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_ �. <br /> APPLICAT��N FOR CONSTRUC . ION PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEOAR STREET•EVERETT,WA 98201 •259•8810 <br /> ❑ DEMOUTION ❑ COM8INATION ❑ BUILDINGn ,'� MECHAnNICAL �PLUMBING ❑ SICN <br /> PRWECT ADDRESS: � 3� �✓e%/tiJ 0�c /%�t �I�L/CE/� 9�z 0� <br /> OYII1Ea MNI�DDRE55 Cltt 7�r PIIp�C <br /> _ �/_fA C�/`�/9/�/1uN //.3� u/��Mo 2� l�U�. El���/T qslz 0/ �22 S p-0 �z J� <br /> TE14NT YNI�DORE55 f.�fY /�P {`nOME <br /> NILMTECTq10E51ONER M1U1�0011E55 Q1Y 7�� PrqNE <br /> (zoc)z6��-5'�Do <br /> GENEMIGONT TOR MIJIAWPE55 LITY ]If f`10NE GI�TEIICENSE� <br /> nll•��,/f� � lloo /�/1.+�,� /(�� A�;w 5����c.� Qf�/Q� .✓o/li/!ti//1�o.� kZ <br /> MEpIMIiCKCONT1UGTp1 MAIL�DDf1E55 Cltt )iP P110NE CT�fEfEN ./ �7 <br /> L X �L ' T <br /> PIVAlMGCONTNACTOR M�IL�OIX1E55 CItY ZIP PNONE STATEIIGENSE� <br /> caurw�cTrwcEOF ory� L �/ D HEATING SYSTEM: �GAS ❑ELECTRIC � <br /> /. il <br /> OESGIME YIORK M $OIJME FOOTW`NV L�� '� ^ L�_ C0111�CT 1150N�NO P �� D / G OO <br /> (.� �l L. !O <br /> CC,c� L' � C 0 �a .f 0 <br /> I HEREBY CERTIFY THAT I HAVE READ ANO EIfAMINED THIS <br /> riqroSEo us[ov eu�d APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> S, /�' , PROVISIONS OF IAWS AND ORDINANCES 60VERNING THIS TYPE OF <br /> WORK WILI BE COMPLIED WITH WHETHER SPECIfIED HEREIN OR <br /> �oµoex�nrna/acriar[nrls�awHe[�owaa�n�cNrvrococies� NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or eioac or AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY <br /> OTHEH STATE OR LOCAL LAW REODUTINO CONSTRUCTION OR THE <br /> PERFOPMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> / ,// OWNER OF THIS PR R TO PERFORM THE WORK FOR WMICH <br /> �b 7l b — Z I�J� D O/� b/ D IIPPUCATION ND I COMPLV WITH TME STATE <br /> �ip M�p CANTfiACTO LA 298200 WAC. <br /> CONSTIIUGiION IONI lENOEP.�0011E55.TELEP11p1E M1M�ER % 1���/Y �/ <br /> SIGN�fI . O�IE <br /> . GtY BUSINESS IICENSC NO <br /> PLUMlIIq MECNANICAL <br /> � N0. TYPE OF FlXiURE OR REM FEE NO. TVPE OF EOUIPMEIIT FEE <br /> , WATER CIOSET(TOILEn � NC—NHNDLa UNfTS ' <br /> BATHTUB ; FORCEDAIRSVSTEMS _�_ <br /> UVATORY(1MASH BASIN) � HEAT PUMP � <br /> SMOWER ' UNITHEATERS ' <br /> KRCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> DISHWASHFR � RANaE HOOD � <br /> UUNDRV TRAY � WATER HEATEP � <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL � METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(WOOD BURNING) i <br /> ROOR DRAIN GAS FIRE�LACE � <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> EXHAUST FAN <br /> i <br /> ' ' " <br /> i i ' <br /> SUB TOTAL f SUB TOTAL f ; <br /> PERMIT f PERMIT S <br /> TOTALFEE f � TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> iRdiTSEIlJ1LK PEARSFTBACN SIpE5F7B�CN Pt�NGII[CNNUW1f11 fEF AfCPPINO <br /> /��J <br /> use¢art IOi ARE� v�cer�t srt¢ FEES VALUATION FEE <br /> ❑res ❑ no ounnwc <br /> HE16HT L�MITATION ra a owewr1c 512E Of B100/11 — — � <br /> UNII$ C�IIA101Nf. � <br /> � � <br /> OCCUPIIHCY Iq(%SIMES OLCUP�NTIO�D B�SEMENL MFGI�NI(M <br /> GROIF <br /> ❑YC$ ❑NO - — . ___ <br /> FIRESPHINKIERREOD �F�SON �l)f➢II(/Ne1 �I�HC�Qf.k , i <br /> — �_ <br /> on�en <br /> FIRE NARM REO'0 AF�SpI — <br /> SV.If PUII��NC SIInC11nIWC <br /> TYPE OP f,ONST rinNs errnoveo av GTY OF EVERETT runur.wo��s <br /> LOCALSALES — — <br /> o�re TAX CODE IS 3105 TOTAL <br />