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� <br /> APPLICATIO.. FOR CONSTRUCTI.�N PERMIT/ <br /> CITV OF EYERETT•BUILDING DIVISION {!C,��� <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259•BB10 � <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ 11NECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDqES�'��f$D��}y���,f�� �q�y E� I ,4sh qPa� � <br /> iea MNL�OWIES.. cm tm r��art — <br /> �ieY�'L �. C�'u»� m � » � c ���- g7$� <br /> i H� uui urnr s ntv t�r ruor�� <br /> �{ICMiCC10ROE51GHCR M111Afqf1E55 pTY !i� P�qNF — <br /> OENER�IGONie�C10R Mu1�0011E55 LiiY )m PrpNF Slei[�ICENSF� <br /> MECNANI�qCONTP�CIOq M1VLAOOIIE55 CITV IIP P11pqE SGIEtICENSE� <br /> PIUMBkMsCON7RACTOR MMlAU0qE55 CIIY pl0 p11pHF. SUfE1.ICENSE• <br /> CONIMCf FPoGE Oi V/qiN <br /> HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> OESC(Y!E Wdilt AND Sd1�P(FOOTA6E MVOLVED cor�ucr rrnsa�ua r�r/o <br /> /J � <br /> h l.s� ����M -l-�r <.�s��� <br /> '�~�_ I HEREBV CERTIFY TNAT I HAVE FEAD AND ERAMINED THIS <br /> nraros[o use or euidra APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS Of LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> WOHK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEMLOESGPoPTIONO�PII01'ERTY�SIqWNpELpWW�R�LHTWOCpPIES� NOT. THE ORANIINO OF A PERMIT DOES NOT PAESUME TO 61VE <br /> �oT_, eiocK or A AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REODUT�N6 CONSTRVCTION OR THE <br /> PERFORMANCE OF CONSTRUC710N.TNAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PpOPERTY TO PERFOHM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PN+ce�ru�i.o.rewreEn ' \CONTRACTORS LAW iB.27 RCW AND 298200 WAC. <br /> 1 � � �\ <br /> CONSIRUL717/lOAl/LENOER./�DdiF.55.TELEi'IqHEMIMBER --- �f��{,(j�` '.l_���i'L��'z�–f��� <br /> �� <br /> S ,� �°l" <br /> CItYBi�9NE55lICENSCIq �. <br /> PWAMIN(i AIECHANiCAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EpU1PMEMT FEE <br /> WA7EH CLOSET(TOILEn —? A/C—Ah1NOL0 UNRS � <br /> BATHTUB ; FOHCED AIR SYSTEMS � <br /> UVATORV(WIV:H BASIN) � HEAT PUMF , <br /> SHOWEH � UNITHEATERS � <br /> NIfCHEN SINK 8 DISP � CLOTHES DRVEFIS ; <br /> OISHWASHER � RANGE HOOD � <br /> UUNDRY TRAY ' WATER HEATER � <br /> � <br /> CLOTHESWASHER � WOODSTOVE , � <br /> URINAL � METAL FIREPLACE(WOOD B:IRNIMG) <br /> DRINKIN6 FOUNTAIN ; FIREPLACE INSEHT(WOOD BURNINO) ; <br /> FLOOR ORAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS J— �3AS RANGE ; <br /> SINK(SERVICE—BAR,ETC.) C,AS PIPING <br /> ' E%HA�15T FAN <br /> _ � <br /> � _ � <br /> � — � <br /> � — � <br /> � __, � <br /> SUB TOTAL f ' SUB 101'.LL f � �_ <br /> PERMIT S � PERMIT S ,� i <br /> TOTAL FEE f � TOTAL FtE f s;�— <br /> FOR OFFICE USE ONLV: <br /> f110NTAETB�ILK REMSETMCM 61p[SFTB�CM M�NQIECKNUMBf11 fFF Mf.F��TNO <br /> ��k1� <br /> USEZONE lO1�RE� wc�Hrs��e FEES VAIUATION FEE <br /> T <br /> _ ❑YES ❑� BUIbINM1 i <br /> � <br /> HEIOHfUMIf�iqN 1qpiDW(LUN6 [IlE0iM00R1 <br /> UNiIS <br /> aw.�eiac <br /> 6���MCY Iq(i151Mf5 OCCWu/1L0�0 B�SFMENf 4FCII�NICM —" —,— <br /> ❑vE5 ❑rM _"__ "_—_ _ '-" <br /> FIFESP{IINKLERREO'D �i�S011 — AOp110N�IM�NC11fLK <br /> _�� <br /> OIIIFO <br /> FIRENMMNEO'D Rf�if� --- <br /> $I�IE 011i1 W`Ri SIIIK�uflOf <br /> noear,oNsr rinHs�nrnovenor CITYOFEVERETT runirw�ec <br /> LOCALSALES --- ------ -----'— <br /> u.�E TA%CODE IS 3105 TOTAL <br />