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APPLI�ATI� FOR CONSTIRUC'�JN PERMIT <br /> CITY OF EVERE7T•BUILOING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION O COMBINATION G� BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS:. �z�� - G«�`����� <br /> � �s�..-1.zzi__�;-«.�( _ ��_���,tf}-- y�Za, �9�as6s <br /> owr+en MeIL�UfNiF.SS cnr rm ruor,c <br /> S��-' - --- <br /> 1EN11Nr �n11.u�00[55 f.nv lir r��oNE <br /> •RCItlTEGI dl DESIGNEf1 M11t1 MNJI1G55 'IIY I�P 1`IIONf <br /> � <br /> a1o��alo�� )nl�.v.��i2 �`v6-.7z S�G3 <br /> GENEO�LCONIMLnIOfI M�RAODf1E55 CIIY 7n PnUN[ Si�t[IICENSf� <br /> � l��c �. 1'� Us �03a 16�1 � S� Sw L�nn�.x.:�� ,�Q�3R l 713325" QECKSRu � obLf� <br /> MELNANICALCONiP�CTOR MAIUbM1E55 Gtt IIP �IIONE StqF.UCENSE• <br /> PtUA�BINGCONfR�CIOii MRIL�WRE55 q1Y )IP P�IONE SUIEIICENSE� <br /> �"' <br /> CONIRAGTOPoCEOFwORK �o HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> �b0 <br /> pESCAI�Wiilill[ANDSOUN�Wj�GE� O'��y �'Lk r.oruucirrnsor+u+nr�wr+rNo <br /> F� U\ �=. <br /> 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPIICATION AND KNOW THE SAME TO BE TRUE ANO CORHECT ALL <br /> vqoroseoyse ov e�nidrxs PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> J WORK WILL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br /> LE611LOESf•PoPTIp10FPROPEf1TY1��T�pELOW01111T7ALHTWOCp'IE51 NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iot�-y-�-� _eioch�—ur � � r I L 1 / 5 AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTFIER STATE OR LOCAL LAW REGULATINd CONSTRUCTION OR THE <br /> PEFlFOHMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> C l{� I OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH <br /> !�D y � a — � APPUC TION IS MADE rfJD, I COMPLY WITH THE STATE <br /> VNN:EITNf 1.0.MIMBER COy A TORS LAW 1827 CW IWD 29C.200 WAC. <br /> N�� � /' � / � /� {( y/ <br /> CONSiMIGT10NlOANlEN0ERA0diES5.TElEn10NENUM0E11 W�"wc-� � � /v_ /l / �, <br /> SIC+N�III E D�IE <br /> Q3/01$ <br /> CITY BUSiNESS IICENSE NO <br /> PLUAABINfi MECHANICAL <br /> .NO. TYPE OF fl1(TURF OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILET) � —NMNDL6 UNfTS ' <br /> BATHTUB /; FO- ED AIR SVSTL•MS � <br /> VATORY(WASH BASIN) / � HEAT MP � <br /> S WER / � UNIT HEA RS i� ' <br /> KIT EN SINK 8 DISP j � CLOTHES D ERS � <br /> DISHW HER / � RANGE HOOD i ' <br /> IAUNDRY AV ' ; WATER HEATEfl � <br /> CLOTHES W HER � � WOODSTOVE ' <br /> UFINAL � MEfALFIREPLACE(WOO BURNING) ' <br /> DRINKINd FOUNTPIIN � FIREPlACE INSERT(WOOD�,URNING) � <br /> FLOOR DRAIN � GAS FIREPLACE . ' <br /> BACKFLOW PREVEN S ; GAS RANGE � <br /> SINK(SERVICE—BAR, C.) � GAS PIPING / ' <br /> EXHAUST FAN ' <br /> � <br /> � <br /> � <br /> i <br /> � � <br /> / ' <br /> SUB TOTAL �� f ; SUB 70TAL f ' <br /> i <br /> PERMIT S � � PERMIT S � <br /> TOTALFEE S ' TOTALFEE S � ' <br /> FOR OFFICE USE ONLY: <br /> [RpITSETR�CN pEMSFTP�GN SIDESETB�Qc PI�NCIIECNNUMlIFf1 fEF REQE��TNO <br /> � /o' S 53al� S/. 3.�' <br /> us¢z tor�n[n 1 V�G�Nf511E FEES VALUATION FEE <br /> ro � '� <br /> Z 1 � / , ❑YE$ NO PIIIIDINC. ��� i <br /> NE16NTlIMIT�fiON NOOiDWEIUNG SiLE0iBt06rtl � <br /> i <br /> � UNIig ` PIUMpING i <br /> � O S —r— <br /> OCCUPANCY MO p 5�(�FS OLCUP�NI IO�U B�SEMEN7 MfC1UHIf.�L i <br /> GfiOVP — -- "' <br /> � OYES O ' <br /> FIHESPPINKLE9RE0'D �FAS(N! �DI)�IIONNPI�NC��fCN � � /`� <br /> � <br /> � <br /> OIIIFII � <br /> (IIIEALARMREO'D PFAC(X! <br /> $�N[OIIIID�NG 511fIGUt1GE � <br /> —. r— <br /> IYf'EO�f.ONST �L�NSAPPOOVFnBY CITYOFEVERETT ����IIf.W011N5 --� <br /> �� J �- LOCAI SALES ——'--- ; <br /> ��„�E � /j�ry� TAX CODE IS �105 TOTnL ' <br /> r� = <br />