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APPLICATI� FaR CONSTRUCT�N PERMI'��,�}� <br /> CIN OF EVERETT•BUILDING DIVISION �� <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> ����--- <br /> C DEMOLRION ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING u SIGN <br /> PROJECT AD�RESS sdUa L�� � ,�� <br /> cm iw r�wr�c <br /> avrrta //�n,I 1 u�n+o/o/n[Ss �j�/f �� <br /> /l"`^��C� T��O IN��' LIiY IP Prq�E <br /> iE�PNi NeLL♦ E55 <br /> /.��cn�u ti � oSs,-3 <br /> �n ��r. =o �� <br /> MLHiiCGTORUESGNEP YMIACOPE55 <br /> t'ry Z� Ayx� SL/.IElICF115E� <br /> fCNEMLLONiPALipf� 4IJLAWRE55 <br /> MECN�tiKKCONtF�CiOR H/�4/.OME55 <br /> CIiV Zn PN012 SiIIElICE15E• <br /> PWNB�M+LOf11N6CipR MNL�DCPE55 <br /> CITY ZW MW� 51/.tEULFNSE• <br /> con.wcivacEavrone HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> O[SLPiBE NOaR�����E��T�GE IfNIX��O <br /> LpR/LL PEHSON uN PrqNE Iq <br /> �� Q <br /> I MEREBY CERTIFV TMAT I HAVE PEAD AND EXAMINED THIS <br /> ' pppLICATION AND NNOW THE SAIAE TO�E TRUE AND CORRECL ALl <br /> aepaaseo use ov am�on�c PPOVISIONS OF LAWS AND OBDINANCES GOVERNING THIS 7VPE OP <br /> WORK WIIL BE C01.1PLIED VIITH WHETHER SPEGFIED HEREIN OR <br /> lCG0.DE5CPIP1q���Pf1WER1Y151qW11BClOWOFAiIACHTNOCOFiE51 AUTHORTVTOTVIOLAOTEAOFRCANCEETHE PROVS�ION OF AINY <br /> ip, e.ocK � OTHER STATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE <br /> FERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE , <br /> OWNER OF THiS PROPERTY TO PEHFOFM THE�M1'OflN POR WHICH I <br /> APPLICFTION IS MADE AND I COMPLY WI1M THE STATE <br /> CONTRACTORS LAW iB27 RCW AND 29fi200 WAC. <br /> CMCLLiAI IC.INMOER / <br /> �/�� �r <br /> (JON9PVL1qNl0/�IENOEP.MDRL55.TELEGN91E1NN0Efl SKsN�tUPE DAt <br /> CIiY BUSIN[SS IICEIISE fq I <br /> MECHANICAL <br /> PLUMBING 7YPE OF EOIIIPMENT FEE <br /> NO. r'PE OF FI%TUPE OH ITEM FEE NO. <br /> NC—NHNDLG UNITS <br /> WATERCLOSETROILETI �i FORLEDAIRSYSTEh15 ' <br /> BATHTUB HEATPUMP � <br /> �AVATORV IWASH BASIN� � UNIT HEATERS � <br /> SHOWER � : <br /> CLOTHESDRYEhS � <br /> KITCMEN SINN 8 D�SP RANGE H000 <br /> OISHWASMER y�p7ER HEATER ' <br /> LAUNDRYTRAV � <br /> WOOD STOVE <br /> CLOTHES WASMER IAETAL FIPEPLACE(WOOD BURNING� � <br /> URINAL FIREPLACE INSERT(W�D BURNING) <br /> DFINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS NANGE ' <br /> BACNFLOW PREVENTERS GAS PIPING � <br /> SINK(SERVICE—�AR.ETC.) E%HAUST FAN <br /> i <br /> SUDTCTAL S SUBTOTAL S i <br /> PERMIT 5 <br /> PERMIT 5 TOTAIFEE S <br /> TOTALFEE 5 <br /> FOR OFFICE USE ONLY: FEE neccinrr+o. <br /> vu c�cc+nuuocn <br /> fPO1R5Eltl/{< PEARSEiN�CK 4pE5EID�LK O/p3 � �� <br /> �SEZONE LOin�[e WC�NIS�IE <br /> FEES VALURTION FEE <br /> ❑YES ❑HO BULLOiNO <br /> PUGNiLIMIiRqN NOOfDWELLIN6 SIZEOFOLW'�� p�UN0iN5 <br /> UNtS <br /> CCCIIY:4CY IIOC�S�OF£5 a�U���liL0�0 BASLMCNI q[�II�NICK <br /> GnWP ❑YES ❑� <br /> I.00ItroNuvWiQ�ECR <br /> FIPESCPiNGL:PPC�U REAW11 <br /> OiNCF � <br /> FIRE�UAF�HLO� �E�`'��� <br /> SteiE BNl➢u1G SMLNMGE <br /> nveorco�isr ru�+s�rano�coar CITYOFEVEHETT �o�nwous <br /> LOCALSALES <br /> o.�c <br /> TAX CODE IS 3105 T�TA� <br />