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i <br /> APPLICATlG _! FQR CONSTRUCT JN PERMIT <br /> CITY OF EVERETT•BUIIDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-881U <br /> ❑ DEMOUYION ❑ C06ABINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PRWECTADDRESS= 7_,� �a /���pai,Cy�a.� <br /> �� MNLMpiE55 cm im ���� <br /> �Qv1 � �ol�FNv�tciCP 3yUl Tulu� 2� �u �,x'tiati ���'ol �U/o -,���- /� 7 a�5� y.�32 <br /> TEMM/T MNI�WRE55 GTY 71P PIIp1E <br /> �/��/'�SS�GrS ��iG-�'� ���//3" C' ('u/��7-�itr G�d+-'.t.(�i 9�YZU/ 25� '`IaU() <br /> �RGMRGTp10E51GNER �ui�nor�e�` cm= nr MqNE <br /> ce��rn.aon M.iQiwones �Yd' S/.3-9CG�o <br /> cnr rir rnune SIGiEtICENSE� <br /> MECNIIMCKCONTRI1�TOf1 MMI�DDpE55 CIIY Z1P PN:NE STATELICENSE� <br /> PLUMlI1CCp.TR11�TOR MAILMCAESS GIfY ZIP PNGNE STAIELICENSE� <br /> CON�MCT iRICE OF Yp11N <br /> � D �T�' HEATING SYSTEM: GAS O ELECT(iIC ❑ <br /> DESC�•M�EE W0111f ANO SOU�qE FOOTAO�MVOIVED �t, CONT�C f PCIISON/�ND PMpNE Ilp <br /> G /'� I GI <br /> I HEREBV CERTIFV THAT I HAVE READ ANO EXAMINED THIS <br /> vnoroseo use oc eu� 0 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT AlL <br /> .S/ / �,Q PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �•r� � MORK WILL BE COMPLIEO WITH WMETHEF SPECIFIED HEREIN OR <br /> tE6K�7UE,5.C'�M�P!T�ONOFP1qPERiY�51qWNSELOWp1ATT/iLN7WpCpNES� NOT. THE OqANTINp OF A PERMIT DOES NOT PRESUME TO OIVE <br /> �oT yy�u_e�opc�oF I� ' ' i AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />� OTHER STATE OR LUCAL UW RE6ULATIN6 CONSTRUCTION OR THE <br /> PEHfORMANCE OF CONSTRUCTION.THAT I AM AUTr1GftIZED 9Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR NMICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> wwcEiie[i .�q CONTRACTORSLAW1B27RCWAN0296200WAC. <br /> 3 0 - ��� - p/ - � �/ "� ,/ <br /> CONSTRIILTION IOIW lEH0ER.11DDnE53.fElER1p1E MIMBER X�XQO�(/vt^ l"!� ��'c.��' ��_ <br /> SIGNATURE UI1TE <br /> CITY BUSINESS IICENSE N0. <br /> ��� MECHANICAL I <br /> NO. TYPE OF Fll(iURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn � �_�Np��� , I <br /> BATHTUB ; FORCED AIR SYSTEMS ' <br /> T <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> ��A ' UNIT HEATERS � <br /> NITCHEN SINK 6 DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � RANGE HOOD � <br /> IAVNORYTRAV ' WATER 4FATER ' <br /> CLOTHES WASHER � WOODSTOVE , <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD AURNING) <br /> ROOR DflAIN � GAS F�REPIACE � <br /> BACMrLCW PREVENTERS ; GASRANGE ; <br /> SINK(SERVi�E—BAR,ETC.� GAS PIPING � <br /> ' DCHAUST FAN � <br /> � � <br /> � , <br /> � � <br /> � � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL f � <br /> PERMIT S i PERMIT S � <br /> TOTAI FEE S � TOTAL FEF, f <br /> FOR OFFICE USE ONLY: (1,� . /J <br /> FqONiSETPACKO REMSET&1CK SIDESETB� PUNpIrEC,RIJ�M�fi fE �I `Z� f1Ef.FlPTNO <br /> `5 / n / _ <br /> CjV (!/ <br /> uSETa+� � IOTAREA v�c�NiSiiE FEES VALUATION FEE <br /> �j ❑YES ❑ NO BUII.OMO�� ��3.�- V .� ��' i �(� <br /> IIEIGNT LIMITAiION AO OF OY/ELLIN6 SKE OF BLO6R1 � <br /> UNqS � t p�pM1101NG i <br /> a�ANGY Iq p 51(NtlFS OCCU�ANi IO�D BASEMENf MECN�HIG�L I <br /> � � ❑VES �NO � <br /> � <br /> ADDII ION�I PUN GMf.f.N � <br /> FlRESPWNKI/EJR�pEO'D REASON . <br /> �"� otr�En � <br /> FlHEMMMNEO'D Pf�SpN � <br /> Y� �A/MI/.� SfA1EBUILDINO511RG1UR6E { ��'� <br /> /V�/6C/ __" � , <br /> rrPe ov r.onsr ninNs e"r�vnoven sr CITY OF EVEREIT rueur,vroans Q�; �p <br /> � �/M LOCAL SALES — — 5�' -;--z'- <br /> o�Te TAX CODE IS 3105 TOTAL 7 � ��v <br />