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APPLICATI�.1�f FOR CONS'�'�iUC'► rON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259•8810 <br /> ❑ DEMOLITION �] COMI�NATfON � BUILDING ❑ MECHANICAL � PLUMBING ❑ SIGN <br /> PROJECT AD/D' RESS: c�Y � �7 I / Q/� 7 CZo6 )Q <br /> ONR�EP �N�lSS1I��GMN4JESS ST�Zvmm G� T�7'pl( IP gCIV�C�HONE ��C, +���� <br /> , TENIWT MNL�OOi1E55 CI�Y ZIP rMONE <br /> �pCMTECTOROESIGMEP MAIIAfMRE55 CITY 71P PHONF <br /> SpmE p5 �I i3odE <br /> pENEp/�L�q�tppp7pq MIJL�OORESS CrtY 21P PNONE SUTEIICENSE/ <br /> yEpUNICµt�!liRACTOR MMADORE55 COY IIP PNONE STATEUCENSE� <br /> PLUMlRl6CONTR/�CTOR YAIt�ODRE55 CIIV ZIP PHONE STATELILENSE• <br /> caarw�crar�awonK / 7 — HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br /> �S�qOE WpUf 11N0$OI�ARE FOOi/iGE VOLVED GONT�GT PEASON M!D P110NE NO. <br /> if F � � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> . . APPUCATION AND KNOW THE SAME TO BE TRUE AMO CORRECT ALL <br /> wqroseo use uiwroo PROVISIONS OF LAWS AND ORDINANCES GOVERNIPw9 THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br /> �p/�pE�pNp�ppppEqry�5lpyyHBE�pWpq�R/iCN7WOCORES) NOT. THE ORANTIN(i OF A PERMIT DOES NOT PRESUME TO 61VE <br /> �m�a�� � AUTHORITY TO VIOLATE OH CANCEL THE P50VISION OF ANY <br /> OTHER STATE OR LOCAL UW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEO BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOH WHICH <br /> APPLICATION IS M E AND 1 COMPLY WITH THE STATE � <br /> � v�qcaT�tti.D.rur�e�n ��'�T� SLAW 27 CW / D298.200WAC. <br /> ^�/�' $' � 18 96 <br /> CONSiP11CilON LdW LENOER.�U011E55.TELEP110NE NIIIABER x Cu- <br /> S URE DATE <br /> CITY BUSINESS LICENSE NO. <br /> ���� MECNANICAL <br /> Np. TYPE OF fl7(TURE OA REM FEE NO. TYPE OF EWI�PMEMT �E <br /> 3 WATER CLOSET(TOILEn � /VC—AMNDL6 UNfTS ' <br /> BATHTUB ' FORCED AIR SYSTEMS � <br /> UVATORY(WASH BASIN) � HEAT PUMP ' <br /> S��p � UNIT HEATERS ' <br /> J KITCHEN SINK 6 DISP � / CLOTHES DRVERS � , <br /> DISHWASHER � RANGE HOOD : <br /> LAUNDRV TNAY ' WATER HEATER � <br /> CLOTHES WASHER ' W���T�� � <br /> URINAL ' MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> FLOOR DRAIN � / GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; / GAS RM1GE � <br /> SINK(SERVICE—BAR.ETC.) � GAS PIPING ' <br /> � IXHAUST FAN � <br /> i <br /> � ' <br /> � � <br /> � ' <br /> SUB TOTAL S ' SUB TOTAL S i <br /> � <br /> PERMIT 5 � PERMIT f � <br /> � � -� � � TOTAL FEE S ' TOTAL FEE S ' , � <br /> FOR OFFICE USE ONLY: <br /> Fpp�7glg�(�( pEMSETBACK SIDESETB/�Ck PlANC11ECKNUGBER FEF REf.E1PTN0 <br /> �6 � 7_� � �� � � 2 �n� �3 <br /> useza+¢ IOTAPE�� v�awr FEES VALUATION FEE <br /> es ❑rw awioiNa l7Z 3 IS,� <br /> . HEM.HT UMT�T�.� J �i oc o'�wrrs ��a f ��qe�� PIUMBING ' !� <br /> �� Glvint4 f <br /> ��Z/ <br /> pCnCaU�PANCY NDO�SIMFS OCCUFANTLOAD B�SEMENT � MECNMlIC�L O �O� <br /> K-3/J•� ❑res � <br /> ADDIIION�L PI�U!Cl/f.GH � <br /> FlRESPPoNKIFRREO'D RE�SON ' <br /> i <br /> OTNER <br /> flREAIMMREO'D pE�SON � <br /> �� <br /> STATE 9111101NG SURCN�Of.E � <br /> � <br /> _' T— <br /> TYVE O�f.ONST PLANS�PPAOVEO BV CITY OF EVERETT ���911f,WORNS a(� 1y(j(� <br /> LOCAL SALES I� <br /> _�� o�TE TAX CODE IS 3105 TOTAL ' <br />