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APPLICATIf Y FOR CONSTRUC'[�DN PERMIT <br />CITY OF EVERETf • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•6810 <br />!� DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: Lf00 i �'��,`��C <br />LClO/Pi✓ PROOPRTY 397o HOYr— .�vNRe•7T Y8.z0/ 206-.zSY'.7�.70 <br />OVMER MeI�ADDRE55 rm � . <br />TENMli M/J1/�00HE55 f.11Y An P110NE <br />�RCMTCCTOROESIGNER AIeII�DDRE55 ��ry '-- ���;� <br />6ENEMlGONtMCfM MAqAIX)f1E55 CIIY JiP PiIONf il�lEIICEN5E1 <br />�R/aro �r�w�sT T�p 970 (�A,p�s� w9 qv t Qvim _9$3B7 �6b-GB3 - S'��T <br />r.irv y�r <br />VIVMBINGCONIRA�IOR M�Ul�U0RE55 �IIY lll� �IIONE S7AIELICENSE� <br />bESCRIBE WOp1t AIN $pU�RE ippiAOE INVOLVED <br />Gi°ir,c<� Yi o ,v _ <br />�� <br />Ff10PO5ED USG OF BUIlDINO <br />IEGAl0E5CRIPTION 0� Pl10PEf11Y �5110WN 6ElOW pi �I I��I17 Wp CW+IES� <br />wT e�oc� oF <br />PNICEL UA I.D. NUAIBER <br />H'/l 9-o/Z - OC�y - �JOO 7 <br />CONSTINICTION IOAN IENDEq, AppRE55. 7E1EV110NE NUMBEfi <br />� <br />PLUMBING <br />� NO. TYPE OF flXTURE OR ITEM FEE <br />� WAiER CIOSET (TOILET) <br />BATHiUB <br />� LAVATORY (WASH BASIN) <br />SHOWER <br />KITCr:EN SINK 6 DISP <br />DISHWASNER <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIN6 FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />SUBTDTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: `� <br />IRONTSETPACK PEARSE78�CN 90E SETB�CH <br />USE ZONE <br />HEIGIIf pMIUTidI <br />OCCUP�NCY Iq (MS <br />OROUP <br />FIAE SPPINKLER REO'D <br />Fine nunM neo•o <br />tO1MEA V�C�NISIt[ <br />❑�ES ❑ HO <br />NOOFDWELIING 512EOFBLDGRI <br />UNqS <br />OCCVPANIlO/.D 9ASEMENt <br />❑rE5 ❑ N� <br />HEATING SYSTEM: ❑ GAS O ELECTRIC ❑ <br />CONVCiPC�SDq�N9 PIIONENO <br />/PndFq r L. I�RA/.✓ <br />e�06 - a5 y- ,ZO,zG� <br />I HEREDY CERTIFY THAT I FiAVE READ AND E%AMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF lAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. 7{iE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTI-IORITY TO VIOIATE OR CANCEL THE PROVISION OF ANV <br />OTI{ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THnT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PFlOPEHTY TO PERFORM THE WORK FOR YIHICH <br />APPIICATION IS MADE AyN�1D I COMPIY WITH THE STATE <br />CONTRACTO� �g.27 q�� pg6200 WAC. <br />�,/l/ L./� c <br />x ��L .�e� O� �i . � ��1i'u-� /�'i <br />SIONAIURE D�IE <br />CIIY OUSINF.55 LICENSE NO <br />MECHANICAL <br />NO. ___ 7YpE OF EQUIPMENT FEE <br />NC — MiNOLG <br />FURCED AIR SY <br />__ I IEAT PUMP <br />UNIT fiEATERS <br />MGiAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WO00 BURNING) <br />GAS PIREPLACE <br />GASRANGE <br />GAS PIPING <br />FXIIAUST FAN <br />SUBTOTAL f <br />PERMIT S <br />TOTALFEE S <br />N�NCIICCNN111A11f11 fEF f1Ef.El%NO <br />OIIIIfIRIb <br />P1111AOINO <br />�EGInNIf.M — <br />�UOIIIONN. PI �N CIIlf.N <br />onrzn <br />Stnte nunnn+nsuncunncc <br />CITY OF EVERETT rumrt:�vnnres <br />LOCALSALES — <br />ThX CODE IS 3105 Toin� <br />