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APPLI�AT,�.UN FOR CONSTRUG't'ION PERMIT/ <br /> CITY OF EVEREIT• BUILDING DIVISi��J {!C^��� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-�810 � n' <br /> f7 DEMOLIT{ON �I COMBINATION � BUILDING ❑ MECHANICAL i-I PLUMBING fl S1GN <br /> P� ROJECT ADpRESS � <br /> � � <br /> L- � c'.-' -- - j''"o"-' '_ ,�' i� d�. <br /> o}"N�� MAILA�DIlE55 cirv nr PIIO�IE <br /> ) - Ll`/ {�Frr..�� ' J;l (-. -(� L.rra lni nJ� i ' � 1y/- /J�? �..r:'U � 1 :1 .1' - ';7 ? O <br /> IENAN� M4ILAOUpG55 GtY ZIP PIIONE <br /> nncnrt�cronu�s�:nm MnILAU�IlE55 CItY ZIP PIIONE <br /> GENEf1nLCON111AC10t1 MNLAU�f1E55 CIIY ]IP PIIONE SIN@LICLHSE� <br /> �,An�� i� `.: ✓:uiLcF.'_ "��q�t.yNiiiol �l <br /> M�CIIAtlIC4�COWMCtOf1 M�ILADUIlE55 CIIY ZIP PIIOIJE St��LLICEI�SE� <br /> PWM9INGCONIMClOf1 MNlAU011ES5 CIIY ZIP PHONE S7AIEUGENSGI <br /> CONIMCI PqICEOF W:'�nR '— <br /> ' ! �` '� HEATING SYSTEM: �GAS ❑ELECTRIC ❑ <br /> U[SCNOEWOIIRANUSOUAOEFOOIAGLINVOIVED n . CONI�CtPcfi50Nr1NDf'lI0NLN0. <br /> _ �. / �yir�i r - �✓� LV �;/� .`>iC_ �f��4 }� 1� Y� 1� Jf.. [ <br /> ��:�' i J:.Cf.vL ` 'J" -L ;� <br /> /' 7 1 3 ; � r . ,l s- 37Aa �_ , r zcc� <br /> �� �� �y �? e�� , .� �� G��— 1 HEFlEDY CERTIFY THAT I HHVE READ AND E%AMINED TFIIS <br /> PROPOSED USEOF OUILDINOr�— �PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND GADINANCES GOVEFNING THIS TYPE OF <br /> ''������� �` °""` �� �" °� -�F"��" WORK WILL BE COMPLIED WIT4 WHETHER SPECIFIED HEREIN OR <br /> iecn�oescniri�aaorrnor mr�suowNut�owonnrrncnrnocor�es� NOL TH[ GRhNTING OF A PrdRM1T DOES NOT PRESUME TO GIVE <br /> ior � o�ocK or �' �V rr (�<<�-k u� AU7HORITY TO VIOLATE (,A CANCEL THE PROVISION OF ANY <br /> OTHER S7'ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> 1%Rb.`_�7 /"AiFI� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TIiIS PROP'cRTY TO PERFORM THE WOqK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY VJITH THE SiATE <br /> rnnce�Tnx i.u.eiur,men CONTRACTORS LAW 1827 RCW AND 2gG20D WAC. <br /> �c�19 - c, r��-, - Cip � �� <br /> CONSIf10C110NL0AtlLENUGII.4DUf1E55,lELEPHONENlIh10Ef1 X � _ �-�_ _ �,;�-� ,_�r• � - � p -/� <br /> SIGNATf1RE DAIE <br /> CIiY�USINESS IICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUfiE OA ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATERCLOSET(TOILET) r NC—NHNDLGUNITS—H.P. —T <br /> — �— <br /> 8l1THTUB ; FORCED�IRSYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(W,4Shi OASIN) i HEAT PUMP , <br /> SHOWER � UNITH'eATERS—D.T.U. M � <br /> KITCN.EN SINK 8 DISP i CLOTHES DRYERS <br /> DISHWASHER � VENTILATION FAN —i-- <br /> L�UNDRY TRAY i RANG[HOOD ° <br /> — � <br /> CLOTl1ES W�SHER � WATEH HEATER �— <br /> URINAL ' VJOOD STOVE � <br /> ORINI(ING FOUI�7AIN i METAL FIREPLACE(NlOOD BURNING) i <br /> FLOOFi DRAW � FIREPL�CE IMSF.RT(\Y90D BURNING) �-- <br /> BACKFLOW PREVENTERS � GAS FIREPL�CE ' <br /> � <br /> .SINK(SERVICE—BAH,ETC.) i GAS RANGF. � �— <br /> ' GAS PIPING � <br /> � E:!HAUST FAIJ � <br /> — —�— --r._ <br /> i , <br /> — — � -- — � <br /> . i � <br /> ---T— - —� —�— <br /> � , <br /> SU�TOT�L $ � SUO TOiAL 5 ' <br /> — i <br /> PERMIT $ i PERMIT $ i <br /> TOT�LfEE ; � TOT�LFEE $ —�— <br /> FOR OFFICE USE ONLY: <br /> rnoNrseioncK J n[nnsElOACN � soeseroncK�' rtnNc�i�cKr+uuom ^ Fee - n�cemrNo. <br /> � GC% � ��;C . -.'L , . . - <br /> USE20NE „ r � �ornne�� �� vncnNrsn[ FEE3 VALUATION FEE <br /> _ K. nves n r+o ou�mu�c ��� O �i��/ 15,7 <br /> ueim�ruuirmiou, r�o.oruwe�uric sizeuro�ocn.i � <br /> 7 uruus ZC"-1355� `naGE rwnmwc --'-- <br /> occurnr�cr uo.ovs�omes xcurnNtion OAS[MENT � <br /> Gt10UP M[CI141lICAL ._�_ <br /> 3 2- N�} ❑YES a,� ' <br /> � <br /> F!OEALAPMIIEU'0 IIEASON AO�IIION�LPLANCIIEGK sJ � � - <br /> i�/i <br /> � ' <br /> oriien ; <br /> i <br /> -i e srnn�Hien neo�o nensoN _ <br /> srme nmiovuc suncunnce �r-�� <br /> nreorcor�si. rv,NsnrrnovEuov CITYOFEVERETT ruoucwo�Ks - I . <br /> ��_�� J'I'� LOCAL SALES — '��� �— <br /> _ uniE ��p �jj TAX CODE IS 3105 TOTAL /J,�C�' '/ � <br />