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APPLICATIG.J FOR CONSTRUCT.JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-8810 <br /> ❑ DEMOUTION � COMBINATION BUILDINQ ❑ MECHANICAL ❑ PLUMBIN(i ❑ SION <br /> PROJECT ADDRESS: 02 3/9 7 �(L,,�S <br /> !`(L� / �LS�SL T .)�� )// �LV. ��GL�ILC�L��' IP/�/-!L. PROME /.�Z G- �!U <br /> -,-�/ 7�/'/, �p <br /> TEIUNT� 4WL 55 f.IIY 7�� P11pNE <br /> ARCNiELTdiDE516NER M1UlA00RE55 tltt TII` PMONE <br /> OEJ�RIwFON�C70R/ YNL�DOpE� IfY 11� PIqNE SI�TElKFNSE� <br /> v�� �a-tt/ �/3��� /1� .�,� �fc�dri�s 19�.FztP i3� �'Zz �'citLS/� <br /> MECMW�ICAICONTR�CTOR 1MILNJDRE55 fA7Y 21P P110NE ST�IEIICENSE� <br /> PLU4lNOl:ONTRACTOR MMl�00f1ES5 CItY 21P PIqNE STAfELICENSE� <br /> conmecrr�awowc� �O C U HEATING SYSTEM: ❑GAS O ELECTRIC � <br /> � <br /> [Y:SCRIlE MI0111(11N0 SOU�RE FOOTII6E WVOIVED GONTACT VERSON N/O i1qHE!q. <br /> 1�. . v _C <br /> � I HEHEBY CERTIFV THAT I HAVE READ AND EXAMINED TNIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT AlL <br /> ������p PROV�SIONS OF UWS AND ORDINANCES 60VERNING THIS TYPE OF <br /> WORK WIIL BE COMPIIED Wlhl WHETHER SPECIFIED HEREIN OR <br /> itaK wwrae�arnovEmr ee�ow n Hnweon si WpT. THE ORANTINp OF A PERMR DOES NOT PRESUME TO OIVE <br /> wr � � e�oac��ac � v . AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW NEOUTATINO CONSTRUCTION Op THE <br /> � �. �') PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> ONMER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> _ _ i APPI.I ON IS MADE A�D I COMPLY WITH THE STATE <br /> MMf�L TA% .D.111MlER RACT H 'OAW 1B27 R AND 298200 WAC. <br /> CONS71NIC110N1 1��I NOEP.AOORESS.TElEP11p1��� x � � � <br /> iVIE D� <br /> /y(� �` 7 9� an eus�ss iwer+se ra <br /> PLIIAlN16 MECHANICAL <br /> NO. TYPE OF Fl FEE NO. TYPE Of EOINPMFM FEE <br /> WATEH CLOSET(TOILEn � �—�p�Rg � <br /> BATHTUB ; FORCEO AIR SVSTEMS ' <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNITHEATERS � <br /> KRCFIEN SINK 8 DISP ; CIOTHES DRVERS ; <br /> DISFM/ASHER � RANOE FiOOD � <br /> LAUNDRY TRAY ; WAiER HEAiER ; <br /> CLO.THESWASHER � WOODSTOVE � <br /> URINAL � MEfAL FIREPIACE(WOOD BURNINO) � <br /> DqMIKIN6 FOUNiA1N � flREPIACE INSERT(WOOD BURNING) � <br /> ROOR DRAIN � OAS FlREPLACE � <br /> BAq(FLOW PREVENTERS ; GAS RAN(iE ; <br /> SINK(SERVICE—BAR.ETC.) GAS PIPINO � <br /> ' IXHAUST FAN ' <br /> � <br /> � � <br /> � � <br /> � � <br /> � <br /> / SUB TOTAL S � � SUB TOTAL f ; <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> f110NTlE7l�Clf / PEM SETd1LK / SIOE SETl�Y M�N CIIECK MM4E= �EF��V)L� REf.EIPT NO <br /> L/Gi ,� <br /> usezor�� Z ioru�� v�uwrs�te FEES VALUATION FEE <br /> � <br /> O�ES O MO 6UIlDINf. G�` � <br /> IEqNTUMTATqN NO �UWELUNfi 512EOill06R1 � <br /> UNII.. �/ PlU401NG � i <br /> N <br /> UVAMCI' NO 0�SfpIFS OCCVPANf IOI�D BASEMENT � <br /> MECN1WIf.K <br /> 1 <br /> . o.ES �o — --,��n <br /> flRESPNNcIERREOV RE�SON <br /> •OdIION�t A�N C�N.CM <br /> OTNEf1 <br /> FMENARMREOV REnSON <br /> i�SUTE BUILOINC SIIRCIUf10E � <br /> __ � <br /> IYVEOif,pNST PUNSMPROVEDBY CITYOFEVEREIT �IIBIIf.Wq1N5 �� <br /> -�7� � r �J� LOCAL SALES --'— <br /> d[--N oeiE � Z (� TAX CODE IS 8105 TOTAL I� <br />