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APPLICATIO.� FOR CONSTRUCTIJN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-BB10 <br /> '(� DEUAOL.IT�ON 0 COMBINATION ❑ BUILDING O MECHANICAL 0 PLUMBING ❑ SIGN <br /> PROJECTADDRESS: 2G.30 E, �F-'�ldO E✓c�%____�Y=�' <br /> �p MULWMiE55 Clrv 71r ruON[ <br /> �-ad/� �1 � ��a»s i�o�a 39�'D�, s�. c'✓�rrr7 --�La�....._ 33��'yc� <br /> TEN�NT Nµ�5$ f.IIY 11V PININF <br /> 11qLMTEGiOR0E51GNEf1 M�II110d1E55 Litt i�i:..—...— r�ror+r <br /> GENEMICONTMC70R MUL110011E55 CIIY --- in.—�_'���"_ PnONF. GGTEIICENSE� <br /> MECHI�MCJLL LOMiRACTOii AAIUUDIXIESS Cltt 71P FIIONE STATE IICENSE• <br /> RUMBNGCONIRFCTOR M�Il�00BE55 CII\' --IIP—""'-- PIqNE S/�fELICENSEi <br /> �°"T""`T"'"`E°"'r�" HEATING SYSTEM: O GAS ❑ ELECTRIC ❑ <br /> pE5Cp1lE NqRK ANO SOU�NE FOpi�GE NVOLVED f.IX1t�CT 1`Cf150N�N�MIONE ND <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXIIMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> vnoroseo use ac eu�allo PROVISIONS OF LAWS AND ORDINMICES GOVERNING THIS TVPE OF <br /> WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OP <br /> iEa�o�se�PTwe�avra�RT.�yrohmx�awan�n�eNnvocor�si NOT. THE ORIINTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iot xocac or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � � OTNER STA?E OR LOCAL LAW RE6ULATINO CONSTRUCTION OR THE <br /> PERFORMIINCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WOqK FOR NMICH <br /> APPIICATION IS MADE AND I COMPLV WITM THE STATE <br /> �`*�i D M�p CONTRACTORS lAW iB.27 RCW AND 298200 WAC. <br /> � .ti dv 2 6 00 \' �/ ��„r� <br /> �pNSTRlIC110NLONllENOER.l10p1E5S.TEl�^��U�ENUMEEN ��j[��±�'7 � <br /> *��� � DIUE <br /> COY BUSINE55 LICENSL NO <br /> �V�� MECHANICAL <br /> NO. TYPE OF FlIfTURE OR ITEM FEE NO. TYPE DF EGUIPMENT FEE <br /> WATER CLOSET(TOIIEn � _ NC—NHNDLa UNITS '__ <br /> FOHCED AIR SYSTEMS � <br /> BATHTUB � � <br /> LAVATORY(WASH BASIN) � HEAT PUMP _ ' <br /> S��R � UNIT HE�TF�S � <br /> KITCHEN SINK 8 DISP ; CIOTNES�R�ERS ' <br /> DISHWASHER � RANGEHOOD � <br /> LAUNDRY TRAY ; WATER NEATER � <br /> CLOTNES WASHER � WODD STOVE ' <br /> URINAL � MEfAL FIREPLACE(1NOOD BURNING) � <br /> DRINKIN(3 FOUNTAIN ' FIREPLACE INSERT(WOOD BURNING) � <br /> � <br /> FIOOR DRAIN GAS FIREPLACE � i <br /> BACKFLOW PREO'ENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING ' <br /> EXHAUSTFAN <br /> � � <br /> � <br /> � <br /> � <br /> : <br /> i <br /> � <br /> SUB TOTAL S ; SUB TOTAL f � <br /> PERMIT S � _ PERMIT f � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFlCE USE ONLY: <br /> FfIp1T5ETl1�CK AE�RSEIBACN $IDESFTB�CN �I�NCIIEf.NN11MpfO fEF �FCPIPiNO <br /> �/�3z <br /> useiorre lO1�RF� V/�G�NtSIIF. FEES VALUATION FE_T_ <br /> ❑res ❑ No nunrnr+c <br /> NEI6HTLIMITATION NOOFDVIELUNG SIZEOFlIOGrtI <br /> ------ ' <br /> UNIfS I`111Y111111: i <br /> __--'.____�__ T <br /> OCCUPANCY NO(%SIMIfS OLCUP�NTIJ�D fl�SEMENT Mlf.1111Nu:e1 � <br /> Gf10UP ❑Y[5 ❑NO -- .. I <br /> 4pDlilONM�L�NCIIfCN , <br /> FIRESPRINKLERREO'0 �FASON _______ �— <br /> on2n <br /> FIREAIMMREO'D ���� <br /> S1AIF OIIRblq6 SIIOI;IintlGF <br /> TrOEOFf.ONST Pl�NSAPPROVEOBY CITYOFEVERETT �IiAIICWCN1n5 � <br /> LOCAL SALES ------- — `— <br /> o�iE TAX CODE IS 9105 toTAL <br /> i <br />