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APPLICATI4.� FOR CONSTRUC7 .JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEOAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINA(/TvION � BUILDING ❑ M'E/CHANICAL ❑ PLUMBING C7 SlGN <br /> PROJFCTADDRESS: 3��_���''�5��� �j yJ-7�9 <br /> �iv���r�,/•�Q��"� __ citt rm rHor�E <br /> ��Eq ! MUL�00f1E55 <br /> �Oli ��� f110NE <br /> IEN�NI {� /'� {� � /������(5�5/�� / f IY T� <br /> ��UI�XJ�W�N �`�'CL_'__ ___— �NONE <br /> I.q�MTCGT0110E5�GNi11 �,/ M��I�IN/`��Ep55 <br /> LiIY l��' <br /> ����i�•�i(,f/ • '"u�� '--- nuON[ SUiEIIGENSE� <br /> OENEIUIGOMtMC100 M�II��DPE55 CiIY 7�� <br /> — �RONE St�iE tiCENSE� <br /> MELN�C�LCONIH�C1011 MML�DO�E55 fl� J�r <br /> %UMl�N6CONTP�CTOR M�IlA70AE55 <br /> CIIY S�n PIIONE SI�TEUCENSE� <br /> CpNTMGTPPoCEOFw01a HEATING SYSTEM: ❑ GAS O ELECTRIC ❑ <br /> CONI 1 PCf150M�M�PIIONE NO r��O'r L, �6' [�6 7 <br /> pE$LPIEE WOnM�ND SOU�AE f007/�GE INVOlVEO '��d�y�R /4,�R� i <br /> U R QUIC.AI✓ � �r7uo �f � HEREBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS <br /> �la-p Q L,M1. APPLICATION AND KNOW THE SAME TO BE TRUE AND COARECT AlL <br /> vrqroxouse a euiara PROVISIONS OF LAWS AND ORDiNANCES GOVERNING?HIS TVPE OF <br /> �wV.�G� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lE6AL0ESCA�PT�a�RTr��b��E������MTWOCO01E51 NOT. TNE ORAMINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PflOVISION OF ANV <br /> �oT s�°CK °f OTHER STATE OR�OCAL LAW RE6ULATINO CONSTRUCTION OR 7HE <br /> PERFOFiMANCE OF CONSTHUCTION.THAT I AM AUTHORIZED BY THE <br /> A PLECA�IONHI SP MADET AND PERFCOMPLY FWIT�H K1HER ST TE <br /> CONT/i�/CTORS LAW 18.27 RCW AN�D/2J96200 WAC. <br /> wu�cei rui i o.uween 'R-o�- / /`�+✓r!� ' / / <br /> �,� /e LY fl <br /> �,p�gipllCTp/101W lENOER.�OO�E55.TEIEP�WNE MUWBER X D�TF <br /> 51 NI1E <br /> CIIY BUSINESS IICENS[NO <br /> PLUMlINO MECHANICl1l — I <br /> FEE N0. TYPE OF EOUIPMENT FEE <br /> NO. TYPE OF FIXTUNE OR ITEM a�_pMNDLO UNRS � <br /> WATER CLOSET(TOILE� ' <br /> i <br /> � FORCED AIR SVSTEMS � <br /> BATHTUB ' � <br /> UVATORY(WASH BASIN) � HEAT PUMP , <br /> � UNIT HEATERS � <br /> SHOWER � CLOTHES DRVERS ' <br /> KITCHEN SINK 6 DISP ' � <br /> DISHWASHER � RANGEHOOD � <br /> � WATER HEATER ' <br /> UUNDRY TRAY ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> � METAL FIREPLACE(WOOD BURNING) <br /> URINAL � FIREPIACE INSERT(VJOOD BURNIN6) ' <br /> DRINKIN6 FOUNTAIN ' � <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> � pAS RAN�E ' <br /> BACKFLOW PREVENTERS pqg p�pIN6 � <br /> SINK(SEiiVICE—BAq,ETC.) E%HAUST FAN � <br /> � <br /> � � <br /> � � <br /> SUBTOTAL f ' 5UB10TAL f � <br /> PERMIT f ' <br /> PERMIT S ' TOTAL FEE f <br /> TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: rEF necemt r�o <br /> rl�N cI1FCK MU W1f n <br /> FP(M1TfiETB�LR PE�OSFTP�CN 90ESFiB1CM ��J�� <br /> FEES VALUATION FEE <br /> USF iONE lor enE� v�c�Nl S�rE ��Q ��J .. 7 ���� <br /> ❑res ❑�� p1111O�N0 �� -� ' <br /> HEIONT UMITATION UN a�E�UNO 911E Of llO6Rl PlUM111N6 �{�� <br /> I 57 0 5 _____ - ; <br /> MFC�UNIC.�I � <br /> OCCUP�NCf MU 0'S�(�[S a��'�Nr`O•� O�SE Nt �___ <br /> 6RIXM. � S � ❑YES ❑NO 7�'- �� _ <br /> �ppillON�l�I�NG�lLN �..� � i <br /> FIPEBPRINI(LERREO'0 �F�Sp1 � <br /> Y�S U8� Vn0 ' "_ nm¢n <br /> � <br /> i1RElLLAR REO'0 RF�SpI i� <br /> �� ��'')4 St�IC 011i1OIN65�111C1Ut10E __ _ r <br /> J ; <br /> Pl11NS� ��OVFOB'/ runnr.vmn�n �_ <br /> rrve a r.ons� -�j � C17Y OF EVERETT _ �/ � <br /> � / /J I.00ALSAIES TOTAL �iY 1;f_'��o <br /> /V ���q� TAXCOUEIS �105 <br /> __ _ <br /> � a��C . �U .._—-- -- <br />, _ <br />