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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> TY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT; WA 88201 •259•8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDING Qf MECNANIC�L ❑ PLUMBlNG ❑ SIGN <br /> PROJECTADDRESS: �—I J1 C�� Y�iL� L��/�'. � FL <br /> rr� �.��`—��rPt �Ic� ,�.7�c . <br /> own�a;— wu� ss an nr r� <br /> _� YYI�leS �U� C7�1 t�-F �A 1/f'. , �l � �t/e I'�' <br /> TENNIT 4NLMp1E55 • GTY llP p11p�E <br /> �'r�sn� T�l�n��� C�Q� TC:t,c�-P�' .131G�- -`,�l�e o�b2-�3 <br /> -(u v►�Y C�l'f���s�� �D(,C� G1U��2 t,P v„a,E <br /> GENEMICOqfiUGTOR 4NLMME55 CITY lIP � ������ �OUfATEIICFN� �� <br /> � .Z.�-�-J'Y'�i'7IC�Q/ ��SP i_�f'l�l'I f�,�° � �l�!� �L�S I Y/ l�.t$ <br /> MEd1AWCALCOHIMCTOR WIlA0d1E55 Cltt IIP � P110NE ST�TEUCENSE� <br /> �-ux�o �vvz� �.2� <br /> PIUMlM1C CONf1uGTOR Yu��55 CIfY liV P1qNE STATE LILENSE� <br /> 0 <br /> CpITMLT►IVCE OF NUqR <br /> HEATING SYSTEM: ❑GAS ❑ ELECTRIC O <br /> OEBCRIlE ANO SOUARE FOOiA6E N CONTACT P4RSON NIO PIqNE NO <br /> �.-�-- � I HEREBY CEflTIFY THAT 1 HAVE READ AND ERAMINED THIS � <br /> ��o����� APPLICATION AN�KNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> PROVISIONS OF LAViS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED W17H WHETHEH SPECIFIED HEREIN OR <br /> IFMLDESCHPTqNOFVIqPERTY(5lqWNBELOWp1�TiALM1WOCOPIES� NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT uuac a� AUiHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OF LOCAL LAW FEGUVUIHO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUl HORIZED BY THE <br /> OWNER OF THIS PRnPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAlI1.D.M161BEP `/� �� CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSIPUGTION lON1 LENOER.AO'M1E55.TELEPIqNE MMEER x /I�I�_�� <br /> SICN�TUIiE DATE <br /> . . CITYlUSINESS IICENSE NO. <br /> PLUYOINO MECNANICAL <br /> _ NO. TYVE OF FlXTURE Ofl ITEM FEE N0. TYPE OF C-0UIPMENT FEE <br /> WATER CLOSET(TOILEn � � NC—AMNOLO UNlTS � <br /> BATHTUB ; FORCED AIR SYSTEMS ; <br /> LAVATORY(WASH BASIN) � � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS ' <br /> KITCHEN SINK 6 DISP � CLOTHES URVERS i <br /> DISHWASHER � • � � � RANGEHWD � <br /> LAUNDRY TRAY ` � '� � WATER HFATER ; <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) ' <br /> DRINKIN6 FOUNTAIN i FIREPLACE INSEH�(WOOD BUflNING) i <br /> FLOOR DR�IN � GAS FIREPLACE � � <br /> BACKFLOW PREVENT RS ; GAS RANGE ; <br /> SINK(SERVICE=B ,ETC.) � 6AS PIPING � ;�''.��� <br /> . � ' EXFiAUST FAN ' � �. . .9C <br /> . . � �Jf,y�i <br /> . , � <br /> � � <br /> � � <br /> � � <br /> i � <br /> SUB TOTAL 2 ' SUB TOTAL f ' <br /> PERMIT S � PERMIT f � <br /> TOTAL FEE S � TOTAL FEE f ' <br /> FOR OFFICE USE ONLY: <br /> f110NT SET9dCN pEAN SETMLK 9DE SET&KN PLANGI[CK NU �� • iEF / i�CFIPT NO <br /> �3' � <br /> USESONE IOT�NE� v�cu1�sire FE S VALUATION FEE <br /> OYFS O NO BU1lDIN0 J <br /> HCIGHTUMTATqN NOOFDWElUNO SI2EOFllDCJf.I � <br /> 1N11i5 PLIIMBIN6 i <br /> OCCUPANCY Iq pf SI(riE5 OCCUP�NT LO�D BiISEMENT MFCNNIIC�L ' <br /> 6ROlA � <br /> ❑1ES ❑NO � <br /> App110N�L%�J!CN[LN i <br /> FlRESPHINKIEflHEO'D NEASON i <br /> � <br /> 07NER � <br /> FlRENMMREO'D RFACp/ <br /> S1�lE 9UIl0ING SURCH��GE � <br /> TME CF f,ONSi 1`LANS MPROVED BY � <br /> CRY OF EVERETT rueur.vroa�s <br /> ',�M LOCAL SALES �— <br /> o�rc 11 1AX CODE IS 3105 TOTAI � <br />