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APPLICATI� FOR CONSTRUC�N PERMIT�}�► <br /> CITY OF EVERETf•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257•8810 ���' <br /> ❑ DEMOLRION ❑ COMBINATION O BUILDING ❑ I..ECHANICAL PLUMBING O SIGN <br /> PROJECT ADDRESS ���� D_C�1�,��E� �t/F, <br /> �w <br /> pyM[R 411L/�DMESS LITY SV A1�1E <br /> �1.v1�9 n+�/H'1' 2J13 PaC.�'FFC4(f�AVf- F�-Q!'7�1M ���201 � ��zS�- zs2 �'�{9� <br /> TENNIi M1R�WAE.S CItY ZF %qhE <br /> A1ICIIItEC1qiDC5qNER MA0.I.O��E55 LIIY Si A1'�NE <br /> fiEHER�t[ONiRALiCP N�It�OME55 N GILV SO %q11E SUIEIICENSE� <br /> 6' <br /> sn,n7i cS7' �o4z7• zi �wsL �K�zFfT +w 9Baot' D:s -3'�e7cy c--�yJ/,�„ <br /> MECIUNC4CONiR�LtOF Y�IL�GO�E55 LI}Y � SV %1�I.f S��iElCENSE• <br /> nWuelvpCpN1N�CTOF M�iUDpPE55 Llrv 2o RIp�E S��IEIiLENSE� <br /> corrtnr.ctrncewww+e HEATINGSYSTEM: 'GAS ❑ELECTRIC ❑ <br /> ocscniec wonn uw souu+t roorwc nnavco covuci rcnsa�u+o rrqra w <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION ANO KNOW iME SAME TO�E TRUE AND CORRECT.ALL <br /> naonasmu:e�x eunoiiu PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WNETHER SPECIFIED HEREIN OR <br /> i¢o.�pcscew*ronorrnorcnm�s�wwnanowrnenncHmocorics� NOL THE GRANTING OF A PERMIT UOES NOT PRESUME TO GIVE <br /> ior BioGK or AUTHORITY TO VIOLATE OR CAItCEL THE PROVISION OF ANY <br /> OiHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTI10R11[D BV TH[ <br /> OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WMICH <br /> APPLICATION IS MADE AND I COMPLY WITM THE STATE <br /> rerctuex io ruueen CONTPACTORS LAW 1B 2 CW AND 296200 WAC. � <br /> CONSiRUC�roNtOwIENOE4NARESS.IEI[RqNFNuuBEP �j� /� Q����/ <br /> SIGN� IpE� �y OeiE <br /> CIiY BW�NE55 ULENSE Iq <br /> PLUMBING MECHIINICAL <br /> NO. TYPF OF FI%TURI'OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEp NC—a�NpLG UNITS � <br /> i <br /> �ATHTUD ! FORLEDAIRS15iEM5 <br /> LAVATORY(WASN DASIN� HEAT PUMP <br /> SMOWER '• UNITHEATEP� <br /> KITGMEN SINN h DISP j CIOTHC�ORYERS <br /> DISHWASHER RANGE HO00 <br /> � <br /> LAUNDRYTRAV WATERHEATEF <br /> CLOTNESWASHER i WOODSTOVE <br /> UFINAL 1 METAIFIREPLACE(WOODBURNING) <br /> DRINKING FOUNTAIN ! FIREPLACE INSERT�MOOD BURNING) <br /> FLOOR ORAIN GAS FIREPLACE <br /> BACNFLOW PREVENTERS ! GAS RANGE <br /> SINN(SERVICE—BAR,ETC.) ; GAS PIPING ~— <br /> E%HAUSTFAN ' <br /> i <br /> i <br /> i <br /> SUBID7AL S i SUB707AL S � <br /> PERMIT S j PERMIT S <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONIY: �OGIC'L/ <br /> rnou*scm�c� nE�nsc*e�c� siocs[*e�eK rune��[tKnwecn rce n[cemtra <br /> usczor+� io*ene� vm�.vrsire FEES VALU�TION FEE <br /> ❑r¢s u rvo eunona <br /> ��cicN*i�uir.rron raorowEuna six[ore�oo.rti. <br /> u�+rts <br /> RUUBi1q <br /> OLCV1'ANLY IqCi5t04i2 OCCUP1NfL0�U BASCMENi qECNGNICR <br /> GIIWP <br /> ❑vE5 J ND <br /> finESCPIrytltENPFO� PGSON '����k����E�K <br /> o*ncn <br /> rmc�uaun[oo n[nsoN <br /> sr�t[euaorcq Suncx�ncc <br /> �rveoreor+sr ttens+>rrpvcoer CITVOFEVEHETT rueinwwas <br /> L7CALSALES — <br /> o„� TAX CODE IS 9105 70711L <br />