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� fi c. i� c,2 -� L Q,4 s(�. � i-o ( . <br />APPLfICAT10N FOR CONSTRUC'�'/�N PERMIT <br />CITY OF EVERETT � BUILDIN� pIVISI� <br />3200 CEDAR STHEET • EVERETT, WA 98201 • �. - eB10 <br />❑ DEMOLITION C 1 COMBINATION fit BUILDINR k] MECHANICAL k� PLUMBINQ ❑ SION <br />PR(1JECT ADDRESS <br />�oi� (,��s� �.11 D�. <br />i.mness cnv Zi� <br />CIIY <br />ArICItlTECfOR0E510NER Mf„I.�OOffE55 <br />OENEMLCONIRpCfOA MAi1.A0bf1E5J CIIY Zlp <br />,._. , __ P��Q��E SUTEUCENSEI <br />. -- �.�vnc SIq�E4CEN5E1 <br />PLUMBMlOCONIRqCtOq MAllA00PE35 CIIY IIP <br />PIIONE STAIELICENSE� <br />CONfR�i PRICE OF WORK '1 _. . <br />SOU'AE FOOIAOE INVOWEO <br />LO7 Z� BLOCK pp_ � - . <br />Arhnr (:lon <br />PMCEITNf I.O. NUM9ER - <br />CON9IM10110N LON! lENOEp AOUf1E5y,�IEIEP ONE MIMBEP <br />���no�i /K,or�a�C 7�S-SZ, <br />��os- :�as s� { s� �q �t.t��.,a(� Te., <br />PLUMBIN� 96� <br />NO. �TYPE OF FI%TURE OR ITEM FEE <br />a WATER CL03E7 (TOILET) <br />1 BATHTU9 <br />3 LAVATORV (WASH BASIN) <br />1 SHOWER <br />KItCHEN 81NK 6 DISP <br />013HWASHER <br />LAUNDRYTPAY <br />ClO7HE8 WASHER <br />URINAL <br />DiiINKINp FOUNTAIN <br />FLOOR DRAIN <br />FOR OFFiCE USE ONLY: <br />FRONf SEIBM1CN � IIEM SETBACK <br />` �_ <br />U9EZON W� IOTAREA <br />- 3 u 55Z- - <br />HEIONTUMIII1ilON � NO.OFDWELLINO <br />�, 2i • ur��s <br />8E0'D <br />J <br />SIOE SETB'CK <br />5 <br />VqCANT S lE <br />ES O Np <br />�r etoorta. <br />i2 SF Uvii,t( <br />f�L SE Gaac <br />9PSEMEN� � <br />OYE9 tT'NO <br />""'' CITY OF EVEqETT <br />—�J unie 7� �°% S T/1% CObE SL3 05 <br />HEATIN4 SYSTEM: Dq pAS fJ ELECTRIC p <br />CONIACI FEI150NAN01'IIONE NO. <br />I HEREBY CERTIFY 7HAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOV'cRNINO THI3 TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER �PECIFIED HEREIM Op <br />NO?. THE ORAN11N0 O� A PERMIT DOE9 NOT PRESUME TO OIVE <br />AUTHOqITY TO VIOLAl'E OR CANCEL THE PHOVISION OF ANY <br />OTHER STATE OR LOCAL LAW qEOULATINCi CONSTflUCTION OR THE <br />PERFOPMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THI9 PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPIICATION 13 MADE AND I COMPLY WITH THE 9TATE <br />CONTqACTORS LAW 1827 RCW AND 288.200 WAC. <br />Select s, in� �II <br />x$Y: r�i��/ �� <br />siorvniunE onie <br />CIIY BOSINE55 UCENSE NO. <br />ORITEM I FEE <br />4NOLQ UNIiS — H.P. <br />AIRSYSTEMS—B.T.U. M E.A. <br />'ERS — B.T.U. <br />ORYERS <br />ON FAN <br />METAL FIqEPLACE <br />FIREPLACE INSEHI <br />QAS FIREPLACE <br />OAS <br />PUN <br />em�on+o <br />riuuewa <br />MECIInNIC�L <br />�ObI110YAL PLAN CIIECK <br />O111Ef1 <br />S7NE BUIlDINO SI1f1Cf1AP0E <br />rueuc wonks <br />TOIAL <br />FEE � PECEIPTNO. <br />. <br />