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p.,q r�' <br />AP�LICATIG�i FOR CONSTRUCi ■dN PERMIT <br />CITY OF EV[RETT • BUIL6ING DIVISION �/ <br />3200 CEDAR STHEET • EVERETT, WA 98201 • 255-8810 <br />❑ DEMOLITION ❑ COMBINATION p'BUILDING O MECHANICAL ❑ PLUMBING L7 SIGN <br />PFiOJECTADDRESS:�O �--A��MCIZ �Ppp \E�.'�TnF ��'-'�LL� EV�E'iT <br />�'� rr_ c���,.� �� 4iS l AKEV��W Y�0#i�� LYNN��e�D luN 9NU37 (�Zo� —7k7—G_ '� <br />IENANT M�IV�ORE55 CIIY 21G PIIONE <br />ARGNIiEGTO��ESiGNER MAllA00RE55 GIiY l��' �HONE <br />;' i�c���/ ✓tsv�i« i/��,�� �NC. SdF2�oi�1�/ ���l�N���s�x .szs-�'v3- <br />GE�iEfIAI CONiRRLTIXI MAIL A�DRE55 CIiV IIP PIIONE SIAiE UCENSE �' 2`JS'� <br />G�� o rrt�. ('��i_F�,M.I OA __._— <br />MECHANILAL CONTRRGTOO MAIL ADURESS f.11Y ZiP PIIONE STnTE IICENSE i <br />PLUNBINGCONTR�CTOR u/.RADORE55 CILY ZIP PIIONE SiRELICENSE� <br />UESCRIBE YMJfiK �NO SOUARE <br />LEGAI DESGR�PTION ot vnore� <br />�p7 BLOCK <br />��2rr� vF n�L- <br />�y�,0.(� ��� r�� <br />R�'�i `"'Fs')� <br />cF.�ISUr �C ' <br />7WNB� �RAf.IITWOGOPIES'. <br />-- °F %V.�RPJEl,si 1 <br />;�iE.G�t� u��A2rz2 oF <br />X��,�e E � E/�-ST <br />CONSTPUCilONlOANLENOER.�DDRESS.�ELEPNONE NUM�E� <br />PLUM8ING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET (TOILET) <br />BATHTUB <br />IAVATORI'(WASH BASIN) <br />SHOWER <br />KITCHFN SINK 8 DISP <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVEN' <br />SINK (SERVICE — BA <br />FEE <br />0 <br />HEATING SYSTEM: � GAS <br />CONT�Ci C[R50�1 �ND PHONE NO <br />❑ <br />I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND K:dOW THE SAME TO B� TfiUE AND CORRECT AlL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEfiNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETIIER SPECIFIED fiEREIN OF <br />NOT. TNE GRANTING OF A PERNIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE FROVISION OF ANY <br />OTHER STATE OR LOCAL LAW R[GULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED OY THE <br />OWNER OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOPS LAW 18.27 RCW AND 296200 WAC. <br />���'�_�G�`���� 9 /� <br />x or,r <br />SIG . Uf1E <br />GITv BUSINE55 LICENSC NO <br />MECHANICP�L _ <br />NO, TYPE OF EOUIPMENT FEE <br />fJC—A/HNDLG UNRS � <br />FORCED AIR S1'STEMS <br />HEAT PUMP ' <br />UNIi HEATERS <br />CLOTFIES DRYERS _I ' <br />� FIREPLACEINSERT <br />GAS FIREPLACE <br />� GASRANGE <br />� GAS PIPING <br />� FXHAUSTFAN <br />� SUBTOTAL 5 i <br />PER�41T S � <br />TOTALFEE 3 ' <br />rOR OFFICE USE ONLY: <br />F1ICNTSEfpALK AEPII�F.i6ACN SIOESETB�C�: <br />USE20ME IOTAPEA ��CANtSRE <br />❑YES O��+i� <br />NEIGNiLIM1TATIUY �OGUWEILING SIZEOFOIOG?I <br />IvrEOFC,oNST IP!nNSArPPOVEn <br />DAiE <br />SUBTOT�L S <br />PERMIT b <br />iOTALFEE S <br />ni...,c�.ec�r�mni��i�% reF seeem:�+o <br />Jr��SQ� � %� <br />OWIDING I I -- <br />I-��i <br />PIUMpING <br />❑YE$ ❑'�n <br />Ap01110N V. �L�N Cu[CN <br />OIHEfi <br />� <br />SiAiE 0„d0�rv� SURCHnf1fE <br />CITY OP EVERETT r�mnr, wonr,s <br />LOCALSALES <br />TAX CODE IS 3105 7oTAl <br />