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�►,�P'LICA"TIO. _ F�� �O�+ISTF�tJC7� )N PE�i11r91'['//, <br /> CITY OF EVERETT• BUILDING DIVISION G�� <br /> 3200 CEDAR STR[ET• EVEREl7, WA 982C1 • 259-8810 � <br /> f�l DEMOLITION ❑ COMBINATION ❑ BUILDING, ❑ MECHANIGAL ❑ PLUMBING ❑ SIGN <br /> T1 n j / 1 <br /> PROJECTADDRESS: ��l 7 � � � .���' �(/ <br /> " ✓ <br /> MALL�OOnEss �n ilr r��o`�c <br /> �c�uPu�i o� Tr�e Na�,Hwcsr 332z �� u ��F e�rT �i�aoi 2�b> 33g -3oa� <br /> 1EHM1 �AAll�0�RC55 � I�P PnO��E � <br /> APCN��EGTORDESIGI�ER �AeilA0DRE55 Gltt ]iP pMONE <br /> I <br /> �NERALCONTMCTOfI M�ii�toonE55 / cnr am riroSE / ( � t E <br /> �11i i cHC-.�,_�-xC.��V irrJGlNc /<3S"/���¢,p�(�R1yS '� d►�u a'�,� R82�� -- <br /> �E IUNICALCOhTMC70R MAIIADDFE55 f,ltt ziP PIIONE STAiELICENSE� <br /> PLUTABINGCOtliRACtOn IAnIU�DRESS ❑fV ZIP PNONE Si�tELICE�ISE� <br /> CONTRAGI PqICE OF WORN <br /> HEATING SYSTEM: Ci GAS ❑ ELECTRIC ❑ <br /> OESG9i�E WORN AND SOU�AE FOOTAGE MVOLVEO LONTACT PEf15CN AhG PHONE NO <br /> I HEREBY CERTiFY THAT I HAVE READ AND EXAMINED THIS <br /> PRGi'OSEDUSF.JF 9UIlDWG NPPLICA7�ON AND K�.�bW THE SAME TO BE 7RUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGAl0E5CRIPTIONOFPROPERtt(5110WHOElOWIXiATTACHTYlOCOFIES{ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or oiocK__oF_ AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHER ST�TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY 'i0 PERFORM THE WORK FOR WHICH � <br /> APPIICATION IS MADE AND 1 COMPLY WITH THE S�ATE <br /> PMCEL TA)c 1.0.NUTAOER CONTRAGTORS lAW 1027 RCW AND 296200 WAC. <br /> CONSTPUCTION lOAN lCNOER,AD�PESS.TEIEPNONE NUIIOE:7 X <br /> SIGNAiURE O�tE � <br /> CIiV�LSINESSIICENSE NO . <br /> PLUMBING MECHANICAL <br /> NO. Tl'PE OF FIl(TURE OR ITEM FEE NO. lYPE OF EqUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—A/HNDLG UNITS ' ' <br /> EATHTUB ; FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) i HEAT PUMP � _ <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINfC&DISP i !:LOTHES DRYERS i <br /> DISHWASHES R.4NGE HOOD � <br /> UIUNORY TRAY ; WATEFl HFATER <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL � ME7AL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAW FlREPLACE INSERT(W000 BURNIN�) � <br /> F1.00R DRAIN GAS FIREPLACE <br /> — � <br /> BACKFLOW FiiEVENTERS ; GAS HA�JGE <br /> SINK(SERVICE—BAR, ETC.) GAS PIPING <br /> FJCHAUST FAM <br /> _ � <br /> _ � <br /> SUBTOTAL S SUBTOTAL S ; _ <br /> PERMIT $ PERMIT 5 , <br /> TOTALFEE E TOTALFEE $ _ <br /> FOfl OFFICE USE ONLY: <br /> FRONT SETOALN REAO Sf.T�ACN SIDE SETB�CN PInN Cll[CK NU1AP[R fEF �iEf.EiPT ND <br /> J�7 7 � <br /> use zor+e im enen VACAHI S�1E FEES VALUATION FEE <br /> T <br /> ❑YES ❑ NO OWLDiNf. � <br /> _ � <br /> HEI611TLINITAiION NOOGDWELIING SIZEOFOIDGrtI <br /> UNIiS P�UTAOING <br /> T <br /> G OUp�NGY Iq 01510P:E5 OGCUPFNiIOAD BASEMENT M[CIIANtLAI <br /> ❑YES ❑NO <br /> FlRESPRIN%LERREO'D REA504 ADpI110NALPlANC11ECN i <br /> T— <br /> o�uEn <br /> FIREAV6iMRE0'0 AEa50rv <br /> $TAl E 0 W!OiHG SURCIU(if E <br /> Tra¢ovr,oNsr rt,��+5erpnOVEDnv GTY OF EVERETT rumicwonKs 1 <br /> LOCHL SALES — -- --�— <br /> o�TE TAX CODE IS 9105 TOTAI <br /> � <br />