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APPLIC/lTI� FOR CONSTRUC�N PER1!AIT/ <br /> CITY OF EVERETT•BUILDING DIVISION Geb� <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-8810 � <br /> ❑ DEMOLI'iION ❑ COMBINATION � BUILDING I,�(MECHANICAL � PLUMBING fl SION <br /> PROJECT ADDRESS /�/D � / � /) <br /> ,V14 t,fo/ �( /�i iP i <br /> OWNE .. •.. MNLMME _,�hGltt bP plpN[ <br /> ���lA,�.� � �.�-L�L �87a�a� o�v� 9ft-z�a .3<<v— n��� <br /> ..�O/i�rsG �'Ss•!i.✓ .T�p7HC�� <br /> A11pYtELTp10E510NEP WAMqVE55 Li�Y II� P1qNE <br /> • � �� .7)e[�(d si f!'% T�).C>3 3�tr-n�7� )NltfS /�2..�[i <br /> o[ rrtucirn uu��op�css on� nr P�qNE sr�n.iKcr,se� <br /> ,(�p�t/ QSP �GA-/rfNti� MSUL IlSr/- /.-7llO <br /> fuwu��c�uc�f�cTOfl MIJIAWNE55 piY 2iP PIpNE STAL�:lKEHSE� <br /> �JP>fl, PL. 1�0 .t3�exa/Ge E�/` d37 :.1758' .GR/cD//oi.2� <br /> iY11AlN6GONIPAtTOi1 MYIADOPE54 OIY SiP PHpNE STAiitlLExSE� <br /> [IXIiMCT VNCE p W011R <br /> �c�p��;�nn �� �//(p(yd7 HEATING SYSTEM: GAS f7 ELECTRIC f l <br /> Oi.5fMI0ENp1NNq50UM£f001bEWv0.VEU CIXI CiPE1150NNOPIA]NF.Iq. <br /> �D�.iOA7i•.��FRAAhN 9 i SIO� i�e r.�✓ - D 7 <br /> �' ' �f/� ,✓T � a 0 <br /> 1�' id�/��L rfA,1�G� %' ,3�0) I HFREBY CLRTIFY THRT I NAVE READ AN7 EXAMINE� TMIS <br /> p��p�� �� � APPLICATION AND KNOW THE SAME 70 BE TRUE AND CORREC7 ALL <br /> r.;��� � � , PROVISIONS O�UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � WORK WILL BE COMPUED WITH WHETHER SPECIFIED HEHEIN Oft <br /> lEMLOESLHPfILNOFPf10PEP}Y�SIq'MiBELOW q1�iTAGNTWJCCPIE•ul i NOT.THE GRANTIIJG CF p pERM1T OOES NOT PRESUME TO GIVE <br /> ior�_eioa or�� ��/ AUTHORITY TO VIOLATE OR C�NCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REdUUTIN�CANSTRUCTION bH TM� <br /> ���5 ��.t yE.K � �Nr o �ue PERFORMANCE OF C NSTRUCTION.TNAT 1 M/AUTHORIZED BV THE <br /> OWNEF OF THIS ERN TO PERFORM TME WORK FOR WHICH <br /> XPPLICATION .1 MAOE ANO 1 MPLY WITH TNE STATE <br /> wacELT�xi.o.,nneen CANTMCTO LAW 1B2 2 WAC. <br /> 7 CS� /1/.t /�f�� ` <br /> LONSIMICIWNIOANLEIAERMIXIES9.iFLERqNEMMlER x �j <br /> SION � E <br /> CI YBUyNC5511GEN$ENp. <br /> PLUMSINO MECHANICAL <br /> NO. TYVEOFfI%iUNEOqITEN FEE NO. TYPEOPEWJIPMEN{ FEE <br /> WATER CLOSET(iOIIET) A/C-ARiNDLO UNIB-N.P. <br /> BATHTUB FORCEOAIRSYSTEMS-B.T.U. M E.A. <br /> LAVATORV(WASH SASIN) HEAT PUM� <br /> SHOWER UNITHEATERS-B.T.U. M <br /> XITCHEN SiNK 8 GiSP CLOTHES DRYERS - <br /> DISIIWASHEP VEMILATION FAN <br /> UUNDRV TRAY / RANGE HO00 <br /> CLOTHES WASHER / WATER HEATER / � <br /> URINAL WOOD STOVE <br /> DRINKING FOU�TAIN METAL FIREPLACE�WO00 BURNING) <br /> FLOOR DRRIN FIREPUCE INSERT rylOOD BURNIN�) <br /> BACKFLOW PAEVENTERS GAS FIREPLACE <br /> SINK(SERVICE-BM,ETC.) GAS RANGE <br /> OAS PIPINO <br /> EXHAUSTFAN <br /> -� SUBTOTAL S SUBIUTAL S <br /> PERMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> rnaursrm�� n[�ns[*� �cestrwc� oi,wn�uuu� rEr� � r�c[mrrvo. <br /> � l.� ��J <br /> us¢:or�e �arnn¢e wceq�s�t[ FEES VRLO�TION FEE <br /> - f1YE5 ��M1O BUIIDING I)/ '$S I <br /> UO <br /> nero��r uurf.� Ho a owcwwo sre a eiovri <br /> � uwis (�i SF AIuw4F nivuewc <br /> 1 GA?A5: <br /> OCNPANCY 1Al%SIMFf OCCIIP/JIiIO�p B45EIAENi MECII�MLIL � <br /> 011WP / <br /> _ s � � 2 ��.ES r.Fo <br /> fIPENNI4RF.00 f1f�5W I.WIIpNAII'UHCHFCN <br /> an�En <br /> i111F5%11NNlERPFQD PE�SpV <br /> S1AlE ONIpNG SUIq1AfIGE <br /> rvoeorr.ousr vuHsuwnavsoer CRYOFEVENEI'f rum�r.woncs - <br /> J►k �oca�sa�es <br /> �- os�e � i $ TA%COUE IS J105 TOTAL — <br />