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APPLICATI�..� FOR CONSTRUCT�JN PERMIT� <br />CITY OF EVERETT • BUILOING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />p DEMOLITION ❑ COMBINATION 0 BUILUING O MECHANICAL p PLUMBING ❑ SIGN <br />PROJECTADDRESS: �Z.�O� �dYT� <br />OYmEN MUL�00RE55 cltt Im r��pN[ <br />CPAI�EK' / C7J1�(tt lt�1SJ12ai�10E 2101 N�iT E�1E12E.�" 3',�+ SEx� <br />1EN�NT M�IIM)D{IES$ CI1Y 71P PupNf <br />�. �ki��c�s 1�0 �.1 . ��13� $1'tORr.1,1�IG, W�k . Qt'�\33 2oe� 5�b, �jb3b <br />A{iC111tCGipqDE51GNER M�IITWpE55 CIiY )IP PIIONF <br />cREs� N� c�'tY�.�cRoN 3943-11�3�' s�• NE ARUNG"CDN w�. 3i� bs� �1�� <br />GEHEfUICONIR�LIOR MAIUOORE55 C:IY IP PIIOryE Sf�14lICGNSE� <br />MECH�NIC�LCONTR�CiOA MAII�DDRE55 Qtt Ili` PNONE SfFTELICENSE� <br />PLUM6IN CONiR�f,10R IAAILADDRESS CItY <br />� 5 OJc� <br />GpNIMCiPRICE FWOPN <br />IZEMWE EKIS�1t�G S�NG�� I�ANr, (i�A'�I <br />OESGRIBE YqRH �NO SOU�RE FOOUGE INVOLVE� <br />REPI,AC� W�TFt Z,c(o S�vp w�l,l.S ANn <br />INS��A"�,� G�A�ING <br />PROPOSEO USE O: BUI <br />��� <br />LE�AL �ESLRIPTIpI pF PBOPERtt �SHOWN BELOW Oil ATT�CM TWp COPIES� <br />ior � eiaK G2-� oF P�i OF CUE�2E'fT <br />�4391 - (�24 � � l - Oex�S <br />PMLEL TAIf I.O. NUMBEF <br />CONS`TNMUC,TI`ONIOMILENDER.�DDRESS.TELEPMONE NUMBER <br />IVVN� <br />PLUMBING <br />NO. TYPE OF fl%TURE OR ITEM FEE <br />WATER CLOSET (TOILET) � <br />BATHTUB ; <br />LAVATORY (WASH BASIN) � <br />SHOW'cR ' <br />KITCHEN SINK 6 DISP i <br />DISHWASNER � <br />LAUNDRYTRAV ' <br />CLOTHES WASHER � <br />—y <br />URINAL ' <br />DRINNING FOUNTAIN <br />FIOOR DRAIN <br />BACKFLOW PREVENTERS ; <br />SINK(SERVICE—BAR,ETC.) —� <br />SUB TOTAL E <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />Ppq1T SETpACN RE�R SFTpALN 9DE SE7BACk <br />USE ZONE <br />ME�GIIi LIMItATION <br />OGGUP�NCY NO d 5 <br />cnour <br />FINE SPRINKIER REO'D <br />/�/ 0 <br />iIPE NARM REO'D <br />�L J <br />1YFE Oi f.pNSi <br />v- �/ <br />lOT �tiE� <br />NO 0� OWELLING <br />UMfG <br />� <br />V�C�NT SITE <br />❑YES ❑ NO <br />5�2E Of BIUGrtI <br />IIP <br />HEATING SYSTEM: <br />❑��ONE ST�iEIICENSE� <br />�.GAS ❑ ELECTRIC ❑ <br />206 54b �be� <br />5 ^ 41�� /,.�" 1. 1 1- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVEFNING THIS TYPE OF <br />WORK WILL BE COMPL�ED WITH WHETHER SPECIFIED NEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THF. PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTqUCTION. THAT I AM f UTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION �S MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />x�idw�t�1� /�12o�G� <br />SIGN�TUfiE D�IE <br />pTY OUSINESS IICENSG NO <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />NC—AMNDLG UNRS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />META� FIREPLACE <br />GASfIR[PLACE <br />GASRANGE <br />PUN CIIECN N111A6F.0 <br />FEE! <br />OUIIDIHC <br />Pl11MpING <br />6�SE�AENf MECN�NIUL <br />❑YE$ ❑ MO <br />�DDII ION�I �LeN C11f GN <br />OIHEfI <br />SipiE ONIDiNC SIIRdUfICE <br />CITYOFEVERETT rup��r.woares <br />LOCALSALES <br />TAX CODE IS 3105 io7AL <br />u <br />FEE <br />SUBTOTAL S <br />PFRMIT S � <br />TOTALFEE S <br />f[F �FCE�Pf NO <br />