br /> PERFOHMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> --- OWNER Of TMIS PROPEHTV TO PERFORM THE WORK FOR WHICH <br /> I ApPL ATION IS MADE AND I COMPLY WITH THE 6TATE i <br /> PMCEI Ull I D.M1MlEN CO ACT RS UW IA2 RCW AND?96.200 WAC. <br /> CANSTRULiIONIOMIIENDER.Md1E5S.TElERqNEM�M�lER X D� ^ <br /> sarutunE � <br /> CIfY BUSINESS IICFNSE NO <br /> PLUIMINO MECHANICAL <br /> ►q, TYPE OF FlIfTURE OR ITEM FEE NO. TYPE OF FOUIPMENT FEE <br /> T <br /> WATER CLOSET(TOILE� � MC—M1NDL0 UNRS ' <br /> BATHTUB _ ' FORCEDAIRSVSTEMS _ T__ <br /> UVATORY(WASH BASIN) � HrA1 PUA1P ' <br /> SIIOWEH UNIT HEATEPS � <br /> � <br /> NITCHEN SINK 6 DISP i CLOTHES Of1VERS _ � <br /> DISHWASHER �— RANGE HOGD ____ � <br /> UUNDRY TRAV � Vd.4TER HFATER � <br /> CLOTNES WASHER � WOOD S1DVE � <br /> URINAI ' METAI.FIREPLACE(VJOOC BURNING) <br /> � FIREPLACE INSERT(VJOOD BURNIN6) � <br /> DN!NKIN6 FOUNTAIN � <br /> � OASFIREPLACE �� ��� v�� �- � <br /> FLOOR DRAIN � <br /> BACKFLOW PREVENTERS � GASFiNNOE � <br /> SINK(SERVICE—BAR.ETC.) � GAS PIPING nf�i� Y�M ' <br /> — � IXHAUST FAN —��� <br /> _ � <br /> i � <br /> � <br /> _a— � <br /> — i � <br /> � <br /> � <br /> SUB TOTAL f ' SU9 TO1AL i O <br /> — PERMIT f —'} ----__ PERMIT f �� � <br /> TOTAL FEE f <br /> -- 70TALFEE f '� <br /> FOR OFFICE USE ONLY: _ <br /> nrcrm�No <br /> fIqI1TRETR/�['ll RFMSFTMCK 510ESE1RM'M n1�Nf!!(CMM14Rf� 11f <br /> FEE9 VALUATION FEE _� <br /> usEea� iore�� WG�Nf51I( _ __�-- <br /> ovss ❑µ� nwrn�+n � <br /> -- -----�-- ------- -- � <br /> ��ea�n im�uiwa �, a ow[iura s�tF or e�nnn� ------..— � <br /> UNI(G 1'111401N1i ____'�_ �_�T� <br /> _—__._._'__ __ � <br /> pCCINGNCY M01%SI(ql(5 OLCUP�MILO�D S���NI �-'-�" '"— MFf,IUHN:M ! ___ <br /> 6f1dM' ❑YFS ❑rM� -- _---"- ___—'.- —' � <br /> -- �ObI11p11MA�NG1(CM T_ <br /> f111E6P1YNRLERREO'D PHSON ____ _..___ <br /> OUH� <br /> f61EHMMREQU FF�iOM --.'__.__'___ __ _— - 1 <br /> SGIE fl11q0�N651111C����E "___. .. _ _—i _ <br /> ivrtorr,or�cr aeMsu�vnrnenev CITYOFEVERETT �ue�u�w�n"s � <br /> LOCAISALES ----- ���-� - -�-" �� � <br /> --- _ � -------'-- <br /> --- <br /> o��f TAX CODE IS]105 TOTAL � <br />