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4PPLICATIO� FOR CONSTRUCT,AN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISIOP: � <br /> 3200 CEDAR STREET•EVERtTT,WA 98201 •(425)257-8810 ���� <br /> ❑ DEMOLITION �] COMBINATION � BUILDINnG ❑ MECHANICAL ❑ PLUMBINO ❑ SION <br /> PROJECTADDR�FSS�� IUB �✓�ST lcl�( <br /> ���AfCf3lS l'pNST. l0Ef�2 W��bb..s �40 (..[�. S'[' �j R82Sb 3�0-'776'7 <br /> OWNEN M��L�[ORE55 GIY Zil' VIqNC <br /> 1EN�N� M41�IfME55 LIiY !IV V�qNF <br /> '�c�.SiGv, L�w�ES IGIS www��cn c��ttatc=^rT 5'SfL�2 '��-�3S1 <br /> �npa*ccroeossmvcn uu�eorm¢ss urr nr r�qmr <br /> ��JJw2(jIS �nviC'f IUS�42 �+lumc,.� QO Ck�TnAi�S 3SG' 17Ga EJJ1�1lC�d(.C(,'Ih <br /> G[N[fnUICONIp�CIOq Y4lA0�AF55 Gllv !�P P�IpYF 54fFliCCNSE� <br /> I,U1� ��LRTi 4 7.�2.z i ( -ri A,i ��F R.�Cc.�c-zav. (�vz-1 N r 9E I 22 n^y� <br /> MFLH�FIC1t LON1R1C10B MMl• F55 LIiY }ip P F ^St�iF IICENSE� <br /> �-� K ,�.uw.4�r+5' �.a . �K �"7o z gan.{e.c.c.. �_,.�a a7s-i�aS <br /> 1'111MBINGCOMR/.f,iOP M�il• F55 LIiY jIV plq4f SUIEIICEMSF• <br /> �S.WV � <br /> ca+rn�c�rmce <br /> HEATING SYSTEM: GAS ❑EIECTRiC ❑ <br /> DESCPiBEYqR1(�NOSW�PEi00lI.Gf WVOLVEO Cd11�CIVFP$ON�NpVIKK1ENp <br /> *31'i �C Z � 5-Le�J` � '3 c.-'i 76'"1 <br /> I NEREBY CERTIFY THAT I MAVE READ AND ENAMiNED TMIS � <br /> APPLICRTION AND KNOW THE SRME f0 BE TRUE AND CARflECT��� <br /> rnanoseo use o�emmnx� pROVISIONS 0F UWS AND OR01NM10ES GOVERNING THIS TVPE OF �� <br /> WORK WIIL BE COMPUEO WITH WHETHER SPECIFIEO HEREIN OR <br /> `E�WLOEScmvnp�OfB`�RiY�5W1Mbk1�OWpien�e nvoforie5y,� �THORTY TOTVIOU E^OR C�NCE ETME P OVSuON OF AINY <br /> / .� (O `7 <br /> T OTMER STATE OR LOCAL UW REGUUTIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.7MAT I AM AUTHORIZED BY THE <br /> OWNER OF TNIS PpOPERTV TO PERFORM TNE WORK FOR WHICM <br /> RPPLICATION IS MADE AND I COMPLY WITH THE ST�TE <br /> p�wcEi u�i o mp�BEn CONTRACTORS LAW 1837 RCW ANO 296.200 WAC. <br /> � a�l o�a o�a_ o�o� ��� � <br /> Cd�Sl11uGIKJNtO�N.ENOEP.�DORE55.iElEAqNEM1MUEi1 x � (�yZ7-9"7 <br /> S�GN�IDPE � O�tE <br /> GiT'BU4NESS IICEMSE NO <br /> PLUMBING MECNANIC�L <br /> NO. TYPE OF Fl%TURE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—AMNDLO UNITS <br /> 2 BATHTUB FORCEDAIRSVSTEMS <br /> IAVATORY(WASH BASIN) HEAT PUMP <br /> 7K. SHOWER UNITHEATERS <br /> KITCMEN SINK 8 OISP � CLOTHES DRYEHS <br /> 1 DISHWASHER RANGEHOOD <br /> LAUNDRV TRAV WATEH HEA7ER <br /> CIOTHES WASHEH WOOD STOVE <br /> URINAL METAL FIPEPLACE(WOOD BUPNING� <br /> ORINKING FOUNTAIN FIREPIACE INSERT(WOOD BURNING) <br /> F�OORDRRIN / GhSFIFEPLACE <br /> BACKFIOW PREVENTERS Cr15fL1NGE <br /> SINK(SERVICE—BAR,ETQ) � GASPIPING <br /> E%HAUSTFAN <br /> SUBTOTAL E SUBTOTAL f <br /> GERMIT S PEAMIT S <br /> TOTALFEE S T0IALFEE S <br /> FOR OFFICE USE ONLV: <br /> fnOHfSFTplCe RF�PSF}B6C SlppSfIBKN PI.WCUE[GNIIURfP fFF PFCOPlNO <br /> 2 0 �• 30' Sd- � o' s(o�'ac� 3� <br /> usslo+r�//� �meaEe v�cee�sne FEES VAIWTION FEE / <br /> \��1 �� �� ES ❑Iq Blpl�l� /�a/rT _�/J <br /> HEiGu�UunqiON b00�UWEWNG SREO�pIOGrtI n <br /> ♦ INII[ I 5 PIUMPINO �/��� <br /> I 31�4c8 �y y� <br /> pccur�scr eoorcine.iti ocr.�meH�m�o a�.vTEv' pFf,NI.NM.M <br /> f110�11' QOi <br /> u Z ❑Yk5 xN�] '�� <br /> IIPC JIMiNNt[B PEO'0 11F�SfIN �DMI ION�I PI�M O�[CR <br /> \y �:.J OIBER <br /> iIPCAUIMP[Q'U Ff��OV /� <br /> 541(flV�IUM<iSVnOOn6C — fl '�� <br /> _L <br /> �meorr.aar mnusenrnovcnov CRVOFEVERE7'T runur.wn�xs <br /> LOCAL SALES -- — �O��— <br /> �— n��e o 2,; TAX CODE IS 7105 TO7l1l <br />