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�„-�, <br />� �;� <br />� APPLICATI�1 FOR CONSTRIDC'�R! �ERI1flIT <br /> , � <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEOAR STREET•EVERETT,WA 98207 •257-8870 <br /> ❑ DEMOLITION ❑ COMBINATION � BUILDING �3. MECHANICAL PLUMBING ❑ SIGN <br /> PROJECTADDRE55 / <br /> � �-!o(,�, �ti, oz'�'�Z <br /> � �-� PARApDRE55 CIiY ZIP PHOIIE <br /> �.�fe�ant n�v /P .--d- LL� �o.BxGzk M�e�/�e 9�L7c �1LS-7�/2-�/�Cc <br /> �, uvr u�eooness cm iw p�E <br />\ (,� � <br />��� . recr �.,�, crzr ziv r�axe <br /> { -.--enL� .� � � y�at- 2s� e��3i . <br /> � AII; u� MA�L��ORE65 pRY IIp pNONE SLAiEL E14EI <br />�«� ��- 4Jm,.e , <.F — �/?t, o���_ S•l�?�� <br /> � � �.icuwnra�mon uuunoeess ertr xu� v�qe�� � s*nr¢uc xsc. — <br />�.� C ��� �b � 90 � <br /> !ii40 1 IIA tOr`R1 Ml qE55 CIiY Zip %IJNE ^SiAIELICE115 i �, <br /> J ^ l <br /> � L'�174QPPICEOfWOPn`� ' GI�S 7 0 - � Cl" _ <br /> �� ),�.5; @Oo HEATINGSYSTEM: GAS ❑ELECTRIC ❑ <br /> -�r,:oewoa� sou,werooucertrvavco ce�r�crnEnse��nrrov�iaHzrw. - � <br /> xJ � S b !.' C.�n L- , t/a.S .3 9 !� <br /> _ �>.,.< _tb .� O o <br /> .,i. I HEREBV CERTIFY THAT I HAVE READ RND E%AMINED THIS <br /> - � �^usc ew�o� APPLICATION AND KNOV/THE SAIAE TO BE TRUE AND CORRECL ALL <br /> ��`� PROVISIONS OF LAWS ANO OR�INANLES WVERtvING TMIS NPE OF <br /> u��+�DesGai^ WOR4 WILL DE COMPIIED WITN WHETHEF SPEQFIED HEPEIN OR <br /> narvorvF atett srowxee�owo ucenvo ow¢5 d NOT. iHE GFAhTING OF A PEHMIT DOES NOT PPESUME TO GNE <br /> �o*�„�_o�ax ar � . ti �n+ .K: AUTHC�RITY TO VIOLATE OR CANCEL THG PROVISION OF ANY <br /> C (�, ('i � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> •-�LQ l�{�. 1 , wyt PERFONMAP:CE OF WNSTPUCTION.THAT I Ald AUTHOHIZED BY TME � <br /> OWNER OF THIS PROPERTV i0 PERFORM THE WORN FOR NMICM <br /> �Sn�.-n0�- . O/ OS� APP�IC/QION IS 1.1FOE AN� I COMPLV WITH iME STATE <br /> rnec��u..i vu�msn _� CONTPACTORS lAW 1U2]pCW AND 296200 WAC. <br /> " c . � ct�. l��..,..-� mw`� ` . <br /> cavs.nuc ior+�o�xiErrorn.woness.rcurnonEr.vuo[n � � ��^ '�/��/4 � <br /> . •� 1 � y s=5/�f- o��n s�ci��� or.re <br /> ` cirr ousw¢ss ucsrise rn�. <br /> PLUt.101NG MELHANICAL <br /> NO. TYPE OF FI%TUflE Ofl ITEM FEE N0. TYPE UF EOUIPMENT FFE <br /> _ WATEflCLOSET(TOILET� i NC—WdNOLGUNITS <br /> BATHTU� FORCED Rlq SYSTE�dS <br /> LAVATORY(WASH BASIN) � HEAT PUMP <br /> � SHOWER UNITHEATERS <br /> ,.� KITCHEN SINK 8 DISP __ CIOTHES DFVEPS <br /> OISHWASHER _ '.� PANGEHOOD <br /> LAUNDRV TRAY WATER HEATEP <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE(W00�Bl1RNING) <br /> DRINKING FOUNTAIN FIREPUtCE INSERT�WOOD BURNING) <br /> FLOOR DRAIN i GAS FqEPL10E <br /> BACKFLOW PREVENTERS � GFS NANGE <br /> SINK(SERVICE—BAR,ETC.� GAS PIPING <br /> � E%HAUSTFAN ; <br /> i <br /> t <br /> i <br /> SUBTOTAL 5 SUBTOTAI 5 <br /> PERMIT 5 PERMIT $ �'� <br /> TOTALFEE S TOTALFEE S �. I <br /> FOR OFFICH USE ONLY: ���' <br /> �';� <br /> fPONi5ET9ACN pENi5ETB4K Si0E5ERASK %ANCN'CCNUN.DER FEE f1ECEIPTM1U. <br /> Z� o S -�,i <br /> U,E2oH Lo�nnEA V.¢u�TSnE FEES VAIUATION FEE i <br /> 'Z � O`I�z. S �'es ❑no euio�.m �S( 9y5 p;.; <br /> r�Ew�rtuui.�_ig�� , rroovowcunm :ize;Fe�ocrri. <br /> � uiiirs ,J-Z Z��{38 �i ✓ S vwuowc <br /> occuvu.cr ria.asnn¢s occw.wr�oeo onseuenr <br /> Gy�1/OyP � � NCCH�NICAL <br /> I�S 'I Z ❑YFS �'T!0 <br /> FlflESFPINNLERPE00 qEA50N ADDRqI1,LLpVJICHvCK <br /> OiNER I <br /> FlOCeI.�nMRE00 FEASON I <br /> SUiE 9ULL➢IKG SUPCr4AGE I <br /> tYPEOFCONSi p�/,N5IPVPOVFpBY CITYOFEVEflETT WBIqWOPKS <br /> �� LOCALSAlES � <br /> _ onrE Z �00 TA%COOEIS3105 TOTAL <br /> — . <br /> ryy� <br /> ' `� 't <br /> 1 5 F <br /> r ; �qsA <br /> r y� <br /> ; .� —��:L—1 � 3j• <br /> _ t..� , . <br />