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APPLICATIt�A FOR CONSTRU�1 .1?�1 PERMIT� <br /> CITY OF EVEREIT• BUIIDING DIVISIUN <br /> 3200 CEDAR STREET• EVERETT, WP.99201 •259-8810 '�'�" <br /> fl DEMOLITION f 1 COMBINATION rl BUILDING � C,9ECHANICAL i 1 PLUMBING �I SIGN <br /> PRO�IECT ADDRESS T <br /> 9.�_ � i �' A�d sE F��t Rsr �e�.��-� • <br /> �NER MAILAODRE55 ` G�TY 7iP P:10`�E <br /> c,v��'rv�l`�,� 4»f astr°�.SE 6ur;-.>> f�.y��4- »�-:%.Pe'S' — <br /> t ANT um�nonness cir� nr ruoNE <br /> CHITECTORDGSIGNEH NFIIAD�RE55 LITY � 21P PNONE y <br /> r ^ !� <br /> �y�.���crMicetar� y11�/ I�9 ��P�•S.e_ fvEk3'lY' /�J�� =3?-/�55 C�S,�lc� C Pf99iCl� <br /> G rnICONPt�GTOR MAILApORE55 CIH .i� PIIO`�F SiATELIC[NSE�� <br /> MECHAM'.'.�IGONTRCCTOR-- M1�A�LAO�RESS CIN ZIP PHONE STAIELICENSE� <br /> wo��y ��,,KS so�, ��aNrs� st� sw��,t�.»,s� s���� aEsr-a.�.�� <br /> PLUMBINGCONTRACTOR NAILAODRE55 Cli' Z�P P��ONE STATELICENSEr <br /> u <br /> �� ��U. ` _ _' <br /> CONT �CTPRICEOFWORK <br /> HEATING SYSTEM: f� GAS fl ELECTRIC �1 <br /> p �f.qIBE WOFN AND SOUAFE FbOTAGE INVOLVED �s CONi�CT F[RSON AND PIIONE N0. <br /> �tli � uG M --1-3-SU—SG />/ <br /> �` <br /> �-1� I HEREBY CERTIFY lH,4T I HAVE READ AND EXAMINED THIS <br /> PROPOSED USEO aou+c � -- APPLICATION AND KNOY!THE SAME TO BE TRUE AND CORRECT.ALL <br /> � PROVISIONS OF LA6VS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ��—_—_ - <br /> S'iyr M ___.._ WORK WILL BE COMPL!ED WITH WHETHER SPECIFIED HEREIN OR <br /> L[GAL SCRianoryovvao�lvl no�wee�owona7raci�Twocovie5, NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or %S --ai.oc�c— - '��!L'�Yu AiiTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> 1 � - �' OTHER STATE OR LOCAL LAY!REGULATING CONSTRUCTION OR THF <br /> r ���A. -� UC I--fl-O -'�/O - z PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � �� � ^ ,/�/ OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �J ��7�p„ '�.� 9� APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PARCELTA%ID.NUM9ER <br /> h��� -i� CONTRACTORS LAW 18.27 PCW AND 296200 WAC. <br /> Ngo� -a� cs��s � 0700 y <br /> CONSTRUCTON LOR��EN���jER.ROJRf53 `EI LPMONE NUMPER � / +�— � .� ���' /S <br /> Fi-adT��v Ran.K__33;t S!<� _€��T� si v E � onre <br /> IR'N /� a� I � I�/yf � p �� CITv0115iNE5SlICEN5EN0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FIXT�!RE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> WATERClOSET�TO�LE7) � A/C—NHNDLGUNITS—�i.P. � <br /> BATIiTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> L4VATORV(WASH BASIN) —�� HEATPUMP <br /> SHOWER _'�__ UNITHEATERS—B.T.U. M <br /> � KITCHEN SINK R DISP � CLOTHES DRYERS _�_ <br /> DISHWASHER � VENTILATION FAN <br /> LAUNORY TRA1' / RANGE HOOD i <br /> � CLOTHES WASHER / WATER HEATER <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) <br /> BACKFLOW PI7EVENTERS ; GAS FIREFLACE T_ <br /> SINK(SERVIC[—BAR,ETC.) GAS RA��E ' <br /> � GAS PIPING i <br /> i EXHAUSTFAN _ <br /> _ _ � <br /> i ' <br /> SUB TOTAL 5 ' SUB TOTAL S <br /> PERMIT S � PERMIT 5 i <br /> TOTALFEE 5 ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SET�RCN REAR SETOACN SIOE SETOACH PIAN d1ECK`lUA'OFli FEE� REC�I T NO <br /> 20� zo � s ' � �k �p - 2i9 <br /> use zoNe � ior nn[a vncnrvr siie �F ES VALUATION FEE <br /> �� nves nr+o BUILDING 7Z �,6� ;Ov <br /> MEIGMT LIAIITFTION NO OP DV'[LLING 512E OF OIOG�fI. <br /> � uNirs 135o s� L�dc� rwuoiNc �7� I[�U <br /> OCCUPPNC� NOOLStOBiES OCCUP�`lTLO/U �PSEMENT AIECIIANICAL �1 ��Y� <br /> G�P <br /> A fl\'ES 1. NJ <br /> FIREAU\R�REO'D REASON A�DIIIONAIPUNCHECK I <br /> �VO on�ea O ' (�D <br /> Fiae snnWF�n�Eo�o REASON � � <br /> �� rrnicom�oivcsunc��nncE � ��(� <br /> ttreorcor+sr �unsaraA veqav CITYOFEVERETT runucwonKs �71� 7 <br /> � LOCALSALES <br /> �—' OATE � 3' SS TAX CODE IS 3105 TOTAL /y�l/ �� <br />