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� \ /�� <br /> APPLICATIV�1 FOR CONSTRUCI .ON PERMIT�� <br /> CITY OF EVERETT•BUILDING DIVISION �%V�J_ <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 ��r� <br /> ❑ DEMOLlTION (�[ COMBINATION ❑ B 1 ING ❑ 61ECF1ANICAI ❑ PLUMBiNG ❑ SIGN <br /> PROJECT ADDRESS: / ��, <br /> �Crrr�r �O iS . S"/4 � uo�G. F�,�e� !�(� z01 �i �� ^��� � <br /> . OMMEH M 1�00f1E55 ptt S�P f•1qNE <br /> IEMWT Mul G1Y l�� M�ONE <br /> �rZ/ePFVc'�tT�' C/�7f� <br /> tTonoES�GbEa w MONEJ� � cm 7�r M�a+E <br /> ��ssc�_�u�cD � ^ 04" Ev,V�c•t.�DR E'v�E.'1`�95t7o� �S.t-�3?7 �,5scH533iU r <br /> 6EMEw�lta+m�cton MiVl�ooiiFss arv /nr —' M�oNE Cr�1[��CEMSE. <br /> MECMNlIVLfANTRACTOR MI4ADOIIf55 (91Y 71C %qNE ST�TEUCENSE� <br /> �Q�,�� Ayn�A�u(, CGI�'�T.o..1�.nea nt�:t� ���.�s �9o�9�S� �o�utr•�o»� <br /> UMlRqCONTNAGTOR MMl�00RE5S � GIfY $IP P110NE $1�fEl1LEN5F• <br /> CONTIUCT PR�GE OF WOIIR <br /> HEATING SYSTEM: ❑GAS ❑EIECTRIC ❑ <br /> • sou• ooT vEo ca+ucro[asor��r�oaHweroo <br /> �r <br /> r <br /> ^ 1 HEREB\ CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> P�� - �'�� APPLICATION AND NNOW THE SI1ME TO BE TRUE AND qORRECT ALL <br /> �°F�0µ0 PROVISIONS OF UWS AND ORDINANCES GOVERNING 7HIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �awces2ciwZna/amor¢nTr�sHorvneeioww�tr�cNnwco � NpT. THE ORANTIN(i OF A PERMI7 DOES NOT PRESUME TO GIVE <br /> �oT_,L�xoa a AU7HORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL UW REQULATINO rANSTRUCTION OR 1HE <br /> ���+ � � �� r PERFORMANC�OF CGNSTRUCTION.THAT I wM AUTMORIZED BY THE <br /> OWNER Of T�itS PROPERTY TO PERFORM TME WORK FOR WHICH <br /> \ y� �. APPUCIITION IS MADE AND I COMPLV WITN THE STATE <br /> ►w�l T�tc i 0. � CONTRACTOR 182�RCW AND 296.200 WAC. <br /> _��/-c6� �33�r.� <br /> CONSIIRICTId1 ION/lENOEH.�ODf1E55.TFI FAIp1E NIMlER x (p <br /> 0 E <br /> G:/BU9NE55 LICENSC NO <br /> •LUINI110 MECHANICAI <br /> N0. TYPE OF FlIfTU11E OR ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � /VC—NMNDLO UNff3 <br /> BATHTUP ; FORCED AIR SYSTEMS ; <br /> LAVATORV(WASH BASIN� � HEAT PUMP <br /> SHOVYER ' UNIT HEATERS ' <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS i <br /> DISHWASHER � RANGE HOOD <br /> UUNORY TRAY � WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL � MEfAL FIREPLACE(WOOD BURNIN:.� <br /> DRINKINCi FOUNTAIN i FlREPLACE INSERT(WOOD BURNING) i <br /> FLOOR DRAIN GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GAS HANGE ; <br /> SINX(SERVICE—8l1R.ETC.) GAS PIPING <br /> IXHAUST FAN <br /> � <br /> — — ; � <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT f i PERMIT S r <br /> TOTALFEE S � TOTALFEE S <br /> FOR OFflCE USE ONLY: <br /> i110NT SETBdLk REAR SF.TB�LN S�OE SETBIICM �R�N LI�riNU � fEf RFf.FIPT NO <br /> �G <br /> o5eior� toter�n V/�CANfSRE FEES` VALUIITION FEE <br /> ❑YES ❑ � BUIIDINf. ' <br /> 'J� L <br /> HE16H�UMII�TION �a a owewua s�ze ov x�ocni <br /> UNIT$ PIIIMBING —� <br /> 1 <br /> GC�CW��NGY NO CF StMFS OCCUPANf l0^0 lASEMENT MFCN�n�CM. <br /> N . ❑YES �0 <br /> �= �Dpi11pN�1.M�N C�If Ch <br /> FIRE SPRiNKLEF{'EO'D Rf�[ON __ __ <br /> on�en <br /> r�aeunr:Maeo�o nF.ca+ , <br /> sieie euno�vc sunc�unce J� <br /> rvoE a r,oqsi rinNs enrnoven nr CITY OF EVEiiETT runi ir,wae�s ' <br /> � J� LOCAL SAIES — — — --"�— <br /> �—�J o�rE 6 TAX CODE IS 3105 TOTAL <br />