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�, � <br /> APPLICAT16�1 FOR CONSTRUC7 ■ON PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT, WA 98207 •259-8910 <br /> fWDEMOLITION fl COMBINATION I-1 BUIIDING f� MECHANICAL f� PLUMBING f� SIGN <br /> PROJECT ADDRESS <br /> prn�p / Mu��oonEss cm nr rHor+E <br /> �RQ(� ' ��Fnl CE L' o�v�M:t.»i fti NEa/rG. Fo�,c oiJAr�� <br /> 7EN11NT �+ MNLADpiF.55 f.ITY ZIP PNONE <br /> �/ 03 �AG :t•G CvE'rtcll � �✓�' <br /> ARCIIITECTOROES�GNER M�IlllppfiE55 LITV IIP 1'HONE <br /> . . E'n� E/�'it:sc--2 oZ3iS /8S[� PL .v[-' A,eL .,.� �.� IP � ca%� � /22 Q-�! <br /> cer�rutconm�cton Ma��op�ess cirv g�Ziz� riwr+e sr�teucFr+sE. <br /> MECMIINIGALCONTR1CiON MML�DDRE55 CIiY 21P PNONE STATEIICENSE� <br /> PLIMlMGCONTRIICTOR M��L�DOilES$ CITY 71P PNONE ST�IELICENSE• <br /> CON7A�ICT NIICE OF WOIM <br /> HEATING SYSTEM: I l GAS rl ELECTRIC f-1 <br /> pE$CIMpE NVRK 11ND 50U�RE FOOThGE MVOWEO CONT�CT PERSON�ND PHONE NO. <br /> 2 � <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED Tli15 <br /> APPLICATION AND KNOW THE Sr1ME TO BE 1RUE 11ND CORqECT.ALL <br /> moPoseo use oF eu�on+a PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS riPE OF <br /> WORK WILL BE CAMPLIED WITH WHETHEH SPECIFIED HEREIN Ofi <br /> �o�tpesc�nvnpwo�rnorErm�sqrmee�owoa�n�cNtwoeanes� NO7. 7HE ORIINTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> iot.�_µp� 7 2 Z a AUTHORITV TO NIOLATE OR CANCEL THE PROVISION OF ANY <br /> �, \ N OTHER STATE OH IOCAL lAW REQULATINO CONSTRUCTION OR THE <br /> v i2 C � � -v� PERFORMANCE OF CONSTRUCTION.THAT I AM AU?HORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM iHE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> p��tNc i.o.M».�a CONTRACTORS LAW 1827 RC'N AND 296200 WAC. <br /> 3 '= 2 — o — aoo , . �./ � /�,��9�95 <br /> �ON$TqUC710N IOMI LEIAER.AOOi1ES5.IELERIp/E MIMBER x <br /> SN'iN�T IE �T� <br /> CITY BUSINESS LICENSE�- <br /> K�� MECMANICAL <br /> NO. TYPE OF FlIfTIME OR ITEM FEE NO. 7YPE OF EOI11rMENT FEE <br /> WATERCLOSET(tOILET) � NC—AMNDLOUNITS—H.P. ' <br /> B�m� � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> S�p�R � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS � <br /> OISHWASMER � VENTIL�TION FAN ' <br /> LAUNDRV TRI1V ; RAN(iE Fi000 � <br /> CLOtHES WASHER � WATER HEAtER ' . <br /> URINAI ' WOOD S70VE � <br /> DRINICINCf FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; 6AS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE ' <br /> � OAS PIPIN6 <br /> � EXHAUST FAN ' <br /> � <br /> SUB TOTAL S ; SUB TOTAL S ; <br /> PERMIT S � PERMIT S T_ <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> fi10NT5ETPACK RCIWSF.TB�CN $IDESETA�CN �UNCIIECKNUWAfR fFF RFCEIPTNO <br /> use¢or� LOi�RE� V�C�Ni 511F. FEES VALUATON �E __ <br /> IIYES fi NO � <br /> pUIIOMG � __ <br /> i <br /> /1E16HT IIMITAT�ON NN'TOF VWElUM6 SIZE Of BIOG/1.1 � <br /> PlUM01NG <br /> �+___ <br /> I <br /> pLC11P�NCY Np(If 51(RIIkS OCCUPANT LO�D BRSEMENI M(CII�NICRL � _ <br /> GRIXIP <br /> IlYES ll NO <br /> ADDIIIONM.f'I AN G��fCK � _ <br /> FlRE ALIIRM NEO'D RGASON <br /> � <br /> O111EP � <br /> FRfS^PINNLERiiF.O'D RF�S(X! ' <br /> 5141G BUIIDWf SVf1f.H�fIGE � <br /> ----t- <br /> trreovr,orvst rinHs�rvnovenav dTYOFEVERETT runnewa�Ks <br /> LOCAL SAIES — <br /> u�iE TAX CODE IS 3105 TOTAL _. <br />