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` <br /> , <br /> APPLICATIO.. FOR CONSTRUCTI JN PERIINIT . <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION � COMBINATION ❑ BUILDING ❑ MECHANICAL p PLUMBING Cl 51u't: <br /> PROJECTADDRESS: 36X�� �a�c` y � Ve <br /> /'- <br /> OYMER MML�DOf1E55 CITY 21P PMONE <br /> �11A�1�o SukaN�,;��1� ���oaPa��1- P�o��Jw Mz�y...-�qe SBa�� a10 8607 <br /> iE1UN7 NAILADOAE55 L�7Y 71P PNONE <br /> � ��_ . <br /> ARCHITE,C,T-O1R,OES\IG\NER MAL�OORESS GITY IIP PMONE <br /> (_i�'ct�t�e�Ae�--�cn cC 7 �—� <br /> GENER4LCON R1ILTOR MIJL�DDRESS GIfY IIP PRONE SfATEtICENSE� <br /> I_�FC s1-,Ic 1��+0 l�'aw,e � ---_" I.��Si�CC'6�-t�tic l <br /> MECNANICAC TPACTOR MIULADdiE55 CITY ZIP PI'DNE STATEUCENSE� <br /> MUIIBINGCONTNACTOH M�IL�OORESS LItY ZIP P/10NE Si�TELICENSE� <br /> Qw�� <br /> CONTMCT VpICE OF VIOi1K ��S V O / / � / _ <br /> S� 2 HEATING SYSTEM: �GAS ❑ ELEL'TRIC ❑ <br /> OESCIMlENpRK�NO5IXIAREFOOTAOEWVOLVED jfj • CONT�CTPERS9�NIOPr ONf.110 � '/ ' <br /> �'{� o-�-�1ut J,�ar Fo �v �tioc�ic f� a I o � s2�d- <br /> ��:� d� �,.�w � <br /> z�py�� I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PIIOPCSED USE OF BI11LpN0 PROVISIONS OF IAWS AtJO ORDINANCES GOVERNING THIS TVPE OF <br /> S•� �5���� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �cuoesc�arna�ocanovERn�s��owr�e¢�owon N C�E NOT. THE ORANtINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT�_e�oac�oF � � �- AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> J � OTHER STATE OR LOCAL LAW REGUUTIN6 CONSTRi1CTION OR THE <br /> '�tiy PERFORMANCE OF CONSTRUCTION.THAT I MI AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AN I COMPLY WITH THE STATE <br /> PMCELTA%I.D.MNBEq .51;_ –� �� CONTRACTORS LAW 1827 R W ND 296200 WAC. <br /> �..r ��- �� � 96 <br /> CONSiRlICT10NLOANLENOER\ADOHE55.TELENIONEN`JMBEPC� x� �" �� I� / <br /> � � U p� "�-�' . �7� � (J6 SIGNATUIiE DATE <br /> �` 'h}(.t.}lJ�uh <br /> C�S�S - �-l5 S � Sw S— II � 7Byo7 CITYBUSINESSIICEN5EN0 <br /> PLUM&NO MECHANICAL <br /> NO. riPE OF FlXNRE OR ITEM fEE NO. TfPE OF EOUIPMElR FEE <br /> 3 WATER CLOSET(TOILE� � NC—NHNDLO UNfTS � <br /> ( BATHTUB ; I FORCEDAIRSYSTEMS ; <br /> 3 UVATORV(WASH BASIN) /// � p HEn7 pUMP �— <br /> 2. SHOWER ' UNIT HEATERS ' <br /> � KITCHEN SINK 8 DISP � I CLOTHES DRYERS � <br /> DISHWASHER � I RANGE HOOD � <br /> Ia' LAUNDRY TRAY ; WATER HEATER ; <br /> I CIOTHES WASHER � ,� WOOD STOVE � <br /> UHINAL ' p MEfAL FIREPLACE(WOOD BURNING) ' <br /> ,Q DRINKING FOUNTAIN i ,Q FIREPLACE INSERT(WOOD BURNING) i <br /> �Q FLOOR DRAIN � ,(7 GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> ' EXHAUSTFAN // <br /> i <br /> � <br /> � � <br /> � <br /> � <br /> , � <br /> SUB TOTAL S ' SUB TOTAL S ' <br /> i � <br /> PERMIT S i PERMIT S � <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: 53. 7 <br /> FHONT SETfiA�K AEM SE7B�ICK SIDE SEIPACK �IAN CII�NU j Efl I FEF ,�n REGEIPT NO <br /> � � <br /> G YJ w 5' r�r� �- � u -� <br /> IlSE20NE IOTARE� V�CANTSIfE FEES VALUATION FEE <br /> R'I ^J � �YES ❑ � DUILDINf. 5 � i�(� <br /> NE�GNTUMITATION NOOFDWELIING SIZEOF lIX'Jfl ' ' � <br /> �!J/.L � O <br /> n � � UNIfS 1 � }�S S P�I)MBING <br /> LU � _ ,,y�q ' D �i <br /> OCCUVANCY NOOfSIMufS OCWPANTIO�D BASEMf1U MECNeNILAL (/�U � C't„� <br /> , _ �. N� ❑YES �NO � <br /> FIRE..PRINKLEqpEO'D �E�SON ADD�110N�LPl�NC��F.CR , <br /> NC on�en t <br /> FIREMMMqF]'0 AEASpr� � <br /> STAIE DUilDIN6 SIIIIC1UI16E ��_J <br /> ��_'_— '__' r <br /> i <br /> tvreoFr.oNsr rinNserpaov�oov CITYOFEVERETT runnr.wonKs '� <br /> S LOCALSALES ��"'-- <br /> � �r./ �_- � <br /> � D�IE � -�' TAX CODE IS 3105 TOTAL � / �I <br />