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�, , • <br /> APPLICATI4. . FOR CONSTRUCT►.1N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREFT•EVERETT,WA 98201 •259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SI(iN <br /> PRWECT ADDRESS: �33Z F��'T� J�YC, <br /> OVYNEq MNLADpiESS CITY SIP PHpNE <br /> �itR• lx�•J tAww�Pl N33z F��esr DK , ����rr7r, ccvk 9Bz�1 ZSB-4�y7`� <br /> 7ENM1T Y�J11100f1ESS CITY 71P PIIONE <br /> ARLNTECTOR DES�GNER /.wl ADDRE55 GITY 71P P1qNp <br /> OENEMLCONiMLTpi MAILAODNESS LITV i�� 1'.IIONE Sf�TELICEN5E1 <br /> A Pt�Dt<�Rst�n� con�.c�_ co• Ihlc� �u�cc�fr�..� • 2�zr.� 2�7-7z��� PPrFi�rr�c�,zNS <br /> dECHJWICI�LCONTRALiOR MAlLA0DRE55 CI7Y llf' PIIONE ST�TELICENSE� <br /> PIUMBIN6CONTRhCTOR M�ILAODRE55 CItY ZIP P1qNE STATELICENSE� <br /> CONTMCT Pf110E Of M1011K /`.! D <br /> HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> OEBI:RIlE WOIrI I1ND SOUAIIE F007KIE MVOWED CONT�CT VERSON�ND PIIONE Iq <br /> T X3z c—N.ea�l� � <br /> I HEHEBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> �p����� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF . <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEOKOESCpIPT10NOFPfqPEHTY(51qWNBELOwOR�Th1CNTMOCONE51 NOT. THE ORANTIN6 OF A PERMIT OOES NOT PRESUME TO QIVE <br /> �pT r,�_�� 2 pF T VK l40 � AUTHORITY TO VIOLATE OR CANCEL THE PHOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REOULATINO WNSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> ���o q CONTP.ACTORSlAW7827RCN'AND298.200WAC. <br /> CONSiR11CTION IOIW lENOER.l100RE�tEP11p1E MIMlEP x ��{/'�""--� J�' Z Z' �� . <br /> SqN�TURE � OATE <br /> CITY BUSINESS LICENSE NO. <br /> p�UAlINp MECHANICAL <br /> N0. TYPE OF FlIITURE OA ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILEn � A/C—NHNDLO UNRS ' <br /> gATHTUg ; FPRCED AIR SYSTEMS ; <br /> UVATORY(WASH BASIN) � HEAT PUMP � <br /> $HpYVEp � UNIT HEATERS ' <br /> KRCHEN SINK 8 DISP ; CLOTHES DRVERS � <br /> DISHWASHER � RANGE HOOD � <br /> I.AUNDRY TRAY ; WATER HEAiER ; <br /> CLOTHES WA3HER � WOOD STOVE � <br /> �q�� � MEfAL FIREPLACE�AIOOD BURNMO) ' <br /> DRINKIN6 FOUNTAIN � FIREPLACE INSEflT(WOOD BURNING) � <br /> FLOOR DRAIN � CiAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> �_ <br /> � IXHAUST FAN ' <br /> � <br /> i � <br /> i � <br /> i � <br /> i � <br /> 3UB TOTAL S ' SUB TOTAL f ' <br /> PERMIT S � PERMIT S � <br /> TOTALFEE i � TOTALFEE S _ ' <br /> FOR OFFICE USE ONLY: <br /> FIIONTSE�� REAHSE7B�LK SIUESEiB/�CN/ PlANC11ECNNUMBfR iE�O� �j�� �CEIPTNO <br /> fY <br /> � <br /> useia+E„ / lOTl1PEA WCANTSITE FEES VALUATION FEE <br /> �C. '� ares ❑ ra auuon+c � qpp ; _ <br /> 11EIOHT UMT�ION/ � NUNOI OF DWELIIIq SRE OF BLD61f.1 /� � <br /> � �bS .S F. �yA� PLVMBING _�_ <br /> �ANCV NO Of iIMES OCCWANT IOAD BASEMENT � <br /> MECH�NICM. <br /> OYES O � <br /> �DD1110N�L PL�N GnEf.k i <br /> fl1iESPNNI4ENRE0'D HEISON ' � _ <br /> � <br /> Oi11Ef1 � <br /> FlREMARMRE�'0 NE�FON � <br /> STAIEBUII��NG51111G1UMiE —_ i <br /> TYPEOFCONST PL�NSAPPROV OBY CRYOFEVERE7T �IIPIICWOOrcS � <br /> �JJ� LOCAI SALES —�— <br /> ,��� DAtE S/2y �Xo TAX CODE IS�105 To7AL � <br />