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APPLICAT101. FOR CO�OSTRUCTI�.N PERMIT <br /> CITY OF EVERETT•BUILDING OIVISION � <br /> 320n CEDAR STNEET• EVERETT.WA BB201 •259•8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDINO ❑ MECHANICAL �PLUMBINd ❑ SIaN <br /> PROJECT ADDRESS: -�5'�� E eAS � N� P� . <br /> Pl/3 /932G >�'s' -2Z�5 <br /> 01N/Ea M1u1I�00f1E55 `c�ln,�'_ 7�r rNONE <br /> Vetr-c /! 1vaiS�1-( �JN�� -�`� ���`� <br /> 1 N�NT 4IJ1�0011E55 f.ITY 71V 1'IqNE <br /> 11qLMttG1 OR OESIONER M�II�OOf1E55 Cliv 7���—�—_ �MONi <br /> � (2f.i�a..n �uC.,L�uQ� 2f�LTr SW_ f sa�Jt�eCt.— G I 6 '7�'b - �' 7`j 9 -�IOD <br /> OENER/dGOM11UGi MuII�DDRF55 <br /> arr !�r mroNf SGIEIICENSEr <br /> NELN�NICQ�yOMTi11�GTOR MIJL�DDRF55 CITY AP P110NE SGTE IICENSE� <br /> �Etz �"1,�..�a'uz (-flt9 STONCI�A�1 nJ .SPa Sri`'--3 ?ob_ r���-/�a ��/��zT,r3U <br /> %U4RIN6 COMfR�CTq1 MMl ESS CIIY 1��' ���E ST�IE IICENSE� <br /> coNrrucrvmcEor NEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> , � ��ti.�aor-ts <br /> st,tree � ��o u�voouoewvaveo cm�ucrv�nsa+u�or��a 'l.oL b7�•�^IA`0 <br /> iw l,'��6s� <br /> � i I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> Pnovoseo us[or eu�pNo PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TVPE OF <br /> WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iE�µpE���aPrqrEarr�s�qwaeE�pwon�n�cNrvvocories� NOT. THE 6RANTINO OF A PERMIT DOES NOT PHESUME TO 61VE <br /> `ot ��� «. AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHEH STATE OR LOCAL LAW REOULATINO CONSTRUCiION OR THE <br /> PERFORMANCE Of CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORN FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRAGTORS LAW 1827 RCW AND 298200 WAC. <br /> yMCEL T/UI IA.MAMER ' <br /> / � ! <br /> CONSTRIICTION LO�M lEN0ER.110d�E55.TELEA1plE MU�/SER 7I � p�TE�/� <br /> 5 „ c3o�-9s <br /> CITV BUSINESS IICENSC 1q _ <br /> ��� MECHANICIIL <br /> FEE NO. 7VPE OF EOUIPMENT FEE <br /> Np, TYPE OF FlIITURE OR ITEM � <br /> WAT�R CLOSET(TOILET) � A/C—AMNDLQ UNR9 <br /> BATHTUB ; FORCED AIR SVSTEMS � <br /> LAVATORV(WASH BASIN) � HEA7 PUMP ' <br /> � UNIT HEATERS � <br /> SHOWER � <br /> KITCHEN SINK 6 DISP i CLOTHES DRYERS _T� <br /> � RANGEHOOD � <br /> DISHWASHER — � <br /> LAUNDRY TRAV ' WATEH HF1Q[R � <br /> � T <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL � MEfAL FIfiEPIACE(WOOD BURNINO) _�_ <br /> FIREPIAC[INSERI'(WOOD BURNINQ) � <br /> ORINKINQ FOUNTIIIN ' �— <br /> FLOOR DRAIN � GAS FIREPUCE �— <br /> BACKFLOW PREVENTERS � GASRANGE �— <br /> , C,AS PIPING ' <br /> SINK(SERVICE—BAR,ETC.) � <br /> El(HAUST FAN <br /> � <br /> I � � <br /> _ — ; <br /> . � - ----i--- <br /> � "-- i <br /> SUB TOTAL f � _ SUB TOTAL f � <br /> — PERMIT f � <br /> TOTALFEE f � TOTALFEE S ' . <br /> FOR O�ICE USE ONLY: orr.emi No <br /> i�T s�re��K PE/Ji SfTlACN SIOE SFTO�LN <br /> ri�Hartc��+uunrn �EF <br /> IISE IONE IOI�REA V/�C�Ni S�fE <br /> FEES VALU�TION FE�T__ <br /> � <br /> ❑YES O M� pinlfpNti � <br /> � <br /> HE10N7 UMIT�TION MO O�DWEllINO SKE Of Bl06Rl � <br /> UNIIF �IUMOiN. T <br /> OCCIMANC� NOd51M1[S ��UP�N�l0�0 B�SE4EN1 Mff.N�Nif.�l I <br /> ��x ❑vE5 ❑MO � <br /> �pDiIION�I �I�NCMfCF � <br /> T— <br /> FMEBPNN1tLERREOD �F�SON — — i <br /> � <br /> mnrn ' <br /> � <br /> fIRENMMREO'D Rf�C� � <br /> 9Alf PIIIIO�H(i SIIOOIAII(lE j <br /> �_�. �_ _�.— <br /> nv[ar.or1si oinNs�rrrrovcner CITYOFEVERETT runi�r,wnn�c __�__ <br /> LOCALSALES <br /> TAX CODE IS 7105 7otAL <br /> p�fE --- <br />