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iZI[StATF_o &Oe,. rjF ml-r W 600O3-3s <br />APPLICATIM FOR CONSTRUC&N PERMIT <br />CITY OF EVERETT P BUILDING DIVISION <br />3200 CEDAR STREET P EVERETT, WA 98201 A 257.8810 <br />❑ DEMOLITION ❑ COMBINATION fl BUILDING ❑ MECHANICAL ❑ PLUMBING G SIGN <br />PROJECT ADDRESS <br />?$10 Iy1G�-l�af�l 7-h,iE Fir <br />{o�wN�ER uA1LAooREss CITY zv P.gNE <br />T TF.�a..�LnLY1rK� �..tTlt[_ <br />TENANT uut ADORES ^/I cm ip PHONE <br />Z$10 �IG•-It.A^IO FA✓f_, FAiF�E'T'r <br />ARcmTEcr d+DESICNEn MAKAopNss cm tc PIIpE <br />r��{jMER,�LLCONLRACTOR/ YAILAOIKE55 CITY IY' PN(MC STATE LICENSE • <br />IL�_M71EIV1 [!A.Ns? IZuH4 ZtJi15T SF C�r�t�-Er 9('�r �Lt�33/(d118 <br />MECNANICALCCAITRACTCR PAIL AGGRESS aPLIiY jN prlpq SINE ICENSE• <br />�ETTE�-tLvn..I �iyR La14LQ �>.EP 7-311 1.53 /ll.c.SC S+ouomom 9F+e`i2 (Hz5)33s"-YWs A.ac7L.sme�Nc. <br />PLUMBING CCNT RACTOA MAIL ADDRESS CITY "I PHONE STNE LICENSE. <br />CpIiMCi PPCE CF NCPR p <br />yp HEATING SYSTEM: ❑ 6A3 fl ELECTRIC Cl <br />DESCRIBE WOnM AMp $OIIARE f00TAGC IINIXVFf1 / I CONIACI PERBON ALq PNpf lq <br />[�[YS E.�ri.J •SA2wte LrjL SYtrfm l0 17L>�!%Fc�. �IAJ <br />Ammon) i.l r u -Ti SIT)--L:JPQT Arzs 33s -q6 s <br />90 ! I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PACAPC EO USA PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />Fmtr,,, LrRL t i:IRi�Triw!/1+.LLC WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRVTION a PPOPERTY)SHOWN BELOW OR ATTACH two COPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT IACCK O� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND n COMPLY WITH THE STATE <br />PAnCEt Ma 10 NUMBER CONTRACTORS LAW 18CONTRACTORS LAW 9�200 WACWAC. M <br />CONSTRUCT ON LOAN LEADER. ACCEESS 1LLL' IE)NE NUMBER <br />BO UAL DATE <br />CITY BUSINESS I.Cl ASE SO <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) A/C -AHNDLC. UNITS <br />BATHTUB FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) HEAT PUMP <br />SHOWER UNIT HEATERS <br />KITCHEN SINK A DISP CLOTHES DRYERS <br />DISHWASHER RANGE HOOD <br />LAUNDRY TRAY WATER HEATER <br />CLOTHES WASHER WOOD STOVE <br />URINAL METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN GAS FIREPLACE <br />BACKFLOW PREVENTERS GASRANGE <br />_ SINK (SERVICE - BAR. ETC.) GAS PIPING <br />EXHAUSTFAN <br />i <br />SUBTOTAL S SUBTOTAL S i <br />PERMIT S PERMIT S i <br />TOTALFEE S I TOTALFEE S <br />FOR OFFICE USE ONLY: _ <br />FROIIT SLNASn n[AR s[1BAC[ SIM S[ BACK PL NOIECK NUMBEN TEE ��� RECEIPT NO <br />�CODID-DOl <br />USE:ONE LOT mu IACA, SITE FEES VALUATION FEE <br />n YES nNO OVILdW.i <br />NEONTLMIl.ON NO Cr1. )MUINSVEOfftDGTI <br />UNITS PLUMBING <br />OCCUPANCY I NO CI llC IS OCCUPANI LOAD BASEMLNI MECHANICAL <br />GROUP <br />DYES In NO <br />PAL SPAINKLw REOD RLASON AOdrONAL PLAN CHECK <br />WHEN <br />EWE>LN)M n[OO REA[ON <br />SINE BuudNG SURCHARGE <br />TYPE EUCo ST PLANSr 40Dr CITY OF EVERETT PUBLIC woRKs py <br />LOCAL SALES <br />DATE! It' TAX CODE IS 3105 TOTAL <br />