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APPLICATIC f FOR CONSTRUCT jN PERMIT <br />CITY OF EVERE7T • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 90201 • 259-BB10 <br />l� DEMOLITION O COMBINATION O BUILDING ❑ MECIiANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: /�-p// j%4�+�'pls <br />1 u//Pn� l�Rooe,v7Y , 3 P3o yaY 1— ,� vrRe•7T yg.zo/ �06 -.zSY -.7O.2o <br />OYMEH MULA00RE55 Cltt rm- p11pNE <br />C.IIY <br />�RCMiEGTq10E51GNER M�IlP0�f1E55 C�tt pP <br />PHONE <br />GENEMICONIMLfpf1 M�R�ODRE55 f.IIY )II` PIIUN@ 5fA1ElICENSE� <br />�R/n�o �n�vsT� .Zwir�• 970 ('naisBo.e9 Ro. fP4�iin �%83FZ �60-683 - S 5�`�T <br />MECNl�NICµCONTR�CTOR MAII�DORE55 CIfY 711• PIIONE ST�T[�I�ENSE� <br />PWMB�NGCONIP�CfOR M�ILAW{IE55 CIIY Ii1� p110NE STATEIICENSE� <br />OESCRIBE WONN AHO SOWNE FppTAGE MVOlVEO <br />LL°M06/ Y/O N <br />q <br />VIlOPOSED USE OF BUILDINO <br />IEG�I OESCNPTION Oi MIOPE11tt �SIIOYM OEIOw a1 �11�W I lwa COME51 <br />lOT BLOGK pf <br />PARCEL T/0f 1.0. MIMBER <br />�ii3 -m��. - oo� -0006 <br />CONSTRIICiION IOAN IENDEN, �UDRE55. 7E1EP110NE IAMBER <br />� PLUMBING <br />� NO. TYPE OF FIXTURE OR ITEM FEE <br />� WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWEA <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />SINK (SERVICE — BAR, <br />SUB TOTAL f <br />PERMIT S <br />FOR OFFICE USE ONLY: <br />FRONTSETB�GN PEAqSETB�CN <br />MEIGIITIIMIT�TION NOOFOWEllIN6 <br />UNIIS <br />OCCUP�NCY 1q W SIMiFS OCCUP�NIIO�U <br />GROUP <br />FIRE /�V�RM 11E0'D <br />O�IE <br />S�DE SEfB�LK <br />� ❑YES ❑ NO <br />SIZL OF OIOGRI <br />❑vEi O N� <br />IIEATING SYSTEM: ❑ GAS ❑ ELECTqIC ❑ <br />CONIPCfPU15ON.W9 PIIONENO <br />/PodPR7' �. �RA/�✓ <br />-�59-���.�� <br />I HEREOY CERTIFY THAT I F{AVE READ AN� EXAMINED THIS <br />APPLICATIUN AND KNOW THE SAME TO BE TRUE AND CORriECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI. OE COMPLIED WITH WHETHER SFECIFIED HEREIN OR <br />NOT. 1t1E GFlANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTIIORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OiV1ER STATE OR LOCAL LAW PEGULATING CONSTRUCTION OR THE <br />FERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFlTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />%ONTRACTO�� 1821 RC��200 WAY/ �� �/ <br />�/ <br />� <br />516NA1Vf1 O�IE <br />0 <br />7YPE OF EOUIPMENT <br />A/C — MINDLG UNITS <br />FORCED AIR SYSTEMS <br />I1EAT F JMP <br />UNIT HEATERS <br />WOOD S70VE <br />MC•TAL FIREPIACE <br />GAS PIPING <br />EXIiAUST FAN <br />PI AN �I I[CN III IMpf 0 <br />OUILUMC <br />1411MpMG —__ <br />AI(CII�NILM <br />�OU�IIONAI PI �N f.11f CN <br />ouifn <br />S1�IE NIi1bIHf.S�i�f.11nllOE <br />CITY OF EVERETT rumir. wonKs <br />LOCAL SALES -- <br />TAX CODE IS 3105 7oinL <br />PERMIT S <br />TOTAL FEE S <br />fEF �E(:EI�fNO <br />