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APPLICATI�.rd FOR CONSTRUCI .ON PERMIT <br /> CITV OF EVERETT• �UILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> I 1 DEMOLITION I I COMBINATION I i BUILQING MECHANICAL � � pLUMBING I I SI(3N <br /> PROJECT ADORESS �O J ��j7 /? C ' 'Q n� N <br /> L� J�P/1l lL!/7'T-��� <br /> owr�rn Mnaenmrs� urv n�� r��or�e <br /> Kc1�n�aic,�.�IT avs�F s5? G4s�10 Ev��'1' ��oaG ��/7- s?c� <br /> ifNANT MAII Appf165 Cliv lIP PIIONF <br /> �_�'►'� As Uc�,,•��z�/���_��(-�������„—'��`�//1/f /,�I�i� <br /> enau*rcronoesicrurn unnenonEss '`'"" <br /> ��-�- ��/-=v .31i%�/1o�7 <br /> oeucna covrner.ra� Man eoimcss cirv nr m�nvr St�TE 1.10ENSE• <br /> MECHANICRLCONTR�CTOR MallMfliif55 f.ITV 71P P110Nf ST�iELICFNSE/ <br /> m`�KtrlsTiW .lo' ��.R,x�s�� �iE Qg►��' 7�.z�3�3/�� /J'1cx�,�(�F�'-37�n10 <br /> PWMPIN(iCONiR�C70f1 MPIIRPOPESS tAfY liP I'l1pNE SIRFIICENSF/ <br /> CONTR�CfPRICEOf WOfiN <br /> 3SOr� HEATING SYSTEM: f � GAS f I ELECTRIC f 1 <br /> OESCRIBE.WOIINANDSW�REFOOUOF.INVOlVF.O �+ (��e// D ,/� ������� �fn50N NOP� + �_y�s�j� � �� ��/� <br /> �C� /1•�1.. /Y /�,T�1 <br /> .�AS �-��G 1h4rLE�_ . D � <br /> 1 HEREBV CEFTIFV THAT I HAVE READ AND EXAMINED THIS <br /> -- APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORRECT.ALL <br /> rnoroseo use ov nunnwa /J����� I PROVISIONS OF LAWS AND OHDINANCES OOVERN.;IG THIS TVPE OF <br /> ��'� WORH WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEO�I�F.SLRIPTIONOFPROPERTV�SNOWNBELOWURAtiACN1WOCOPI[51 NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioi eiocK or__ AUTHORITY TO VIOLATE OR CANCE: THE PROVISION OF ANV <br /> OTHER STATE OR IOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOHK FOR WHICH <br /> APPLICATION IS MADF AND I COMPLV WITH THE STATE <br /> PARCF.IU%I D MIMBER - CONTFACTORS AW 18.27 RCW AND 296200 WAC. <br /> CONiTr��tIONIO�NIlNOER.�tlpRESS.iEIE^HONENUMfld11 x ^�/�G��j�/L�� �/��� <br /> _ N LUfiF. �/���� O�TF. <br /> l <br /> QTY AUSME55 UCFNSF NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTUi7E OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AIHNDLG UNITS—H.P. � <br /> BATHTUB � FORCEO NIR SVSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK R DISP i CLOTHES DRVERS i <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAV � RANGE HOOD i <br /> CLOTHES WASHER i WATER HEATER � <br /> URINA�_ � WOOD STOVE � <br /> DRINKINO FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WDOD BURNINO) ' <br /> BACHFLCW PHEVENTERS ; GAS FIREPLACE � i <br /> SINH(SERVICE—BAR,ETC.) GAS RANGE ' <br /> GAS PIPIN6 � — �BkYLE 7 ' _ <br /> � EXF;4l�ST FAN � <br /> _—_ <br /> � i <br /> � T <br /> 1 <br /> SUO TOTAL $ ' SUB TOIAL 5 ' <br /> PERMIT E � PERMIT E �— <br /> TOTAL fEE S TOTAL FEE S '� <br /> FOR OFFICE USE ONLY: <br /> ff10NT5PTP�CN �fMSFiPAfN SIpFSFTp�f.N PUNCIIEf.NN1141BFR fF[ RECEIPTNO <br /> use zorve iot�ne� v.r,�Nr snr FEES VALUATION FEE <br /> �IYFS I� NO � <br /> PIIII�INf. � <br /> R[I6Ni IIMA�T10N NO Or DWElLINO 9IF.Of flIUCRI i <br /> uNirs ri i ie�nia, <br /> OCCUP�NC� NO V�SIOAIlS (%:CUP�NI IORU B�SEMENI MFf.IUNIC�L <br /> GROUP <br /> f7VF5 I1 NO i <br /> FlRE�URMREO'!l �1F�SON �DOIIION�LPUNCIIfCN i <br /> OTIIER I <br /> FlRESPA�NkLFRRFOD RF�tiON � <br /> SiAIF.BIIII�IN(I SURCN�f1OC _ � <br /> i <br /> imEormNsi rinNs�rrnovEoav CITYOFEVERETT rupncwonKs ' <br /> LOCAL SALES �— <br /> „�,� TAX CODE IS�105 TOTAL � <br />