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APPLICATI4.1 FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-BB10 <br /> p DEMOLOTION ❑ COMBINATION ❑ BUILDINfi n/ ❑ MECHANICAL ❑ PLUMBINCa ❑ SIGN <br /> Co/,^3 C.4o ���, �erc� 9�J'Za3 <br /> �ECT AD RESS: Y <br /> � , ��� � ;, .,,— C �'. � �f` y� �� �zc��) 37�- 3'y� <br /> , � . <br /> OYMIFR Mlulli00nF55 CITY I�P VNd1E <br /> iENMlT M41�00HF55 CI1Y 71V P1KA1E <br /> NiG111�ELTORDE516MER M1111/iD0�E55 C�1Y li� �MOMF <br /> i'�,,.L C�9ri/vc� ��'rsf�C�c �'t'ia cS'/�//TP_ �/`�4'- -i�'a.5�7a✓ <br /> ` MIul�00RE55 crtv 7�r ri�oHf . EIICENSE� <br /> 1yEryEWLL CONTP�LTdi <br /> yEpUNICAICONTR�GTOR MM�WFE55 <br /> d1Y 71P PIqNE St�TF IICENSE/ <br /> pWGlMG�pNTR/�CiOR N�Il�00iiE54 LITY IIP P1qNE $TATEIIGFNSE� <br /> i��/ G�10'�- <br /> �ONTP"0TP1�O°�'�0"'� HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br /> i�scwee woa��w sou�ae voor�o[r+vaveo cor�ucr veasor��va owrrt No <br /> 1 r/F.L' OI-1' ra /�� CG �G' <br /> 1 HEREBV CEHTIFY THAT I HAVE READ IVD ExAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> vncroseo use or euvH.a PPOVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS TYPE Of <br /> VW)RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �aioescnirria+avao�4nn�s�owneeiallon�n�cNnwconEs� NO7. THE ORANTINd OF A PERMIT DOES NOT PRESUME TO 61VE <br /> �� � AUTHORITV T(1 VIOIATE OR CANCEL THE PROVISION OF ANY <br /> �OT_ OTHER STATE UR LO(:AL lAW RE6ULATIN4 CONSTRUCTION OR THE <br /> PERFORIAANCE OF CUNSTHUCTION.TNAT I AM AUTMOHRED BV THE <br /> OWNER OF THIS PROPERTV f0 PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIV WITIi THE STATE <br /> CpNTRACTORS LAW 1B 27 HCW AND 298.200 WAC. <br /> v�nce�nvc i o.ran�^ / <br /> �� f� � �5 —/� <br /> �p�5tR11C IION LONI LENOk0.�OOHE54.TEIERIQ�E M�MSER ��O�TE <br /> �TURE <br /> . q7Y&ISINFSSLICENSi.NO ___ <br /> ��� MFCHANlCAL <br /> N0. TYPE OF FlI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> T <br /> � NC—NHNDLA UNIT3 ' <br /> WATER CLOSET(TOILEn — , <br /> �TM� � FORCEOAIFSVSTEMS <br /> UVA70RV(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNITHEATERS �—.-. <br /> KITCHEN SINK 8 DISP i CLOTNES DRVERS �__ <br /> DI6HWASHER � RANGE HOOD � <br /> UUNDRYTRAY � WAIERHEATER � <br /> CLOTHES WASHER � ME�Tq�L F REPLACE(WOOD BURNING) ' <br /> URtNAL <br /> DRINKIN6 FOUNTAIN FIREPLACE INSERT(WOOO BURNINO) � <br /> � <br /> � GAS FIREPLACE � <br /> FLOOR DRAIN � <br /> BACIfROW PREVENTERS � GAS RANGE .�T-- <br /> GAS PIPING ' <br /> 61N1((SERVICE—BAR,ETC.) — � <br /> IXHAUST FAN <br /> � <br /> � � <br /> � � <br /> � � <br /> i � <br /> SUBTOTAL t SUBTOTAL f ' <br /> PERMIT f � PERMIT f � <br /> TOTAIFEE S � TOTALFEE f ' <br /> FOR OFFlCE USE ONLY: �cFmi ra <br /> iRONT9EIR�CII 11El.pSFT&1CM SIOESETBdCk �IANCIIELMNUMBf11 ffF <br /> use iane io��aE� v.cun s�re <br /> FEES VALUATION FEE <br /> � <br /> ❑YES ❑� BUIIDINb � <br /> 11EqNTlIMT11TI0N NOO�OM�ELUNO SI=EOiN�1M1 -- i <br /> UNpS Pl11MPlllp � <br /> -. — i <br /> MfCN�MC�I � <br /> pCCUPIINCY MO fr SIMES OLLUP�NT 10�0 lASE4ENi � ' <br /> 011d1P — — — —+--__' <br /> ❑rE5 ❑Mn � <br /> FOp I IONR�l�N Glf Lk � <br /> FINE6PRIMtLERREO'D RF�� �-- <br /> O111ER � <br /> RRENMMREO'0 RF�SOH i <br /> SI�tE BUl0�N6 SO11CH��E � <br /> __ �� <br /> IYVEOff.pIST 1'leNS�VPfK1VEbBY CRYOFEVERETT rupnr,wtm�s __ _ _ _�_ <br /> LOCAL SALES --- ; <br /> n�ic <br /> TAx CODE IS�105 T07�� <br />