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__ �-�� <br /> .-. -. <br /> APPLICATI�..� FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT•BUILDING UIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 90201 •258•BB10 <br /> O �EMOLITION ❑ COMBINATION O BUILDING LI MECHA'IICAL �PLUMBIN(i <br /> O SION <br /> PRWECTADDRESS: `3uYJ `� Lv�c�J' �c. tn -, 17�<.���c.�_ /p - >>/fj y`�/e�� `Iq <br /> ��e,n �I <br /> pN/ER ° MNL�ODf�E55 LrtY tm— p�pqE <br /> �j�G•n � <br /> TEN�NT MMMptE55 d1Y )In PIqryE <br /> /�ds�:n Fn�� <br /> MC1111[CTp10E5 MNIYIWIF55 clrv -----�--iiP � r11p1p <br /> (T(Q�1F.iu / lvhS(' <br /> OENEMICONifI/�/[Ipl M1UlIi0fN1E55 G�Y --- !�I• � PiNp�f: $UIEIICFNSE� <br /> C'rei)"�/il 1 �✓k S'� <br /> YELIUM�CMCWiR11C10f1 MNt�dN1E55 f.IfY l�P p11pNE SUfEIICENSF� <br /> l��.t'iF.ru � �iA'1 S� <br /> %U4�M16CONIRAGIOP YM�OfM1E55 CIIY l�i' "---- P110NE Sd1E110ENSE� <br /> cwrrucr vaicE or waa —-- <br /> IIEATING SYSTEM: ❑GAS O EIECTRIC ❑ <br /> oeecrysEr�oiuiu/osou�nerooua[wvaveo . � coriur�rrnsrn��nnr�ar��+o <br /> •� I HEf1E0Y CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> �p�o���� APPLICATION AND KNOW THE SAME TO BE TRUE ANU CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNINCi THIS 7VPE OF <br /> WORN WILL BE COMPLIED WITH WHETHEH SPECIFIEO HEREIN OR <br /> i[aKoesciwiqaaororenrv�s�awweeiowoq�n�a�iwocov�s� NOT. THE OAANTINO OF A PERMIT DOE6 NOT PRESUME TO 61VE <br /> tot eiocK or AUTIIORITY TO VIOLATE OR CANCEL THE PHOVISION OF ANY <br /> 07lIER S�ATE OR LOCAL LAW RE6ULATINO CONSTRUCTION OH THE <br /> I'EqFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICA710N IS MADE AND I COMPLV WITH THE 6TATE <br /> �ttu�io.ruw[n CONTRACTOPS LAW 1B27 RCW AND 298.200 WAC. <br /> COMt1MICIqNIOANIENOER.�ODllE6l.IElFP110NEM111lE11 � � 4 <br /> IUf1E WIE <br /> GIY pU5M1E6S IICENSE NO <br /> ��� MECIIAMCAL <br /> NO. TYPE OF fl1fTU11E OR ITEM FEE NO. 7YPE OF EWIPMENT FEE <br /> / WATEH CLOSET(TOILET) � NC—M1NDL�UNITS � <br /> BATHTUB ' FOfiCEOAIRSYSTEMS � <br /> IAVATORY(1NASH BASIN) � HEAT PUMP , <br /> ��p ' UNIT HEATEfiS � <br /> I(ITCHEN SINI(6 DISP ; CLOTHES DRVERS ; <br /> D18NWASNER � �AANOE HOOD � <br /> LAUNDiIY TRAY ; WATEA HEATER � <br /> � <br /> CLOTHES WASHEF � WOOD SiOVE , <br /> URINAL � ME�AL FIAEPUICE�VOOD BURNINO) � <br /> DHMN(NI(i FOIMJTAIN , FIREPLACE INSERT QA/OOD BURNINO) , <br /> FLOOR DRAIN � �IfiEPLACE � <br /> BACNfLOW PREVENTERS ; (iN51LW4E � <br /> � <br /> SMM((6ERVICE—BM,ETC.) � (iA5 PIPINO , <br /> C✓w�i.r tJO/G✓ S D(HAUSTFAN � <br /> 3c�»�'Mr•. l ins ��n� l � , <br /> �Fc� �2-rs s�+E f d.»e ' / � <br /> /..r r l- ... . le.- � ' <br /> � <br /> / nc%.� /�...� r/-l��.++ �.n, � i— <br /> $ B T ' SUB TOTAI f � <br /> PERMIT f � PERMIT f � <br /> TOTALfEE S � TOTALfEE f <br /> FOR OFFICE USE ONLY: <br /> fROMI6Eil�CI( PEM6ETMCN SIpESFiMGIc 1'I�NGICf.KMIMI1f11 IEF RELEIPiIq <br /> usetor� io�u+[e veuwrgrz � FEES VALUATION FEE <br /> �YES ❑MU OUlUM6 <br /> MEIONI 1/41f11f10M NO 0�OWELlINO 91EW NO6/f I —"' � <br /> U11IIF <br /> 1`111M111Nf1 � <br /> OCCUPANC� MOdfIM[f OCCIN/✓IIl0A0 B�SEMENI ----- — �-- <br /> a�air urr,�urxr.0 /l'y/1, <br /> OYES ❑110 - --�—�-��-- <br /> ipEBPNlY0.ERPE0'D 11i�50N �Op11fNUl M�NCIIff.M � <br /> i <br /> --r-- <br /> omrn 1 <br /> v�u�nuneon RE�cfy1 -- _ <br /> � <br /> i <br /> Sl�l E Illnl fllil(i 51111f.lUfNiE � <br /> i <br /> IWEOiCONSf P�ANSM{Mqy[pBY i <br />� CITYOFEVERETT runiu:wrxaa <br /> LOCAL SALES ------ —— --%— <br /> oeit TAx CODE IS�105 ioiAL , � <br />