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APPLICATIt.A FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-B810 <br /> f� DEMOLITION fl COMBINATION f l BUILDING I-1 MECHANICAL � 1 pLUMBING f l SIGN <br /> PROJECT AQDRESS n 2 � <br /> ._9` i �� SE. E,.��c— : �t�/l/ <br /> OMMER M�ILADDRE55 CITV 2iP PNON[ <br /> -l�l�r�t�- /r,�s?-. y6Y/ 5',%P,-f� ���c F�-,�� �` i.��ir/ � ��3 - <br /> TFNANT MMLADMF55 f.liY �IIP 1'110NE /� <br /> ♦f i� rv`vt ��c?�t/ / <br /> �RCNITECT ROE IGN M111 ��DRE 5 CITV �iP ^�ypqONf <br /> �7 �/i / <br /> ��l/hC'. '/{� Q� � � ' LC!/�LCf(��7�� <br /> 6E MCONTIULTOR M�ILADq1E55 f,i1V - 1iP PIIONf 5141[IICENSE• <br /> MECH�NIC�LCONTRACTOR M�ILAD�RF.SS CITv 71P 1'110NE STATF.UGENGE� <br /> PIUMBINGCONi �Ciqi MMLADUqE55 CITY 21P PNpNE SiFI[IICFNSE� <br /> - o ��-,�9 . <br /> coNrn�cirmct vronK <br /> Z O HEATING SYSTEM: f 1 GAS �l ELECTRIC I�}� <br /> OESCPoBEWOi1KANO501AREPOOTAGEINVOLVED CO4IACTPE ONANDPHONF <br /> G�9 � 2,)/ '� �l/ <br /> I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> vrroroseo use ov auawnc APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF ' <br /> WORK WILL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN Ci� <br /> LEGALOESCRIPTIONOF{'RO�'ERTY�SNOWNBELOWqi�T1ACNTWOCOPIES) NOT. THE �RANTMCa OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or � e�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> �' OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORREO BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION �S MADE AND I COMPLV WITH THE STATE <br /> PMICEL T�%I.O.M/MAER ��Q CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> 02 O �7 � 8,/� 1`�.S- <br /> CONSTRUCTIONIbANLENOER.�00RE55.TFlEPNOAE NUMPER X � n+ <br /> SIIiN C ORTE <br /> � � � 1���� <br /> pTY BUSMESS LIC[NSC NO <br /> PLUMB�N6 MECHANICAL <br /> NO. TVPE OF FlIRURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> � WATERCLOSET(TOILET) � A/C—/VHNDLGUNITS—H.P. � <br /> BATHTUB � FORCED AIR SVSTEMS—E.T.U. M E.A. � <br /> UVATOHY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP i CLOTHES DRVEf�S i <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDPY TRAV ; RANGE HOOD <br /> CLOTHES WASHER i WATER HEA'fER <br /> URINAL � WOOD STOVE ' <br /> ORINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOUO BUflNING) � <br /> BACKFLQW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SEflVICE—BAR,ETC.) GAS RANGE <br /> ' CAS PIPING � <br /> E%HAUST FAN i <br /> — — � <br /> i � <br /> SUB TOTAL E � SU�70TA1 $ <br /> PERMIT $ i PERMIT $ <br /> TOTAL FEE $ � T07Af.FEE S ' � <br /> FOR OFFICE USE ONLY: <br /> fRONTSFTP�N� R[RIlSFTBRG9 y3� S��e�B�CN i PI�NU . MlMlff� ([f .` �� �Ef.[IPiNO <br /> Z � ?J�4� � C' �j <br /> usezorv ior�nen vncnr�isne FEES VALUATION FEE <br /> �— � J/� 70� i i ves � r�o nwiniHe -7 �?� .� � i) <br /> �r_ ��.� , <br /> IIEIGIITIIMIT�iION � NOOFUW[LUNG Sll[OfBIIN;T1 <br /> u"ns � � Ot� rwunivr. ' <br /> — —}— <br /> OCCUP�NC.r NO nr s10NEs OCcuPllNt lono MSE�AENt ; <br /> GRBI^P � � M[CIII.NICRI. � <br /> . N q f1YE5 (�FIO — — ; --� <br /> FIRE�LARM R[OD Rf ASON /•DOIIIONM.PIAN CHECK <br /> � ___;— <br /> OIHEP � <br /> fIRF$PRINqFRRfOD RF/.FON <br /> O ST4IEOIIIIOiNfSURf.IURGE �S ' <br /> irreorcor�sr rtnNsnrrnvr ov CITYOFEVERETT runiir,wonres � ' <br /> LOCALSALES � �-'-- <br /> '�_ � c — TAX CODE IS 3105 TOTAL ('� :-� � <br /> UFfG <br />