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APPLICATION FOR CONStpUCt10N PERMIT <br />CITY OF EVEH�TT • BUILbINCi DIVISION <br />3200 CEDAR STREEt • �!'EREt? WA 99201 ! 259-8810 <br />fl OEMOLITION fl COMBINATION fl BUILbINO MECHANICAL i 7 PLUMBINQ I I SION <br />PROJECT AODRE88 <br />3�tu5 AsSA S Cvc, ��� q�ao 1 <br />MMMOIIE59 cirv rm r�ar� <br />�t`���T M b�5r ?��►o�, t�l as�p��� S� Evc��—r R��� 3`3`�-G9 R(2_ <br />TENANf 4M110d7F.55 f.I1Y 71P {'lIfN1F. <br />1111K?IITECfOil0E5N3NE� MMI./1Dpf1E55 CIIY 71f` r�rorvr � <br />AENEMICONIMCTdI M�II.�p111E5S CIIY 71P f`IqNF ct�iF.IK:FNSF� <br />MFCNIIMCI1lCONiR�CiOf1 M1111A0URE55 �IfY 7R' I'IqNE Sf�TEUCf.NSF.� <br />��� `1 <br />im <br />M�RI1W11lJ'3 <br />OF A10PEPTY (�pW�� �IOW pl <br />_ eioac a_ <br />'-111�' 7�c-11-11(Z�- l)(lU <br />MlSTRIlCT10N IOIW LF.MtE11.110(x�ES3. tEIEPIKINE M/MI1Ff1 <br />LUA�lINO <br />NO. TtPE OF FlIlTUIIE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATNTUB <br />UVATORY (YVASH BASIN) <br />SHOYVER <br />KITCHEN SINK 6 DISP <br />DISFMMSHER <br />LAUNDRY.TRAY <br />CLOiF1E3 WASNER <br />URINAL <br />ORINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SUB <br />FOR OFFICE USE ONLV: <br />�fqNT SFT1111CN IIFM SETlACK <br />USE 20NF <br />,�EI(i��� �IMT�,ION <br />107 <br />NO Of OYVElL1N0 <br />IMII$ <br />HEATINa SVSTEM: I�OAS f I ELECTRIC f I <br />cowucr rFnsor+umr�rowF rxi . . .. <br />r '� -�3i,=.� <br />I NEfiEBY CEfiTIFV TNAT I HAVE REAO l�ND EXAMINED THIS <br />APPLICATION AND KNOW THE 3AME TO BE TRUE AND CORRECt AlL <br />PROVI310N3 OF LAWB ANb ORDINANCES (i0VEi1NIN0 THIS TVPE OF <br />WOfiK WILL BE COMPLIED YVITH NMETHER SPECIFIED HEREIN OA <br />NOT. THE ORANTINO OF A PEpMIt DOES NOT PRE3UME TO OIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROV1610N OF ANY <br />OTHER STATE OR LOCAL LAW REAULATINO COMSTRUCTION OR tHE <br />PEAFORMANCE OF CON3TqUCT10N. THAT 1 AM AUTHORIZED BV TIiE <br />OWNER OF THI3 PROPERIV t0 PEpFORM ?HE WORK fOR NMICH <br />APPLICAiION IS MADE AND I COMPLV WITH THE StAiE <br />CONTRA�S LAW 1S.�AND 29e.200 WAC. <br />x n, 1�-7-(- p�e <br />SIAN�I . O�IF. <br />CITYlUSINESS IICENS[ NO. <br />N0. TYPE OF F.OUpMlNT <br />MC - AIHNOLO UINTS - H.P. <br />� FORCED AIR SVSTEMS - B.LU. <br />CLOTHES DRYERS <br />VENTILATION FAN <br />MNOE HOOD <br />1NOOD STOVE <br />METAL FII7EPLACE <br />RANOE <br />°EE t ; � <br />SIOESFtIV1tu fIhNGIFf.kMlMllfll <br />53 SO <br />V�f,11Ni S�1E FEES <br />I IYES 11 NO pItlID�N(1 —'_ <br />SIE pf RIIXirtI ---'— <br />�I ONOM6 <br />�e�se�et urainrncni — <br />I IYE$ I I NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS �105 <br />�DfNUON�I PI�Nf.��fCN <br />omrn <br />srm[ nunnwa surx�nnnr,r <br />runi ir, wnnKs <br />--- --- - -_ _ <br />TOiAL <br />SUB tOTAL f <br />PERMIi S <br />iOTALFEE f <br />rrF nrr.tmtr+n <br />__ _____ _ _—_t_— <br />- ------ ------i---- <br />' __" "'_ __""__"— � __.' _ <br />- --------- --------1- <br />� <br />_ __'"__"' _—"__"—"_�"__ _ <br />_ " <br />--------'-- <br />— -- � <br />E <br />---' -- --- ------- � --- - <br />— - 1 <br />� <br />— --- -- -- - - ._ � _. _ <br />C � <br />— ----- ____ ------- --' - - <br />n <br />