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APPLICA'T''7N FOR CONSTRU� �r10N PERMIT <br /> �� i CITY OF EVERETT• BUILDING DIVISION � <br /> �' � I �) '�` 3200 CEDAR STREET• EVERETT, WA 98201 •258-8810 <br /> ❑ DEMOI.ITiON ❑ COMBINATION ❑ BUILDIN� MECHANICAL ❑ PLUMBINCi ❑ SIG <br /> 'jQJECT AqDF�8 � ' / <br /> Soo3 W. C,ns��a ��o — I.Soe..�(, ya_ 3 33 hhhN — /fAs�E .T� <br /> T��IL lnr,_ �I/��WRE48(J <br /> n` LNQ.IAI�� CO� V i O � L( �� / ZIP PIIONE <br /> TENMR MAILMORfi88 � 3,G'' CITY u.. ��I Zo6 �GSJ'-113/ <br /> 21P PNONE <br /> �NCMIECTOROflqNEH AWLA0011855 LITY LIP - <br /> PNONE <br /> OENEN�IMNiR�CTOf1 WILADORE88 CI7V LIP <br /> .�1 PNONE BTAif UCENB@ I <br /> Ge,,,,Fta� riWKicYJ ��, ��. �bex iz,o 1`�1����7 '�'lSZ7E" 2S'�-6z.9 <br /> "� cormucioA wuuoo�ns <br /> n' IP <br /> PHONE BTATE IICEN9E� <br /> �o�o�� �' ia2� �,� Aut nJ � SSoz� '7!, - a��3 �ac�an�lr <br /> AODRE!! G� 21P PHONE <br /> STA7E t10ENSE� <br /> COMMCT�RIC60FMIORN J • <br /> ��'4os �� HEATINO SYSTEM: ❑Qqg O ELECTRIC O <br /> OE! IIIKMNNf Ip FOOM08MVO:VfO CONTACTPERlIXI�NDFIIdKNO. <br /> '1 F{ //-� <br /> 4v. 32 ,33 ����o� ,S <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �o��p�dHo APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> S PROVISIONS OF LAWS AND ORDINANCE6 OOVERNINO TH�B TYpE Of <br /> iewupup�rnpNpFn�a[�n,rypyM�pq�n,���e� WORK WILL BE COMPLIED WITH W►{�ER BPEC�flED HEREIN OR <br /> NOT. THE ORANTINO OF A PERMIT DOEB NOT PRESUME TO OIVE <br /> ... � °� � AUTHORITY TO VIOLATE OR CANCEL THE PqOVI610N OF ANY <br /> ' OTHER BTATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CANBTRUCTION.THqT I AM AUTHORIZED BV T►IE <br /> OWNER OF TH18 PROPERTY TO PERFpRM THE WORK FOR WHICH <br /> APPLICATION IS M � COMPLY WITH THE STATE <br /> ruicnt��.a r�wscq CONTRAf:TORS CW AND 29�200 WAC. <br /> OOIM111UC110N LOIW LENOER.117CNE!!.TEL[MIONE MIMlER X � �� /•� <br /> 'ro""N� a 2 0 8 6 °"� <br /> dTY NE89 L�CENbE N0, <br /> P���N� ME HANICAI <br /> �• TYPE OF FlXTURE OR fTEM FEE N0. TYPE OF flxTURE OR REM �E <br /> WATEA CL08ET(TOIL � A/C—/VHNDLO UNITS—H.P. � <br /> �r� ' FORCEDAIRSYSTEM8—B.T.U. M E.A. � <br /> LAVATORY A9H BA81 � HEAT PUMP <br /> 6HOWEq � <br /> ' UNIT HEATERB—B.T.U. M i <br /> KITCNEN 81NK 8 OIBP ; CLOTHEB DRYtpS � <br /> DIBHWMMEp � <br /> LAUNDRY TRAY � VENTILAT!ON FAN � <br /> CLOTHEB WABHER ' RANOE HGOD � <br /> �— <br /> � WATER H�ATER � <br /> URINAL � WCGD STOVE � <br /> DRINKINO FOUN�AIN i METAL FlREPLACE(WOOD BURNINO) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUqNINO) � <br /> . - BAq(FLqW pqEyg►ITER8 i OAS FIREPLACE � <br /> SINK BERVICE—BAR�ETC. ' <br /> - _ � OA8 RANOE , <br /> ' OAS PIPINO � <br /> � EXHAUBTFAN � <br /> ' /c. (�yvl4 � <br /> � Kt � <br /> � ' <br /> � <br /> BUB TOTAL f ' 3UB TOTAL S � i <br /> PERMIT S i PERMIT S i� � <br /> TOTAL FEE S � TOTAL FEE f / �, r-�— <br /> FOR OFFICE USE ONLY: ' <br /> . . - . ' � �t�� REAR6ETMI�N BiDE6ETBACK PUNpNECKNU EP FEE RECEIPTNp. <br />, � J :>�. . <br /> ��� aT� v�GNi&re FEE VALUATION FEE <br /> aree n uo BNLDiNO <br /> ( :�IMUYR�TIp! u�8 py/EW�q BI�OFBIDOR.I. <br /> I <br /> "� OLUMEINp ' <br /> Q�`WAMC� MD.Oi!1101lEt OLCIIPANfLWD SASEMEM <br /> un�yr MEd41MCAl <br /> ovea o rro D� 7 <br /> smiu�wwaeov rrc�sa� �oanoN��wwa�Ea� <br /> flRfi 6CPoNKlER REO'0 REA80N OTHER <br /> HTAiE BUIlDINO 6UqpIMOE <br /> TM���+eT. wwa oer CITYOFEVERETT vueucwams <br /> LOCAL SALES <br /> o� �� TAX CODE IS 3105 TOTAL <br /> ! <br />