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APPLICATI�1 FOR C��NSTRUC7�N PERMIT�� <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98207 •257-8870 <br /> ❑ DEMOLITION G COMBINATION C BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS �M ��� <br /> ZZLZ �-dH 4VIa- Fi�B�u'T <br /> OWNER IA�ILMDHE55 CIiY bP PMOIiE <br /> �1 owJ {�{C�bwT 'JJM�C Z�G • S/o• 21�S'� <br /> iENANT IA4LA��PE55 LI�Y Zli� P��ONE <br /> PRCNIi,EO,I/QESqNER AIAilA0DPE55 G�Y T <br /> GCI�[R/.LCOHiflACipP MULI.ODf165 <br /> piy ZIP W10RE Si�tELICENSE• <br /> AICCH>f:ICALCO�IifUCiOP MAILI.���1E55 CILY SIG PHpIE $iAi[LICENSC• <br /> C ;-�^ur,f � So,�s Nd+�-rSnu-c �/� 982?� <br /> VLUMCNGCOIIIRLLiOP MAILP.�'JRC55 CIiY 21P VIIONE Si�tEIICENSE• � <br /> �OU <br /> comAnc.Pr+:ceacwonx HEATING SYSTEM: 17 GAS ❑ELECTRIC ❑ 7 <br /> ocsw�.oc woA.�rio:ou.Ac roouce mvoweo cornnc*Peawr�u+o vuoi+c rm <br /> �� H�� �p S hwt A-+ eur,r <br /> FnR -PvN�e..e_ IifVu.ra <br /> I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAldE TO DE TRUE AND GORRECT.ALL <br /> rv��r•osco us[Or om�ou+c PROVISIONS OF LAWS ANO OR�INANCES GOVERNING THIS NPE OF <br /> VlORK WILL DE COMFUED WITH WHEiMER SPECIFIED HEREIN OR <br /> :�,oEscr+irnorvaPAocentt�s�owrveeiowonuucniwocomesi NOT. THE GRANTING OF A PERMIT DOES NOi PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> ��' ���K �� OTHER STATE OF LOLAI LAW REGl1LATING CON57RUCTION OR THE <br /> PERFORh1ANCE OF CONSTRUCTION.THAT I AM AUTNOPIZED OV TME <br /> OWNER OF THIS PROPERTV TO PERFORh1 'HE WORK FOR WHICH <br /> APPLICATION IS �+�AOE AND I COMPLV WITH THE STATE <br /> GONiRAGTORS LAW 1827 PCW AND 296200 WAC. <br /> PMLEL iA%I D.f10FIBEfl <br /> �— 5/„ o, <br /> GONSiPUCt10NlOANLEN�EP,Ap0f1E'vS.iCt[I'NONENUMO[9 x OAiE <br /> sicr��run[ <br /> crtv ousrt+css uccr�s[r+o <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—0.'HNDLG UNITS <br /> BATHTUB PORGED AIR SYSTEMS <br /> LAVAiORV pYASH BASIN) MEAT PUIdP <br /> SHOWER UNIT HEATEPS <br /> KITCHEN SINK&DISP CLOTMES DRYERS <br /> �ISHWASHER RANGE HOOD <br /> LAUN�RY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAI FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACKFLOW PREVENTERS C�AS RANGE <br /> SINK(SERVICE—DAR.ETG) GAS PIPING <br /> ' E%HAUSTFAN <br /> SUBTOTAL 5 SUBTOTAL 5 <br /> � PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> �fONI5Ei0<CK PEARSEi�ACM S��ESELOACN PUNCOIICLNNVMJEP �'/ �E[ �ECEIPL110 <br /> V <br /> ucEzcnc �otaaen vnuN*srte FEES VALl1ATION FEE <br /> nrss ���o emmna <br /> uc�cMruuirerqr� uNits�owcuiuc sizcamocTi I <br /> PlUM61NG <br /> 'JLLUPANCY IACiS�OF4S CCCUPANiL0�0 BASEIAINL YECIII.NIG4 I <br /> GROIIP <br /> OYES ❑NO <br /> IDOIiIOwLLFVHCNECx � <br /> iIf1E5YRiNMIERRWO AEASON I <br /> OMER <br /> fiRC>LrR1AliWD AEA5011 I <br /> Si�iE B�M1DING SUnCNMGE <br /> rrrcorcn+st runs�PPnweoer CITYOFEVEflETT Puoi�cwaaxs I , <br /> LOCALSALES � <br /> n>tc U+%CODE IS 3105 T�TAL _ <br />