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� � <br /> APPLICATI4N FOi; CONSTRUCI �ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOUTION �, COMBINATION ❑ BUILDING p MECHANICAL ❑ pLUMBING ❑ SIGN <br /> PROJECTADDRESS: �� rU1L'ESi � �✓G(���"� <br /> CMIER MAILAODRE55 pTY IIP' PFIpNE <br /> �Df� �Un15iRI�iQ� 2oF�0� jj�Q[IN/.J 29 �7NE'oE. .-�1tlZ7L �L7U 7�J�-SLj.� <br /> TEN�M7 MNI�DdiE55 CIIY 71P PHONE <br /> � <br /> �M� H��CN Pn n�.�.A1Y E55 CITY 711'.. P�p�yE <br /> V F�Y'IL <br /> .1�i'�gK��"�Rca� �2,� i.zet� sr su� -���'��o�. �r3-z- o <br /> 6ENEMtCONTMCTOR MULAD011E55 CItY 7u� P�Ip1E SIATELICENSE� <br /> -,D ELC�N ST�ULT)pf SFJn�t AS �'J.FtlN�2 1 D NC0'.�'�R`o 7D SL <br /> MECNAN�CQCONTRICTOR MMI�DDi1E55 CITY )If' PIIONE STATEUCENSE� <br /> G+5 � F�;I�F� �'oo �, Man/ IYlav�vL �1(Lj�3o� (}5N6txTGT I�7,Tt� <br /> PLUYBMICCON7R�IOR MAIL�OORl55 pTY 21P PI E ST�TELICEN$E1 <br /> U/f�K� COAs� I�U►nr3� SN� n,� __.��y0 S�.P-6/S� fc�Nl'rF_ Cpo "3CG11N(: <br /> CONiMCT PqICE OF WORN <br /> p NEATING SYSTEM: ,�I GAS ❑ ELECTRIC ❑ <br /> UESLMOE WORN AND SOUARE fppTACE MlVO�VED C.ON CT P[115(k! PHONE NO <br /> �m �A�Dy 74�-�7 3�oe Z50-L9�-' <br /> /77F�N� Z STo,e� 17EtA�HE <br /> - agX �,� I HEREBY CERTIFV THAT I NAVE fiEAD AND EXAMINED THIS <br /> � rraroseo use or eu�oxa APPUCATION AND KNOW THE SAME TO BE TRUE AND CORfiECT ALL <br /> PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR <br /> LE611LOESCqPTIONOFPfqPERTY�51qWN8ElOWp1�T111LHTVpLpNES) NOT. THE ORANTINO OF A PERM�T DOES NOT PRESUME TO GIVE <br /> �oT �Z e�ocu � SPi�1NAK��i� AUTHORITY' TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6UlATINO CONSTRUCTION OP THE � <br /> ' .._ PEqFORMANCE OF CONSiRUCTION.THAT I AM AUTHORIZED BY THE . � <br /> . OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH t� <br /> � APPUCATION IS MADE AND I COMPLY WITH THE STATE � � ..� ^� <br /> � WJiCE�L/TAIf 1.0.MIMBER CONTRACTORS LAW 1B27 RCW D 296200 WAC. . ,,� <br /> �315� - " iJ •- - OI � . .'ri <br /> CONST1111C110NLOANLENOEq.�pppE55.TELEP110NEMMABEP Z -Z � <br /> x �'s �' <br /> �C W ESl� � sroN� oere � - <br /> � . � ,,.? <br /> , QfV BUSINESS LICENSE NO r'� <br /> . PLU7,181N6 MECIIANICAL � �� ��� <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � ` , 't <br /> �_, <br /> WATER CLOSET�TOILET) � A/C-AMNDLO UNffS � � �.��t.`�4�f <br /> BATHTUB � T i � � . �» <br /> . , FOi10ED AIR SYSTEMS � . . .�, <br /> UVATORY(WASH BASIN) � NEAT PUMP , . ,,;;� <br /> ' SHOWER � UNITHEATERS � ', �- - �� -r: <br /> . _ KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; � � � . '��� <br /> �� DISHWASHER � RANGE HOOD � � � � <br /> � UUNDRY TFAY ; WATEfl HEATER ' . � ' <br /> / CLOTHES WASHER � WOODSTOVE � <br /> URINAL � METAL FIREPLACE(WOOD BURNING) � <br /> . DRINKING FOUNTAIN ; FIflEPIACE INSERT(WOOD BURNING) i . <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACNFLOW PREVENTERS ; GASRANGE ' � � . <br /> i <br /> SINK(SERVICE-BAR,ETC.) � GAS PIPING � � <br /> ' F�(HAUST FAN � <br /> � � <br /> , i <br /> SUB TOTAL S ' SUB TOTAL f ; <br /> PERMIT S � PERMIT f i <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: .I�"f�_J",� - ��, ,G, <br /> � FqpNTSETBACK _ ; REMSETBACI(� SIDESETBACN/ 1'I�N411��[R �/ fEF / RECEIPTNp <br /> Gf% � �'�7 S�10. � <br /> I1SE ZONE /` lOf�REA�}' �NI SITE FEES VALUATION FEE <br /> � / / �� ❑YES ❑ NO <br /> "°����N� �i 3 1 3 75<3 ; <br /> HE16NT UMITATION NO OF OWELLIN6 S12E OF BLOGRI � <br /> 7� � UNqA �� S �. PLUMPIN(i I <br /> OCCUV�NCY NO Oi/SJIOPoFS OCCUPANf IOAD 8 SEMEN! MECII�NIC�I �U � <br /> �f (r ❑YF$ NO � � <br /> FIRE PP1NNlEflREO'D REASON �OD�IION�I PIANCII(CN � <br /> � <br /> I <br /> 0111Fi1 � <br /> FIpEAURMREO'D RE�SpN � <br /> ST�lEN1I1nIN6511nCI1�nOE — �/�� <br /> 7� <br /> TYFEOFf,ONST vinNservaoveoer CITYOFEVEREIT runncwnnKs <br /> .�f�- LOCAL SALES - 2U�— <br /> ,}L�N D�IE � TAXCODEIS3105 TOTAL 21�� <br />