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� APPLICATII.N FOR CONSTRIJC7 .ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA BB201 •259-8810 � <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN(i ❑ MECHANICAI. ❑ PLUMBINO QJ SIGN <br /> PROJECTADDRESS: �q �a��T �A��Iti)� RCvI�� - I�1Zr'r �lU/� <br /> owr�n uui�wness pn im rrrorrt <br /> �A1L"i.�;CnDail�M L7hti.'hlD .��I�L'. ��)1 19�:1�_ SF F ,�A_�`61C�{ -�3�D �j����S�-�2C'i <br /> T�E 1 M��l .55 C�IY pr p�qqE <br /> '! HC ;Vi "�71zEL� �G9 �.rns��,+o ��. E.JE1tE'fr_�--9$Zf,g �2Uc) 3SS-3�ov <br /> �RC111 C1p10E5 NER M�II�f1p1�E55 �IN jm MIONE <br /> t' q <br /> oEMENLLCONtMcipl uul�OtN1E55 Cnr -----jn:--� N10N[ S111tlLIC[N$E� <br /> t�Nv� AQi 5�6�°� ���f� "A"Si S .E At1guY� �w 9_gcDi (za �s�.isa.� C.li�'N/NASD31B2. <br /> 4ECN 1LL CdJTR�Ciq1 MMl�d111E55 f.IfV /i� I�IION[ SI�fE LICENSE� <br /> RU�(WIRiW:IM MML�(N1f1E55 CIIY l��' PIqNE <br /> � � Sf�IE l!CENSE� <br /> CONIRACTM piWp111( -- <br /> _��r� ,�t7 HEATING SYSTEM: ❑GAS ❑ELECTHIC ❑ <br /> oeecneewancu/o �taroouoeMvavto ra�i�c�r[ns�wu,nr�ar��u <br /> Rfn��E���STux, �ic,�5 �. i►�srn�., n �� _. G'l:iF��2D M/Ni✓� <br /> ��`,.0 3 sQ r�_ Sih�. ' C�' _.�o�,) Ssz �78'DO <br /> 1 HEREOY CERTIFV Ti1AT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNC W THE SAME TO 6E TPUE AND CONPECT ALL <br /> P�0P0�������LdNO PROVISIONS OF LAWS AND ORDINANCES C30VERNIN6 THIS TYPE OF <br /> ��°�11/l/L-"7�C�NL .�EX�S�TInJ� WORK WILI. OE COMPLIEO WITH WNETHER SPECIFIED HEREIN OR <br /> i[a�uoeacnrr�,uorvna�nrvi e[iavaa�r�twocunesi NOT. THE OItANTINO OF A PERMIT �OE5 NOT PRESUME TO OIVE <br /> ioT_ _eiace or_ AUTI�OAItY TO VIOLATE OH CANCEL THE PROVISION OF ANY <br /> OTIiEIi StAtE OR LOCAI LAW REODU71N0 CONSTRUCTION OR THE <br /> */L-M � SEG A'T'rAC H ET� PEqfORMANCE OF CONSTRUCTION.TNAT 1 AM AUTHORI2ED BV THE <br /> OWNEA OF THIS PROPERTV '0 PERFORM THE WORK FOR WNICH <br /> APPLICATION IS MADE AND I COMPLY WITN THE 61ATE <br /> oiwc¢�rui�o.M�q CONiRACTORS LAW 1B21 RC\V AND 298.200 WAC. <br /> i�i S 1-cicc�-oo i -r� `G�1�u/���t� 3��/ �y <br /> GONSIMICTIONIO/WlENOER.MME55.IElE1MId1EMUYEEII x Y � <br /> s�.���338�I�°"�`T-- <br /> CIIY Pl�&NF.55l�CFNSE NO <br /> PLUMl�MO MECIIANICAL <br /> NO. T1TE OF FIIRURE OR ITEM FEE NO. TYPE qF EOUIPMEqT FEE <br /> WATER CIOSEi(TOILET) �— A/C—MiNDLO UNfTS �— <br /> BATHTUB ' FOfiCEDAIqSYSTEMS ' <br /> UVATORY(WASH BASIN) � HEAT PUMP � , <br /> SHOWER � UNIf HEATERS � <br /> _ KITCHEN GINK 6 DISP � CLOTHES ORVERS � <br /> DISHWASHER i— �M�lOE HOOD � <br /> UVNDRYTRAY � WA7ERlIFATER � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL � METAL FIREPLACE(WOOD BURNINO) ' <br /> DRINKINO FOUNTAIN � FIf1EPLACE INSERT(VJOOD BURNINQ) � <br /> FLOOH DRAIN � GAS f11tEPLACE � <br /> BACNFLOWPREVENTERS ; 6ASMNQE ; <br /> � SINK(SERVICE—BAR,ETC.) OAS PIPINO � <br /> ' EXIIAUST FAN <br /> � � <br /> � � <br /> � � <br /> � i <br /> � i <br /> SUB TOTAI_ S ' SUB TOTAL f _ �_ <br /> PERMI7 f PERMIT f r <br /> iOiAL FEE f � TOTALFEE S ; <br /> FOR OFFICE USE ONLY: <br /> fIIONT!iFfp�CK fi /1EMSFfMCR r^ SIOE��ACK 1'1�NCIKCMMN.q1fp,� fEf_ � / IIEf.CIPfNO <br /> C'7// �l /_ / _t <br /> J-llL�d l!� fLJ <br /> us[za� `e+•ix• v�cent a¢ fEEB VALUATION � FEE <br /> � ' / ,t � ❑r[�, p'rro oim�wm //1 / <br /> �ro �n.n�aror/ rq a mvrwra 6ilE OF o100R1 lllL—�— <br /> �i f�^/G uNnx rivumrm ' <br /> OCCIM�NCY NDOfl1(wfT OGCW�NItO�D E�4EMENf 4FCII�Mf.�l —�— <br /> ONOIIP <br /> ❑YCS ❑M --_ -- � .- <br /> � <br /> iNiEBPIWKLENREOV �F�SON �INM�HIM�1 M�NOIffM i <br /> -• �-- <br /> ourtn j <br /> rmc�uu+Mneo�o ne•c� <br /> xiaemmrorms�inr.n�nat _ // ��, <br /> — — -L-�-- <br /> IYPfOIf,pNSi PI�NS�PI9p10�VFf1BY CITYOFEVEREIT runncvnm.a I <br /> ��iq LOCAL SALES ------ — — --;-- <br /> u,�c TAX CODE IS 7105 iotA� ; <br />