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. ,� <br /> APPLICATIO.� FOR CONSTRUCT�JN PERMIT <br /> CITY OF EVERETf•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-8810 <br /> ❑ DEMOLITION �COMBINATION O BUILDIN(i ❑ M�CMANICAL ❑ PLUMBING ❑ SION <br /> PROJECT ADDRESS. � 2 � � <br /> uwrien� � MNL�0011F.SSr� an. � � P aao 14� <br /> TEIUNT AINl�00i1E55 GTY 2�G VMONE <br /> CT OE516 R M�II MORE55 CITY 11P PIIONE <br /> � � �J�u.hi�k. CJA�S� 'rxC�� .SIQ�it.Q— <br /> 6EMEML LOMTMCTOii M�IL�ODIIESS CITY 1�P PIIONE SiAiE IIf.ENSE� <br /> MECH�NIC/�LCONiR�LTOR MNlA00i1E55 CITf IIP PHpNE STATELICENSE• <br /> PLUMBINGCONTRII�TOR MAILAWRESS G7Y IIP PYqNE ST�TELICENSE• <br /> CONTRM:T PIIICE OF WpU( <br /> HEATING SYSTEM: GAS ❑ ELECTRIC � <br /> OEbpYlE AIQ 'WTAOE W CON7IICT PENSON�ND PIqNE NO. \ <br /> �� <br /> �� lo �- � <br /> 5 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �,,,,,—� �� tiPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �,tJ n � PROVtSIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> "� � WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br /> �aw osviave�,���ov0.�rt N E5� NpT. TF;E ORANTIN6 OF A PERMR DOES NOT PRESUME TO OIVE <br /> . �m �. e�ocK 3�– AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAI LAW RE6ULATIN6 CONSTRUCTION OH THE <br /> { PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEH OF THIS PROPERTV TO PERFORM THE WORI( FOR WHICH <br /> � � ` APPLICATION IS MADE AND I COMPIV WITH THE STATE <br /> awc¢rNc i.o.Mwee y� CONTRACTORS LA 1B CW AND 298.200 WAC. <br /> �/7l ] r � \ <br /> WV �VV <br /> f,ON5i1NICTqN LOAN lENOE .App11E5S.TELEV110NE M1MlER X � � <br /> SI[YIATURE DI11E <br /> qTY BU51�55 LICENSE NO. <br /> � PLUIlNKi MECHANICAL <br /> N0. TYPE OF FlI(TURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER0.0SET ILET) � A/C—NHNDlOUN1T3 � <br /> �TM� w ; FORCED AIR SYSTEMS ' <br /> LAVA70RV(W BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATEAS � <br /> KRCHEN SINI(8 DISP ; CLOTHES DRYERS � <br /> DISHWA&HER � RAN6E HOOD � <br /> LAUNDRV TRAY ; WATER HEATER ' <br /> CLOTHES WASFiEq i WOOD STOVE � <br /> URINAL � MEfAL FIREPIACE(WOOD BURNIN(3) ' <br /> DRINKIN(i FOUMAIN , FIREPLACE INSEtiT(WOOD BURNIN6) � <br /> FLOOR ORAIM � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANQE ; <br /> SINK(SERVICE—BAR,ETC.) � GASPIPINO � <br /> ' IXHAUST FAN ' <br /> � i <br /> ---�--- <br /> � � <br /> SUB TOTAL S ; SUB TOTAL S ; <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S ' TOTALFEE S ' � <br /> FOR OFFICE USE ONLY: —7� <br /> Ff10NT5ETBFCK REAHSETB�CK SIOESET&1LN VlANC11ECKNUMBER FEF RECEIPTNO <br /> ZO ' � l�T� � 525� <br /> use io� LOT�RE� wcu�r S�t FEES ATION FEE <br /> Ge �� �ve � �+o eu�oiNc � D 3� �o <br /> ME16NT LIMTATIOH � rio or owe�unu s�ze a u � � <br /> U <br /> unrt� I 93 � GIv�4 �- PLIIMBINC <br /> 2 f AR,dG� _.�-__ <br /> uru�er w a sre�s occuwwr�o�o e�r,�Nr ' <br /> � MECM�NICAL i <br /> t1 .1 ❑r¢s �+o i <br /> FlHESFNNKIENNEO'D REASON �DDITION�LPLANCHF.CR i <br /> i <br /> OTHER � <br /> i <br /> � <br /> flREAIARMRE�'D REASON � <br /> STAIE BWIDINC SIIRCM�RGE �� <br /> '_ t <br /> iYPEOFf,qJST P��NSAPPppVEDBY CITYOFEVERE7T PIIBIIf,WORNA � <br /> _� J�'� IOCAL SALES — �— <br /> o�re 8 /4 !o TAX CODE IS 3105 TOTAL I <br />