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-� <br /> APPLICATIC"� FOR r4�ISTRUCT �N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-B810 <br /> ❑ DEMOUTION O COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PHOJECT ADDRESS: �� �n 11(.�iz ��� ��e��- ��'�� <br /> p�yqEq^ , I` � Mut�DM�E55 Cttt I�P' PMONE <br /> 7.I9L�L__�S�G-�' IG� S �o�- ��a� AJ �(—�c&?o3 2sq-z ��_�-- <br /> TDanl �'lz�Kc�ES�ro�- ���Y �� ����S7,o3 �„2s�c -Zq �S� <br /> �RCMTECT OR DESIGNEn MNl ADDNE55 C11Y 71P P��ONE <br /> GE E�i �GTIXi MUL,W0�E55 f.YY 11P PUONF 5GTELIGENSE� <br /> � �� z�Roo 'ffloR�l�� �� S�Q�I�t9 �gz-��n No�—c1�u1Nlo3Ra- <br /> MECHhN�CALCONTNACTOR MNL�DDRE55 Lltt TIP CIIONE STAiEUCENSE� <br /> �Hn/l c� .--- <br /> PLVMlWGCONiRACT011 M��LAWi1E55 CIIY lll' PIqNE ST�TELILENSE• <br /> 1C <br /> GONTRALTPNGEOF WORK I zZ� � HEATING SVSTEM: GAS ❑ ELECTRIC ❑ <br /> pQg�rySEWpp�(1Wp5q1AREF007A0EINVOLVED CONUCTPCfISON�NDP110NEN0 I `rn1 I� �/)^ A��— <br /> �,J r<< � <br /> 7 _ �O Z'��'D L� <br /> I HEREOY CERTIFY THAT I HAVE FEAD ANJ EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> aqovoseo�se av euaar+a PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK W�LL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �EaµpES�p�ptpNpFpf101'EIITfI�ro'�'NBELOWOR�T7�LNTWOCOMES� NOT. TNE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO 61VE <br /> ipt BLOGN oF AUTI�IORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> OWNEH OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS E AND COMPLY WI7H THE STATE <br /> CONTRACTORS 18. AN 296200 WAC. <br /> PARCEL TAII I.D.MMBER . � <br /> CONSTRUCTION IOAN LENOER.AOOf�E55.TELEPNONE NUGEER X 0�7E I <br /> SIONqURE ''i <br /> GITY PUSINESS IICENSE NO I� <br /> PLUMBINO MEClIANICAL <br /> NO. TYPE VF flXTURE OR ITE61 FEE NO. TYPE OF ECUIPMENT FEE <br /> -�r— <br /> WATER CLOSET{TOILET) � MC—AMNDL6 UNfTS � <br /> BATHTUB ' FOFlCEDAIRSYSTEMS �' � �I <br /> � <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' i <br /> SHOWER � _UNIT HEATERS � , <br /> � <br /> ' CLOTHES DRYERS ' � <br /> KITCHEN SINK 8 DISP ' � � <br /> DISHWASHER � RANGE HOOD i ' <br /> LAUNDRY TRAY ' WATER HEATER i <br /> CLOTHES WASHER , METAL FI EPIACE(WOOD BURNING) � <br /> UFINAL ' <br /> ' FIREPLACE INSERT(WOOD BURNING) � <br /> DRINKING FOUNTAIN ' , <br /> FLOOR DRAIN � GAS FIREPLACE <br /> BACKROW PREVENTERS ; GAS RANGE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> EXHAUSTFAN � � <br /> � � <br /> i � <br /> � � <br /> � � <br /> ' — � <br /> � <br /> SUB TOTAL S i SUB TOTAL f i <br /> PERMIT S PERMIT S � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: ner.Emrno <br /> rinHc�¢c�Nuunrn ��F <br /> IPONT SETBACK PE��SETB�CK S�DE SETBACN ���/ .` <br /> -i <br /> �'� FEE <br /> tar�nen V�GANISIIG FEES VAWATION 1 <br /> USEZONE � <br /> ❑YES ❑ NO OUIU)IN(: � � <br /> � 1 <br /> NEIGNTIIMITATIdJ NOOPDWELUNG SISEO�BIWRI � <br /> UNIfS P111M01NG �.�__\ <br /> OCCUPANCY ND 0�$IptlES OLCUPANf 10�0 BASEMENI MECIUNIf.�I ' )'D 'v V <br /> GPWP ❑YES ❑ NO ' � <br /> i <br /> �DD�IIONAIPIANCI1fCN � _ <br /> FIRESPRINKLENNEO'D RF�SON i <br /> i <br /> 0111P. � <br /> FIf1EAU�MPEO'D RF�S(k! <br /> SLniG NIIIOIUG SUnGInOGE <br /> LYPEOFf,ONSf PI�NS�PPIIOVEf10Y CITYOFEVERETT runncwonKs __�_ <br /> LOCALSALES ' — ; <br /> o�iE TAX CODE IS�105 iOTAL <br /> � - - - ._� <br /> � <br />� <br />