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APPLICATIC^ l FOR CONSTRUCT �N PERMIY�,�}� <br /> CITY OF EVERETT• BUILOING DIVISION ��� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•BB10 �J—' <br /> ❑ DEMULITION ❑ COMBINATION �BUILDINO ❑ MECHANICAL ❑ PLUMBINO O SIGN <br /> PROJECTADDRESS: 3�03 (N, Cf}Si�/o /L�, <br /> %ffE �oEi�G. Gv,, . D. ax 3`707, r+ SOF�-/s,S�i�1TG�i�%t� 9�iaq <br /> p�//(��'A / M�R E55 f.ItY I�P ��o110NE <br /> {J����V r <br /> IFNI1Nl WUl�D011f55 CIIY pP �nONE <br /> �c. P. d. 6Un /009 , L/tTfr/LoP, e/t-. � g�3--o9�0 <br /> �RLwt(c q10E51aNfR Y�III�WnEss T Clfv ]m nNONE <br /> IyLL"I-�'-NLr/L [�sL�,vE2' L <br /> 6ENEIUICONTO�GfOf1 u�ItAD011F55 CrtY bP PnONE SI�IEIICENSE� <br /> MECN�MCMCONTp�LTql MM�OOaE55 Cltv llP VI�ONE StefEtICENSE� <br /> VW4EM/6CONTR��IOR M�ILAOq1E55 CIIY I�P PIpNE STAfELICENSE� <br /> CdifMCI PRICE Of Nqi1N <br /> �, �op HEATING SYSTEM: ❑GAS O EIECTRIC ❑ <br /> DE^uCINlE YA11N�NO SOU�RE FOOiA6E�:��IVFD CONT�CT Pf115ON�ND P110NE NO <br /> ��ANST�/�-T �rEE� s��D ���� A-srEr�rsons� Z6��-3s"�� <br /> _� b0 S� I HEHEBY CERTIFY THAT 1 HAVE READ AND ExAMINED THIS � <br /> vna�os[D USE a eu�dra APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> (�J� Ty Lr2/� LrL6�GT. SW /TVl'G�i�/L PROVISIONS OF LAWS AND ORGINANCES GOVEHNIN6 THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br /> IEUAL0E5CRIPTIONOfP110PERtt�6/qWNBEIOWOR11T7/�CNTNqCOflES� NO7. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> �or eiocK or AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION OR TH� <br /> PERFORMANCE OF CONSTRUCTION. fMAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPEiiTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PAIICEL TA)c 10.M11MER CONTRPCTORS LAW 1827 W AND 288./20J0 WAC. <br /> Cd14TRlICTqNLWNlENOER.N10RE5l.TELFP110NENUMEER l���• �� `" " � IZ�D�� <br /> �sNnE O��E <br /> LITV BUSINE55 LICENSC NO <br /> PLUMlINO MECNANICAL <br /> NO. TYPE OF flKTUIIE OR ITEM FEE H0. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—NHNDIQ UNR6 ' <br /> BATHTUB ' FORCEDAIRSYSTEMS ' <br /> UVATOHY(WASH BASIN) � HEAT PUMP � <br /> SFIOWER ' UNIT HEATERS ' <br /> KITCHEN SINK 6 DISP � CIOTHES DRYERS � <br /> DISHWASHER � RANOE HOOD � <br /> , LAUNDRY TRAV ; WATER HEATEN � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL � MEfAL FIFEPLACE hV00D BURNING) ' <br /> ORINNINO FOUNTAIN � FIREPLACE INSER?(WOOD BUFNINO) i ' <br /> FLOOR ORAIN � (3A5 FIREPIACE � <br /> BACKFLOW PHEVENTERS � GASRANGE ; <br /> SINK(SERVICE—BAR,ETC.) � (il1S PIPIN6 � <br /> EXHAUST FAN ' <br /> � � <br /> � � <br /> SUB TOTAL S ' SU8 TOTAL f ' <br /> PERMIT f � PERMIT f � <br /> TOTALFEE S � TOTALFEE f ' <br /> FOR OFFICE USE ONLY: <br /> i110MT5ETB�CN PE�RSF.TBI�LM SIOESE1B�Ck M�NCIRCMNUMOffI fEF nrcnrrra <br /> UlEJONE tot�nFe vec�NrsnF FEES VAlUAT10N FEE <br /> ❑YFS ❑NU IIUIIfnNfi 7ye� ��} � � <br /> � <br /> IIEIOIII UMIdT10N NO Oi DWElLIHO SItE OI BLW/II — � <br /> UNtiS q �J PIIIMOIN6 <br /> J —� <br /> OGCUP�MCf M00�f�(�Ff OLCVP�NIIO�D BASEMENi MFf.1uN�f.e1 � <br /> ��_ 1 � ___ _ ! _ <br /> / ❑YFS fdNO � <br /> •ODibON�l M�N G�IfGN i <br /> FI11E6PP�NKIERNEO'D �E�SdI , <br /> — <br /> �— <br /> /�� omcn ' <br /> FIPEMMMREO'D AHF(ri -- � <br /> �u 51�1F�U�I�IN65i1f1OU06F � �i� <br /> �_ �— <br /> rvice or r.onsr ninH nov[o ar GTY OF EVERETT ruqur,wonhs ' <br /> ' / ,�/ IOCAL SALES —y— <br /> V � V ,,�E 2 /J. S [ TAX COOE IS�105 TotAL /(v � ��J <br />