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APPLICATI� FOR CONSTRUC7:�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION �%V�j_ <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 '��r <br /> ❑ DEMOUTION �] COMBINATION ❑ BUILDIHG ❑ MECHANICAL ❑ PLUMBING O SIGN <br /> PROJECT ADDRESS: <br /> J�r�-7 k C'�.•���..• ,�a�r L���/, B✓�r� k�.,�.�d 9d'u3 �'� a90 ��/Z <br /> OYN/EP MnIL�Od1E55 pTY 21P PHp1E <br /> TENIINT MNLMp1E55 GITY 21P 1`��ONE <br /> �RLMRCTd10ESIGNEH WILMORE55 CIiY 71P PHONE <br /> JU57- �;TC Cansiru:.flo,i �j� '�e��ri� �1u� tvuci+ _�,.A 482u3 I.�L��Sr�-rSiL SvsTRc�l�Q`1-I t"�G <br /> OENEMICONTN�CTdi MAIL�DOHE55 CIIY Z�� PIONE SIATEIICFNSE� <br /> MECN/WICAIf,pHTRACTqi MMI�DdiE55 CITY IIP PHONE ST�TEIICENSE• <br /> AUMBkJGCONTR/�GT0i1 MMlA00NE55 LIIY Z�P PNONE STATELICENSE <br /> GONTMCT PitlGE OF M10111t <br /> ��O /U HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> pE A�]$OU�REFOOTA6EK/VOtVED f.ONTALTPER50NANDPHpNElq <br /> ) lS�r:c 4 C - 7 c <br /> M�u e_ /? �eF ,�_ �. e=1-a6 <br /> ��� O� I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> ��0���p� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PRpVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � e � � -�• WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br /> tFa�oE ivna+acw+oae �51q1M/BEIOWOR�R/�LMTMqCOPIES� NpT. THE ORANTIN(i OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �pT .Z �p� � S���9L AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGUUTINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTIIORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> renc�i�vc i.o.Mn.eEn CANTRACTOR LAIi 1827 RCW AND 296200 WAC. <br /> � _ -1 <br /> �CON$ IOAN /�DER. SS.TELENIONEMIIAEER Z �' � ' <br /> .�P,h� 3r� 1'Yz3 S��T� o��E <br /> CITY B119NE5$IICENSE NO <br /> • � PLUAiMINO MECHANICAL � . <br /> � NO. TYPE OF FlIITURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE '•'-...- :k:.� <br /> �i 1''r��.'�`.K4 <br /> � WATERCLOSET(TOILE� � /VC—AMNDLOUNfTS ' . -��;..;_;,�., <br /> BATHTUB ; / FORCEDAIRSYS7EMS ; �,�' �:'ii.. ,, <br /> '.,`� <br /> � UVATORV(WASH BASIN) i HEAT PUMP � �..�t!:�..��r �' . <br /> SHOWER ' UNIT HEATERS ' � ;;`�-'�"n�� <br /> I KITCHEN SINIf 6 DISP i CLOTHES DRYERS i ��?�'� '� -�-";� <br /> ..-a�?.:�.. <br /> DISHWASHER � I RlWCaEHOOD _ � ' � ;--�)�;..y%`y�, <br /> LAUNDRV TRAY ; WATER HEATER ; �. � �, � ;' -�� .!'.�, <br /> � CLOTHES WASHER � WOOD STOVE � � �: .'���,:�A � <br /> �p�� � MEfAL FIREPLACE(WOOD BURNING) ' � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(WOOD BURNING) ' � � <br /> ' ���{P�.:�: <br /> FLOOR DRAW � GAS FIREPLACE ' .[i �" �- � ��.`�; <br /> ;�.'��A'��G,'1 <br /> BACKFLOW PREVENTERS ; ��GE ; ' -'--;F'•",++'�. <br /> SINK(SERVICE—BAR,ETCJ .� GAS PIPING .�'.�r;;!i(;�.-,;:�";�' <br /> � IXHAUSTFAN . -•-�.^ .'.�.r. .�. <br /> ' ' <br /> � � <br /> � i <br /> SUB TOTAL S ; SUB TOTAL f ; . <br /> PERMIT S � PERMIT E � <br /> TOTALFEE f ' 70TALFEE f <br /> FOR OFFICE USE ONLY: <br /> FPONTSETPACK � i�ARSETB�Ck SIpESFTB�M PLl�NCIIECNNUMB[fl fEF RECEIPTNO <br /> .,s3� `�sa o� <br /> use Zon I / l01�REl1 VI�G1Ni SITE FEE VALUATION FEE <br /> ❑res ❑rro eminiNa f36 99J �2 � � � <br /> HEIGMT M�T/�TION HO 0�DWELLING 512E O�BLDGRI <br /> Y , UNIfS �� �o � , �LIIMBING ���_ <br /> � <br /> pCCUPANCY NO(%S�MFS �7CCUP�NI10110 B SEMENT NFCIIeM.CM _ � <br /> K3 � 2 E5 a�a - �- <br /> FlRE �NKLERRFO'U �F.ASON ��DqIION�LPI.�NCNEGK <br /> O111ER <br /> FINEAURMREO'D AF�GON /� <br /> ST�IEBUIIDING511PC1URCE — ! �/ / <br /> ��.�i.a: <br /> TYPEOFf,ONST PL�NSAPPPOVEDBY CRYOFEVERETT �1IB11f.WOPNS ✓ � <br /> LOCAL SALES � ,� <br /> o�TE ( �Q y TAX CODE IS 3105 TOTAL <br />