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APPLICATI�.,�! FOR CONSTRUCS aN PERMIT <br /> CITY OF EVEFiETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259•8810 <br /> ❑ DEMOLITION ❑ COMBINATIdN ❑ BUILDING p MECHANICAL (� PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: �^p�'�5C !�?�R y <br /> •�If—f�ry=f=���t- <br /> �hR MNl�00NE55 �ITY IIP PIqNE <br /> �'v'�,A /-�-�/'�� �un� �:���Y zv�i � si- _�s"y�v <br /> TE11�NT MNLMp1E55 CITY IIP p�npNE <br /> •NCMTEGTORDE$IGNER MAn/�ppqE55 Cltt I�P PHONE <br /> 6ENEMlCAHiR�GTOR MIJ�J,pppE55 GTY )IP PIIONE SIATEIICFHSE• <br /> A ��i <br /> /I�f'�Lvy �JMS %,Oi;�r��v � �5`'�1/ ,?iJ /i% i'+� �ti�/� 7�� )� L �f��`6/ /'� OY� jr���'/J� <br /> MECM�MCKCWTi1�Cip1 M111L�DOHE55 C.Itt � Zi0 FNONE ST�TELICENSE� � <br /> y(l i1d..�.e ��.1��� <br /> rs---1-r. � <br /> RVIlMM CpNiRACTC51 ' MULMORE55 Ct1Y zIP OHpNE ST�TE LICENSE• <br /> S L9/f1N/� /��Jih� ,J�, <br /> CONTR�ILTPRILEpFWpiR ti <br /> =;'c�d ' HEATING SYSTEM: ❑GAS ❑ELEC7RIC � <br /> oEs�wanc�no sou�nE roorwse n.vaveo LONT�CT PERSON NA PIpHE 1p <br /> A/�l,'//v5 N��'� �i�%/Ik/'Ji�, �: t� /7�All`J C�-' ���'/ <br /> �� �'E1'/�/n.5 <br /> I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED T1iIS <br /> vnovos¢ous¢or e�nwmo APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> P�r,��nt. R��Q��(i- PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IECdLaESCNiVT�ONOF WIOPERTY(3HOWNBEIOwOR�Ti/iLN7NqCOPlES) NOT. THE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �aT e�oac a AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTNER STATE OR LOCAL LAW REOUTATINQ CONSTRUCTION OR TNE <br /> PENFORMANCE OF CONS7RUCTION.THAT I AM AUTHORIZED BY THE <br /> ONRJER OF THIS PROPERTY TO PERFORM TME WORK FOH WHICH <br /> APPLICATION IS MADE ANO I COMPLY WITH TME STATE <br /> MRCEL DU!ID.MMER CANTRACTORS LAW iB.27 RCW AND 296.200 WAC. <br /> p - �-/d5-03o -G� <br /> COMSTRIICTION LWH lENOER,�OdiE55.1ELEPIqNE M1MlEq <br /> x `�l,�l�'�« �' �'/� /-� <br /> SbN�TURE _ . ' D�TE <br /> QTY BU5INESS 110EN5[NO <br /> �'V�� MECNANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE N0. 7YPE OF EOIHPMFM FEE <br /> / WA7ER CLOSET(TOILEn � /VC—AIHNpLp UNfTS � <br /> BA�4TUB � FORCED AIR SYSTEMS <br /> � <br /> � <br /> LAVATORY(WASH BASIN) i HEAT PUMP , <br /> CiF10WER � UNIT HEATERS � <br /> KITCHEN SINK 8 DISP ; CLOiHES DRVEHS ; <br /> DISHWASHER � RANGE HOOD , <br /> LAVNDRY TAAY � WATER HEATER � <br /> / CLOTHES WASHER � WOODSTOVE , <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT(WOOD BURN�NG) ; <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> ' IXHAUST FAN <br /> i � <br /> � � <br /> SUB TOTAI S ; SUB TOTAL f ' <br /> PERMIT S � PERMIT S � <br /> TOTALFEE f � TOTALFEE S � � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACN RE�qSETBACR SIDESETB�CK P��NLNELRNVMBEq�� fEF OCCEIPiNO <br /> O � <br /> J <br /> USE ZONE l01�REA vec�dr SitE PEES VALUATION FEE <br /> ❑�ES ❑� OWLOMC vv � � O l <br /> HEIGNT UMITHION NO OF UWEWNO SIZE OF BLOGR.I V <br /> UNIfS � <br /> PLUMOIN6 � <br /> i <br /> OCCUPANCY 1q O�SfM�fS OCCUP�Nil0�0 e�SEMENf MECN�NiUI s I <br /> GROUP <br /> ❑YES O NO <br /> flRESPRINKIEFREO'D RE�SON AODIiIONA�PUNCHf.LR � <br /> O�IIER i <br /> FIHEAUAMREO'D RE�SpN <br /> r— <br /> SiAIE 6VI101N0$IIRCHARGE ;�� <br /> IYPEOFf,pNSi Pl�NSAPPPOVfOBY � <br /> CITYOFEVERETP rueiicwnnKs <br /> LOCAL SALES —�— <br /> D�IE TAX CODE IS 3105 TOTAL i� ;� <br />