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APPLICATII.N FOR CONSTRUCI iON PERMIT <br /> CITY OF EVERF.TT• BUILDING DIVISION � <br /> 3200 CEDAF STREET•EVERETT, WA 98201 •259•8810 <br /> f� DEMOLITION f 1 COMBINATION P�BUILDINfi I� MECHANICAL i i PLUMBING f ! SIGN <br /> PROJECT ADDRESS -, <br /> .s�a3 Lv. CP,-s�n/o 2� �0- yll l <br /> ovmen Mui•ooness ein z�r r�wNe �ir <br /> GL� CAF�r,a� A1nDUL/'�2 SySTE1'�'t,s <br /> tEN�NT M�II.RlORF55 CIfY ]IP PnONE <br /> `►30E �� G . <br /> FRGIIIT[CTOROESIGNFR M�q�0URE55 GTY )iP PHONF <br /> �LN�'�E �. IN'1��s�rrz i�5 <br /> aFNeneicor+rnncrnn uuuonness ri;r — �ir riwNc srerrucrvse. <br /> � C�3P�r�+� M[�'jLA-c- Sy5Ten25 <br /> MECN.�NICPI CONIMf,TOR MM�I1ppRF.55 (;Iry j�P PIIONE �TAT' LICF.N[E� <br /> PLUMBINGCONTti�f,iOil M�IL�COREPS Clh' dIP PHONF. S7�TELICFNSE� <br /> CONfR�CTPAICEOf WOfIN <br /> HEATING SYSTEM: f �GAS r I ELECTRIC f I <br /> DESCRIBE WJRR ANO SW�qE FOOT�OE INVOlVEO f.ONT�CT PfRSON�ND PIIONF NO <br /> /t'SS�--�IS�� 9� uNrT MoO� `n-n, L�Z�ni��_� STEr�Cn/zS�/ 266 3s�3 <br /> �LDG, 7q p rj� I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> PR01'OSED VSE OF PUIl01N0 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDIIIANCES GOVERNING TNIS TVPE OF <br /> -�������� WORH WILL BE COMPUED WITH WHETHEF SPECIFIED HEREIN OR <br /> LEOQUESCRIPTIONpFPRpPERtt�SNOWNBELOWOR�TT�GNTWOCOPIES) NOT. THE (3RANTINO Of A PERMI� DOES NOT PRESUME TO OIVE <br /> �oT _e�oc� or_ AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEU BV THE <br /> OWNER OF 7H15 PROPEHTY TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION iS MADE AND I COMPLV WITH THE STATE <br /> Peneei ux i o.�nmsea — CONTRACTORS LAW 1027 RCW AND 296200 WAC. <br /> CONSTRUCiIpJlO�NIF.NItER.l1MNIF.55,TF.LEf'NONENVMPFP x�� (�'-i7�Y.�-�'�'� ���/ J� <br /> � <br /> SIGN�IIIRE� ��IE <br /> CI7Y Bl151NF.S5lIC[NSC NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM FEE NO. 7VPE OP EOUIPMENT FEE <br /> WATERCLOSET�TOILET) � q/C—AMNDLOUNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYS7EM5—B.T.U. M E,A. ' <br /> LAVATORV(WASH BASIN) i HEAT PUMP , <br /> SHOWER ~_ UNiT NEATERS—D.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRVERS ; <br /> DISHWASliER � VENiILATION FAN � <br /> LAUNDRV TRAV ; RANGE HOOD ' <br /> CLOTHES WASHER � WATER HEATER � <br /> IIRINAL � WOOD STOVE � <br /> _ DRINKIN�FOUNTAIN __ i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINd) � <br /> BACHFLOW PREVENTERS � pASFIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) � 6AS RANOE 1 <br /> ' OAS PIPIN6 <br /> � EXHAUSTFAN f <br /> —�— <br /> � � <br /> � — � — <br /> � � <br /> SUB TOTAL E ' SUB TOTAL S <br /> ' PERMIT S i PERMIT E � � <br /> TOTALFEE f � TOTALFEE S � <br /> FOR OFFICE USE ONLY: ; -�r, � ` <br /> fMNITSFTP�Ck RFMS�Tfl�CN SIpESE1P�Ck PI�NCIIfCRNUMOfj4 �ff �ff.FlP,l�NO <br /> r" 3a/ <br /> u+ezor,e ioienre veeeN�srte FEES VALUATION FEE <br /> HEI(i11TLIMIT�tION NOOffIWFLLING SIZEO�p���RS I; NO �������H� ����I' ��O • '� � <br /> 7 <br /> ur�ns `7`� °�'�p rummr�o --- ----- -------F-- <br /> occurnNcr rp nr5iomt5 cecureN�lo�U B�SF.MENr � � <br /> anour urauwcei � <br /> 8�.� � I IYFS � NO <br /> fIRF./.U`�/GrBFOO � fIf�50N Af1f11IlON�I PI�NCIIfCN —�-- —'_---"_ -- O�� /-� <br /> Y C S U��. (� p120 — — Q �� <br /> — awFn � <br /> nnvsrm KiFnneon nr�srw — —�-- <br /> C (j Ci"( (1110 �tni�nunniNasunr.runre __ - --�� <br /> ivreorcoNsr rinNs�rrnovFnnv CITYOFEVERE7T runnr,wnnxc � <br /> `/ _ r✓ '/ht LOCAL SALES --- ---- -------- '— <br /> ___ u+�E �_ � . TAX CODE IS 3105 TOTAL __ _ �72�� <br /> �r„��wm �2-'�- 9l <br />