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APPLICATI�.N FOR CONSTRUC i.ON PERMIT �}�. <br />CITY OF EVERETT • BUILD�NG DIVISION �/'�%—�_ <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-0810 �Q�" <br />I l DEMOUTION ! I COMBINATION f tYBUILDING f 1 MECHANICAL I I pLU'MBING f I SIGN <br />PROJECT ADDRESS ., <br />l� .k0 � 8�:+� sH,�F DR <br />OW!IER M�Il�o�nE55 cirr rii' r•Htr�e <br />RlCl�h=� R �•�P c-" �'C � /3�=�K.Sti,.: � D�c � cs: �rr `�.!'<<-� (2Cr) i 5 3 - � 7 <br />unu nnonrss <br />�RC111iF.CTr,�oes�,r�en r.uueoontss env zi� rnutie <br />�wvr r�o�rnty �r,tr Fi�p+1��F i(,511 l�-t, ly � y/•��„'�'i'�'��'�% �'� 814 ,rs1 rr��tirP� �ir c r <br />cEnFnn�coNrnncron u�a�onnEss � ��i�� r�r ri�or�� sr�TEucEr+sE+ <br />n� <br />MECNRNIGI CONTP�CTOR M�II�WAE55 pTv DP P��ONE Si�TE LILENSE � <br />� <br />PWMBINGCONiRACip{1 MMtADORE55 LITV IIP PHONE ST�IELICENSE� <br />C/�C PRiGE O� W(AIK <br />� 3' CJ �� �� �D �r HEATING SYSTEM: fl GAS f 1 ELECTRIC I l <br />OESCRIBE WORN ANO SOU�PE FOOT�GE 1 VOIVED CONT�CT t'EPSON �N� {'HONErp <br />/�.�c��,�.�nnl cnF A Po�£ ��PC. '�cR �Tf.Ss lt�1�/L/��� <br />Car.�E u5t ( 99C- � �. ) <br />PRpfq5E0 USE OF BUIlO <br />`�% i�r � <br />LEO�L DESCRIPTION OF PROPERTY �SNOWN BELOW pi �TTACN /Y/O <br />LOT BLOCN Of__ <br />P�RLEL T�[ 1 D ry�MBER <br />?�c 2�-oD"3- C'/�-o.2el <br />cnNSTPIr.90N 1 O�N LFN�[N. 4ItORE55 TELEPIIONE NUMBEIt <br />Q • %CX �IJ�I 0 /�C'Z c i-ti � %if'C'r'� <br />NO. TVPE OF FI%1 <br />WATER CLOSET (TOII <br />BATHTUB <br />LAVATORV(WASH BA <br />SHOWER <br />KITCHEN SINK 6 DISF <br />DISHWASHER <br />LAUNDRV TRAV <br />CLOTHES WASHER <br />URINAI. <br />ORINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOIN PqEVf Nl <br />S�NK (SERVICF — [iA <br />SUBTOTAL <br />f C!t!.11? <br />tOTALFEE <br />FOR OFFICE USE ONLY: <br />ff10NT5FTBACK RF�fISFTfl�CN <br />ZO �'°''s°,1 S � <br />usEZONE lot�nE� <br />_�� / <br />HEI�NTUMIi11710N NOOLI1WElLINO <br />Z � UNIiS <br />UCnGUPMICV NO O�SIONiB OCCUV�NiLOAO <br />` 1�'C � � <br />flqE SPRINI(LER RE00 <br />TVPF. OF CONST <br />,t�� � 19 3— 15 ; ; <br />I NEREBV CERTIFV THAT I HAVE READ AND l�%AMINED THIS <br />APPLICAiION AND KNOW THE SAME TO BE TRUE ANO COPRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TVPE OF <br />WORK WIIL BE COMPLIED WIT}i WHETHEH SPECIFIED HEREIN OR <br />NOT. THE ORA�ITING OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITV ?O VIOLATE OF CANCEL THE PROVISION Of ANY <br />OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THF <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THF <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />C TRACTORS LAW 182 RCW AND 296200 WAC. <br />�:.✓. '� ��'�, 2 -IS �5' � <br />Bl/5MES5lICENSE VO <br />FEE NO. TYPE OF FI%TURE OR ITEM FEE <br />� A/C —AMNDLG UNITS — H.P. <br />; FORCEDAIRSYSTEMS—B.�.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />� VENTILATION FAN <br />� RANGE HOOD <br />i WATER HEATER <br />� WOOD STOVE <br />� METAL FIREPLACE (WOOD BURNING) <br />—�-- FIREPLACE INSERT IWOO� BURNING) <br />SIDESEIBALN & <br />S d /o <br />V�C�M SItF. <br />GAS FIP.EPIA( <br />p,4S RANGE <br />6A5 PIPING <br />EXHAUSTFAN <br />SUB TOTAI S <br />PERMIT 5 <br />TOTALFEE E <br />PUNCIICC�����f � I �/S/ � /S �{RECFIPTNO <br />y � <br />IIYES J�'Rn BWlDINO <br />.�iIZE OF BLWrtI <br />b S � rwMxiva _ <br />6'OEMENt � M[CIUNIC�L <br />^ f1Y[5 KNO <br />�DOIOON�L PI�N LNECN <br />OTIIER <br />ST�IE BUIl�IN6 SUi1CN11M1E <br />I <br />CITY OF EVERETT CUHIIC WOPKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />