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S P�� p`�'"�s <br /> Z-3w.APPLICATI� FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> f7 DEMOLITION fl COMBINATION ❑ BUILDING fl MECHANICAL fl PLUMBIN6 fl SKiN <br /> pqOJECT ADDRESS Q�O �'1�0�l-I �1^l✓� ���F�r �"Jf� <br /> O <br /> c m a <br /> M�il npd�E55 Cin nr nq.vE <br /> �E .(�pA�OMA�w Q�a€ Cro.,.� !7 �✓r.�.� 9F2o_'L3�i3�o//� <br /> rzr+.rrt u�au�mess am rin nae+E <br /> ���uiccronocvcncn M,uiwu.�ss cm nr rrro.,t <br /> �.� a�,� �„�� $Z�o v� w� w �o�..�� W� 9sZ.�. �I�I� ��AiFlOEN5E1 <br /> GEHfM CONI1UCIq1 M�ILAY�ES$ CIIY n� 1�.�i • <br /> A!� (1N���k .iac, �i5[B I�wR �M1- E.VFiflx.� WA� 3s3'�Y72 A13ct�fr �S�oY <br /> uEcr�.��cuco�nn.cron u�i�nooncss c�rv zm a�rz s c cc se <br /> PW4BMGhC�1UCip1 N�il��0uE55 O�Y 2�P MqxE SUIEUCENSE� <br /> s��� <br /> cwmec�rn�csar�wnK � HEATINGSYSTEM: IGAS C7ELECTRIC fl <br /> ISO ppD L <br /> ceumee�wnKurosw�nE�oouce�vare crnv� c�rensor+�Hor nE�a� 353 _7W7z <br /> l�. �l 0 M� <br /> I HEr7EBY CERTIfV THAT I HAVE READ A4D EXAMINED THIS <br /> (p Q) APPLICATION AND KNOW TNE SAME TO BE TRUF ANO CORRECT.ALL <br /> �rrornscou5eoc eu�i aa PROVISIONS OF LAW3 AND ORDIN4NCE5 GOVERNINO THIS TYPE OF <br /> EC�I (�pNST SFI�. WORK WILL BE CO�APLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iEo�i�x prq�a�arvisp�+eE�ex tro.a�iv conr NOT. 7ME GRAN711:O OF A PERMIT DOES NOT PRESUME TO OIVE <br /> io ai�� a. RUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL IAN�REQULATINa CONSTRUCT�ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORICED BV THE <br /> OWNEF OF iH15 PROPERTV TO PERFORM TME WORK FOR YMICH <br /> / �� O APPLICATION IS MAOE AND I COMPLY WIiH THE ST�TE <br /> E ONTRACTORS LAW 1827 RCW AND 29fi200 WAC. <br /> �NICEIiMIDN1IM � 1 � n n <br /> CON5111 LTONIOAN f11.�00RE55.lE1ER10MENUMBEII *L 1A1! 5�2��-9S <br /> ON s��crv�run[ �[ <br /> em euvvess u:cns¢rw <br /> PLUMBINO MECMIINICIIL — <br /> NO. TVPE OF fl%TURE OR ITEM FEE NO. TVPE OF FI%TUflE OR ITEM �E �_ <br /> Wp7ER CLOSET QOILET) A/C—AMNOLG UNITS—H.P. <br /> l BATHTUB FORCEDAIRSYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WAShI BASIN) / HEA'PUMP <br /> xy. SHOWER ,!l UNITHEATERS—B.T.U. M <br /> KIiLHEN SINKB DISP .-' CIOTHES DRYERS - <br /> OISII\4ASHER VENTILATION FAN <br /> f.Y. IAUNDRY TRAV / I FANGE HOOD � <br /> ( CIOTMES WASHER � / WATER HEATER ' <br /> Rj IqINAL WOODSTOVE ; <br /> D9INKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) <br /> pJ F�_OOR ORAIN PIREPLACE INSERT(WOOU BURNING) � <br /> � BACKFLOW PFEVENTERS GAS PIREPLACE / _�_ <br /> SINK(SERVICE—�AF7.ETC.) GAS RANGE <br /> — GAS PIPMG T <br /> —' EXHAUST FAN — <br /> SUB TOTAL E SU3 TOU� S <br /> � PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE S <br /> FOP OFFICE USE ONLY: [E <br /> fPON15ilPACN PUOSEiB�IX 9pE5EiB�CK PlANC4 1Ifl[ f[[ � !S �/IT��Z <br /> ��� �Z�J�T.�.M1'. S �J � <br /> cscrov[ �ainnc� v�uNts*e FEES VIILU�TION �E <br /> I� aC n r�o p �' <br /> `� I PlnlDn�G �4 V <br /> 4[iG11lIM1I�110N NOO�NYRI4(I 51[Of01P'l� <br /> '2$ � uw�s � �j 6 'S�Gp �viti�-f� nuuemo p <br /> ur,cu�uvcr wasiwcs occw.x�io�o s•siuEr/�� uca�unc.0 O <br /> �a�Rr3 Z � 4 Wks nra <br /> 'rm[uu�uncoo nc�sw <br /> �oanon�iru�+wccK l7 �� <br /> OfO[R <br /> RPE51'P�NNLFlIPEOD RF�SON � �!D <br /> ��("' S�� -C LL 7:P � su�c am�ar+o wxH�nce <br /> ir�cacani ruvs�rwrovcoer / CRVOFEVEHETT oueik�xs LV� � <br /> LOCALSALES D <br /> �-!J o��e TAX CODE IS 3105 70TAL <br />