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� �.. <br /> APPLICATIO.. FOR CONSTRUCTI.,�N PERMITr <br /> CIT:'OF EVERETT•BUILDING DIVISION GC� <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 � � <br /> ❑ OEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL � PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: �f�Q (`�j�„�� `�p a�I� <br /> OWNEP MMI�WilE55 C�TY 2�P PNONE <br /> �1R � Mas� -nr�r�YHy ��HD� ��-rr Ra,2o� ,2s9 o)�i <br /> TENANT ,� /� MNL11b0fIF.55 CIIY/� /]�� TIP ,I� P��ONE <br /> �RLMTECTONOESIGNER �O./��(�l�RESII�O �, �[�� �' Glttla�YGl�� Wfl �8z39 ��c�o� �7� SzrP <br /> . <br /> GEN�MC��� �NTYJ'YQADDRE�� I� 1 D ��Glttllfll� �VL�� qb27'�E 795�35771E1ILL���T�/�'Y�1'� <br /> MECNANICAL CONTF�CTOR MM�DDRESS CITY IIP P110NE GTQE UCENSE� <br /> �ID� CHn��6�SL�r R7oo 5D�!`Avs1J� MflCy�ul��s 98z�n [ogia4il <br /> PLUMBINGCON1R�f,lOR M�ILADDNESS Lltt ZIP PHONE STAiEUCENSE� <br /> � � <br /> CONiMGT PRILE OF WORN <br /> D O Oq HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> OESC111BE WOi1K I1ND Sq1�RE F00TI1GE INVOIVED CONT�CT VERSON ANO PHONE NO <br /> � 9 i S b <br /> �r FRM . QM _??O � .FT <br /> , <br /> � I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> arqroseo use oF e�n�arq � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lEWl0E5CRIFTIONOFPfqPEFTYI�������ATT/iCN1WOCOPIES) NOT. THE ORANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> �oT �8 e�ocK 000 D�OO,c �/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> --D PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PNICEL TAll I.D.NINABER — ' CO A�CTOn/RS— 1827 RCW AND 296.200 WAC. <br /> Cp15TRI1CilOHLON1lEq0ER.A0p1ES5.TELEPlIONEMMBER x Y$i^ (I� ��Jla�q(D <br /> 5� nlq3� o.,E —r-- <br /> LITY BU9NESS IICENSE NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF Flf(TURE OR ITEM FEE NO. TYPE OF EGUIPMENT PEE <br /> WATER CLOSET(TOILET) � A/C—NHNDLG UNfTS ' <br /> BATHTUB ; FORCEDAIRSYSTEMS ; <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � FiANGE HOOD ' <br /> UUNDRY TRAV ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL - ' MEfAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUN7�IN � FIREPLACE INSERT(WOOD BUflNING) � <br /> FLOOR DRAIN � GAS FIREPIACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING <br /> � EXHAUSTFAN <br /> � <br /> � <br /> � <br /> � <br /> � , <br /> � <br /> � <br /> � <br /> SUB TOTAL S ' SUB TOTAL f ; <br /> PERMIT S i PERMIi f <br /> TOTALFEE f � TOTALFEE S ' <br /> FOR OFFICE USE ONIY: <br /> iRONT SE7BALK REM SF.TBACK S�DE SETB�CN PLAN CIIELN NIIMBERJ///� fEF �FCEIPT NO <br /> � ' �..JIU <br /> USE IONE lOi�REl1 VAC�Nf SIIE FEES VALUATION FEE <br /> ��f N ����'� ❑VES NO OUIl01Nf. � 3q i�� <br /> NE�GNT UMITATION NO OF DWELLING SIZE O�BLDG/f I <br /> Z' � UNIIG �. PIUMBING a_i O� <br /> q6i 54.f7 GAc_ <br /> OCCUPANCY NO(u 5�(�f5 OCCUPANI IO�D BASEMENT MECN�NIC�� �S�D� <br /> GROVP _ - <br /> � _ ❑YES O —�� <br /> ��D�IIONAL PUN CIICCN ��,� <br /> FIRE PflINKLEflNEO'0 �F�SON .-���� <br /> i <br /> 0711E11 <br /> FIREALARMPEO'D AE�SqN ' <br /> i <br /> SiAIEBUIlUIN65Uf1C1U0fE i �_� <br /> rrPe a r,or+sr rinNserra v1c�n er CITY OF EVERETT ruenr.wonKs � <br /> ��1 LOCAL SALES — -�� <br /> ,p-1� o��E � ` TAX CODE IS�105 707A1 �� <br />