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�-, .. <br /> APPLICATI4.J FOR CONSTRUCT.JN PERMiT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDING �NECHANICAL :�PLUMBING ❑ SIGN <br /> PROJECTAODRESS: yrY�� � �/t£-Z�/_� �� EVC-�LC—t� �,�'L�� ZS�'-�//�,? <br /> O,YnMER M�IlA0pRE55 Cltt =IP PHONE <br /> q-rN(�C-Y���nl ,S ��n-�C- <br /> t¢wJ+r uu�woness arv zm r��owE <br /> Sf G�/�G <br /> ARGIIIiLGTOqDE51GNER M�II/�WRE55 CITY )IP PNpNE <br /> �3--� k �;� �.�.�.ub�-s �'J 13x i�z� L �nrNw�.v� ;.�,�- 9�y� <br /> GENEIUI iR�CTpi I M11L�ODRE55 CIIV III`l MIYG� ��T�CENSE� yY w - <br /> Vl( 77t 6 I�rrJ C .,,, <br /> MECNANICALCONTN�CTOR MAIUDDf1ES5 LITY ZIP FIIONE S1�fEUCEHSE� <br /> PLUMBINGCONTR�Cipi MMLApDRE55 CIIY ZIP PIIONE Si�IELICENSE� <br /> �SA-x.t-c^ �i-ll�v�' T <br /> cor�tw�cr v�ce oF wor+n — <br /> HEATING SVSTEM: ❑GAS ELECTRIC O <br /> DE$LRIBE MNRNANp SW11RE FOOTK.E INVOIVED •- CONT�GT f`ERSONANO PIIONE Np <br /> —f-i.f�L�G(. V L'3lTL� C <br /> O; l�L- . <br /> � ��� �^�� ��� �J -�^+ I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> vnoeoseo use ov eu�tqrx� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �J f= ��� � PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WIIL BE COMPLIED WITH WNETHEH SPECIFIED HEREIN OR <br /> LEG�l0E5CRIPTIONOFPN01'ERtt�SNOVMBELOWORATTAGHTVqCOPIE51 NOT. THE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK ov AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOia OF ANY <br /> (��/�� � �y.� OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTqUCTION.THAT 1 AM AUTHORIZED BV THE <br /> / OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> /� �� APPLICATIO IS MADE AND I COMPLV WITH TME STATE <br /> PMCELIA%LD.MIMBER CONTR OR LAW1B27RC WAC. <br /> CONSTRUCTONION/LEN�ER.�WRESS `ElEP110NENUMBER x � � �� Z <br /> 5 11TU D�IE <br /> CITY BUSINESS LICENSE N0. <br /> PLUMBIN(i MECNANICAL <br /> NO. TYPE OF Flf(TURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> � WATER CLOSET(TOILE� � A/C—A/HNDLG UNfTS � <br /> BATHTUB ; FORCEDAIRSYSTEMS � <br /> UVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HEATERS � <br /> KITCHEN SINK E DISP ; CLOTHES DRVERS <br /> DISHWASHER � RANGE HO00 � <br /> UUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE �— <br /> URINAL � METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) i <br /> FLOOR ORAIN � GAS FIPEPLACE � <br /> BACKFLOW PREVENTERS � GASRANGE ' <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING � <br /> IXHAUST FAN <br /> i � <br /> i � <br /> � <br /> i � <br /> � <br /> SUEI TOTAL S ' SUB TOTAL S <br /> i <br /> PEFlMIT S � PERMIT S <br /> _ TOl'Al FEE f � TOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> iRpJTSETpACN RE�RSFTB�CR SIDESETB�CR PUNCIIECNNUlMB/Cf1 fEf RECEIPiNO <br /> J�d��� <br /> USEIONE ior�nen V�G�Ni51fE FEES VALUATIOH FEE <br /> ❑YES ❑ NO owioiHr. i <br /> HEIGN7UMITATIOH NOpFDWEWNG 512EOFBLOGRI '-- <br /> UNIIG <br /> PUIMOING <br /> OCCUPIINCY IqOtSI(MtlFS OCCUP�NTIO�D 9ASEMENT � <br /> G'IOUP MECN�NIC�I <br /> ❑YES ❑NO <br /> flRESPPINKIERREO'D AE�SON �DD�IIOHeLPI�NCHf.CR <br /> �__ <br /> OLNEA i <br /> FIREAIMMflEO'0 RF�SON <br /> SiAE BIIIIDING SIIRCIUIiGE � <br /> IYPEOFf,ON51 PlANSAPPROVEDBY C�TYOFEVERETT �IIAIIf,WORNS <br /> LOCALSALES <br /> �o�TE TA% GODE IS 3105 70TnL <br />