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APPLICATIO.. FOR CONSTRUCTI.�N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, W.4 98201 •259-BB10 <br /> ❑ DEMOLITION ❑ CONLBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS:� <br /> cL�s+ n�1- LVUff� 95Jr/ <br /> �1un �h�lltr �-v�rr1� <br /> OwHER Yul�WllFss c�iY ]m rNONE <br /> IEN�NT YqI�bOPf55 CIIY l�� PIqNE <br /> 11RCMTCCTORDES�ONE� M�rtADpRE55 O�V )iP Pqpryp � <br /> _ 3.�5� R. T F ro� �OI'i f'rorn„ [� I.,,I p���r�� _ 55203 ��r:.� 'i � .:ST�2C*o�'1(3G <br /> a¢r�nuca.in�cton u•n�oonrss a�v rm m�oHe �uicuccNs[. <br /> /-�-9 7 <br /> MECN�MLQCONiR1�7011 M�It�DDt1E55 f.ITY 71P P110NE ST�fFUCENSE� <br /> IRUMlIN6CONfR�CTp1 MAIL�OONE55 CItY IIP p110NE SGfEIICENSE� <br /> d'le S� — <br /> cor+ra•cr rn�ce o�won� <br /> � �..,4..1 c < ,- HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> OESLRIlE Wp1M�Np SpU�RE FOpT�OE W VOlVEO - GONi�CT I'C1150N �NONE NO <br /> _ l <br /> OY 29D /�'/z <br /> � �� ` I HEHEBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPIICATION AND KNOW THE SAME TO BE TRUE AND COFRECT ALl <br /> rnaPoseouse or uiar+o PqOVIS10NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLIED WITH WHETHER SPECIFIE� HEREIN OFl <br /> LE6�LDE9GRIPTIONOi WqPERtt�51qWNBEIOWOR11TL1CNTW0001'IES� NOT. THE ORANTINO OF A Pf.RM1T DOES NOT pRESUME TO GIVE <br /> iaT eioc� or AUTHORITY TO VIOLATE OR CANCEL THE PqOVIS10N OF ANY <br /> OTHEH STATE OR LOCAL LAW REOULATIN6 CONSTRUCTION OR THE <br /> � � r•} � � c, PERFORMANCE OF CONSTRUCTION.TNAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPEHTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> FMCEL TAM 1 D. FR �� /Z� a� CONTRACTOR L 1827 RCW AND 298.200 WAC. <br /> Cp/SfRUCflONIdWlENOEq, ES . ElE M1NSE0 x �UC L�. /�l� I I� I �' / L <br /> SIO i R DAIE <br /> -�QaJ'�,� - CifY BVStYESSIICENS[NO <br /> PLUTASINO MECMANICIIL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—NHNDL�UNRS � <br /> BATHTUB ' FORCED AIR SVSTEM.S ' <br /> UVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWEq � UNITHEATERS � <br /> KITCHEN SINK 6 DISP ; CLOTHES DRVERS ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY � WAT[R HEATER ; <br /> CLOTHES WASHEH � WOOD STOVE � <br /> URINAL � METAL FIREPLACE(YVOOD BURNING) ' <br /> DRINNINO fOUNTAIN FIREPLACE INSERT(WOOD BURNIN�) � <br /> FLOOR DRAIN GAS FIRGPIACE � <br /> BACKFLOW PFEVENTERS � GAS RANGE � <br /> SINK(SEqVICE—BAR,ETC.) i GAS PIPINO � <br /> ' EXNAUSTFAN � <br /> � <br /> � � <br /> � <br /> i i <br /> T <br /> SUBTOTAL f ' SUBTOTAL i ' <br /> PEHMIT S � PERMIT S i <br /> TOTALFEE f � TOTALfEE S ' . <br /> FOR OFFICE USE ONLY: <br /> iRONTSETB/�CR , RE�115ETB�� � SIOESFiB�C� , Pl�NC11ECMNJ��f1 fEF n` �ECEIPTNO <br /> 3 7J <br /> U9E SONE /�f �/f �or en¢� WCANI S�fE FEES VAIUATION fEE <br /> �• ^` OYES O NO ^��niNry � ; <br /> NEIONT LIMI1�110N / � NO pf DWElUHO SqE Oi 8100rtI � <br /> � UHIIR O � PIVMpIN6 i <br /> � <br /> O C p11NCY ND d SIM+[S OLCVP�NI L0�0 B�SEMENf Mff.IUNICN � <br /> I ❑rE5 NO � <br /> � � <br /> fIREBPpIM(IEPREO'0 �FASON �DbbON�I�UN[n(CM <br /> _�_ <br /> on2n � <br /> i1REMARMREO'D RF�S(y� — —'_ '� <br /> Si�1E OIIp01N6 Spf1C1U110E ' <br /> ♦ <br /> Tro¢orr.or/5r rinNs�rrnovenar CITYOFEVERETT ruqnr.won�5 <br /> LOCALSALES -- � <br /> _ o,re TAX CODE IS 3105 TOTAL , <br /> ------- --_ ---- --�17;-=t <br />