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APPLICA'TIO.J FOR CONSTRUCTIr.1N PERMIT <br />CITY OF EVERETT • BUILDINU �IVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />SIGN <br />p DEMOUTION O COMBINl�TION � BUILDING CI MECHANICAL ❑ PLUMBING ❑ <br />PROJECTADDRESS: L�Cfl � � �U�r'� � I L°W (�1� �L�CiC�`=/� �I� �i �Z.G'3 <br />�/�rritA� Or��� dt.�v�ui/��.��i (aP S'✓��..M T�2G3 � S 5'4z'GR <br />� /� �`'� �' <br />IENNIt MuINN%�E55 t:nv )in ri�oN[ <br />S.�G�-! � <br />ARLItlT[GTIXIOES�GNER MI111�Of1��E55 GIfV ]IP... PIIONE <br />`�j r¢ M '� <br />aerhneiconmeaon uuieamess cnr —iii:_.—. r�wuc c�aEucesse• <br />�7LF/�-( 'L- <br />MECNANIC0.CONIR�GIOR � MMIAIX%IE55 f.IIY l�l` "'—' .�Ilp�[ S1�IE4�ENSE� <br />NU �i � <br />PLUMBMCCONfRA�l0i1 M�41��E55 CItV IIY PIqNE ST�tEIIGENSE� <br />�scwee �waK �vo sou�ne roouce n+vavEo <br />/2�X I¢, � <br />�0,3 <br />,� <br />Plip'OSED U5E O: BUIdM� <br />�ccucesc�yr��a�arnorEnrv�s��owr+eEiowai�tuc��� cories� 1 <br />lOT �:1 PLOCN OF.J�/r • ) � � � � �" .f ' <br />� � � ` 7 <br />PAIY.EI TAR 1 DpM1IABEN �/ <br />�lO�O O00 r�%''.�7 000� <br />CONSTRIICTNN1lOu! IEN�EIi, AOd�ESS. IElER1d1E MIMPEf1 <br />IIEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />r.orner� r[nsoueHn r�wr+e r+o <br />I f1ERE0Y CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br />APPLICA710N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF lAWS AND ORDINANCES GOVERNING THIS TYPE O� <br />WO(iK WILI. OE COMPLIED WITfi WHETHEF SPECIFIEO HEREIN OR <br />NOi. lliE GfiANTING OF A PEHMIT DOES NOT PRESUME TO GIVE <br />AUTIIOfiITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTNER STAtE OR LOCAL LAW RECaULATIN/3 CONSTRUCTIOY Oii TNE <br />PERFOfiMANCE OF CONSTRUCTION. THAT 1 AM AUTHORI2E0 BY THE <br />OWNER OF THIS PROPEFliY TO PEPFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMFLY WITH THE STATE <br />CONTflACTORS lAW 18.27 RCW AND 296.20D WAC. <br />x y- -?%� � ,�-� `,'J- z� <br />S�CN�I F ���� <br />' •J CIIYp:ISMf:S51R:CN5CN0 <br />VLUMBINO MECIIANICAL <br />UFiINAL <br />DRINNINO I�OUNb <br />FLOOR DRAIN <br />BACKFIOW PREVi <br />SINK (SERVICE — <br />OR ITEM � FEE _ � NO. <br />SUBTOTAL <br />PERMIT <br />FOR OFFICE USE ONLY: <br />f110N1 SETP�CN � w AEAlI5F1B�CK <br />'z0 J�E _ <br />USE:ONE wi•nen <br />�- I ,c 5zx <br />��eimaur.m� � � ljNl15 0;'LUNO <br />o[CIIPANLY 1q M S�C/u(5 OLCUP�NIl0�0 <br />� <br />SOfUNKIER REO � <br />SIOE SEiBACK � y,= <br />_ �p- /O <br />V�C�NI Sllf / <br />❑VES A �, <br />s¢, or eiocm <br />❑YE$ IYry1l <br />TYPE OF <br />— MiNOLG Ui <br />CED AIR SYS7 <br />T PUMP <br />f HEATERS <br />RANGE <br />WAIER <br />WOOD <br />MEIAI. <br />f IR[PI.ACE <br />RANGE <br />PIPING <br />� SUBTOTAI S _ <br />PERMIT S <br />TOTALFEE S <br />r�nucncc�Nll+�nt�n/ / r[r�/ �`\-� n[c[m�r�o <br />15 V J <br />_�_ — -- <br />FEES VAIUATION <br />nunuiea O� <br />P11=MI11NR -- �_ <br />IAFPI�NIf.M <br />MNNI IONM PI �N Cllf f.1t <br />on�rn <br />stnic nnnnwr, snnnunuc <br />IYPEOff.ONSt PL�NS�I•r'I�OVfDOY�' CITYOFEVERETT runucwnnKc <br />LOCAL SALES --- — �' ' <br />��_ w�e Sll�o(�� TAX CODE IS 1105 To7AL —� �J �-' <br />