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AP�LICATIO: FOR CONSTRUCTI^�N PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERE7T.WA 98201 •259-8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDIN(i �MECHANICAL ❑ PLUMBIN(i ❑ SKiM <br /> pROJECTADDRESS: ���� 1�C1'� PL. SE EV�R�-•� 1.�aCg <br /> ��p MIU1 MIIX�F55 <br /> 5�11►J ,�+iD�.`�1� 1�1n�1 119�'rpL S�rG�L���9&10� ��,-bq��-- <br /> iFN�NT Y�K 1UYXK55 <br /> •11LM1f.f.Td1f1F51f.Nff1 M�h��M1�1Et5 C�IY lil• �IqNF • <br /> (iFNE11NCON11UC1011 M�il11IXN�F55 <br /> Citr Ar fi10Nf 5GiE1KFNSE� <br /> v � // f.IfY 71f MKklF iT�iE IICF.NCE� <br /> MECNIINM.KC(k1I��Cl:,Y1 M�R�MM1F55 � <br /> 1'LUMbM(i Cp�7Rn(:IOR <br /> M�R�IXM�E55 CItY 71P i`INklE 57QElICEMC.E� <br /> ������ �� O p HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> pE5Cq1�wptlt�Np CMI�AE iOp1�GF.MVOlVF.O <br /> ca+r�cr rrasow�Nn r�arx�+o <br /> T►zsTa�.� 'iS�c 6�S t�6tra�cE — — t���� <br /> o � ' <br /> 1 HEREBY CERTIfV 7HAT 1 HAVE REI1D AND F.%AMINEO THIS <br /> APPLICATION AND KNOW THE 511ME TO BE TRUE AND CORRECT ALL <br /> �o uu o�e�mp�x� PROVISIONS OF U1WS AND OROINIINCES OOVERNINO T1NS TYPE O� <br /> WOR!( WILL BE COIi�PLIEO WITH WNETHER SPECIi'IED HEREIN OFl <br /> lEML0E5C�TqNOr�Rry���������fT�GN1WOCOAES� �THORITV� TOTVOLATEAOR CANCEL�TNE PROVISION OF AN�' <br /> �ot ��� � OtHER STATE OR LOCAI.lAW REOUATINCi CUHS?RU�T10N O��►�'= <br /> PERFOAMANCE Of CONSTRUCiION.TMAT I AM AUTFIORIZE�BM TM� <br /> ONMER OF THIS PROPERTV ?O PERFORM TNE WOAK FOR VVFNCH <br /> 11PPlICIUION IS MAOE AND 1 COMPLV WITH THE STATE <br /> CONTRl1 ORS lAW 1�27 RCW AND 29E2�1O WAC. <br /> ew�c�rra i o.ra�n 1 // 7 � `'� <br /> , An, �tiN'�_. /d '/ <br /> �pN$1p11CIqN 1 OIJ1lEMIFR M1M�F55.TFl E19�OME M�MKR �N^i O�IE <br /> f.lrv BUSINE55 LICENSE 1q <br /> � �u�� MECMANICAL <br /> .� � FEF NO. TYPE Of EOl11PdENT �E � <br /> . t Np, T�/CE OF fl%TU11E 011 ITEM � <br /> WATER CLOSET�TOILET) ' �—�'��$ <br /> � <br /> � � FORCEf`AIR SVSTEMS �— <br /> BATH7UB ' <br /> NEAT PUMP '— <br /> _ LAVATORY(WASH BASIN) � UNIT HEATERS � — <br /> SNOWER � i <br /> KITCHEN SINK 6 DISP , CLOtf1E5 DRVERS <br /> , MNGE MOOD � <br /> DISHWASNER ' <br /> � WA7ER HFAiER ' <br /> UIVNDRY TRAV ' � <br /> CLOTHeS WASHER � WOOD STOVE <br /> � MEtAI FIREPUCE(WOOD BURNIN(i) � <br /> pqlNl(INO FOUNTAIN � FIREPIACE INSEFfT(WOOD BURNIN6) ' <br /> GAS FIREPIACE � <br /> FIOOR ORAIN � ' <br /> � GASRANGE ' <br /> BACKFLOW PREVENTERS {._ � <br /> SINK(SERVICE—BAR,ETC.) �P�A�N� ' <br /> �(HAUSTFAN <br /> � <br /> � � <br /> � � <br /> � ' <br /> —r— : — <br /> SUB TOiAL f ' SUB TOTAL t � - <br /> PERMIi f ' <br /> PERMIT S ' TOTALFEE f ' <br /> TOTAIFEE f ' — <br /> FOR OFFICE USE ONLY: n�Nc�ircK��rry'3 rrr nrr.rrt�a <br /> f110NfSFTP�CK PF��SFIP�f,R 51UESEIP�CM f <br /> `��j�v VAlUAT10N FEE <br /> FEES <br /> use ror+c �o�s�c� ver,er��s�ie ---- --' , <br /> ❑YCS 17 NO pItlINNf. � <br /> �� � <br /> - ____—__"' � <br /> 11EK111IIIMII�TION NO �OMTIIIN(i 92EO��lf%:�I p1114piN�- "_-'_"" _ � <br /> IlNllc ____ <br /> i <br /> OCCINNiN:Y NO(M SIIw1i15 OLCUP�NI IO�D P�GFMFNI MFCIUN�f.nl _ _"_ <br /> � <br /> f11IXT ❑YFS ❑NO —_'-"—_ � <br /> — - �p(tI110N�1�I�qPllGk � <br /> (IPF51'fiINNLfRfiW'O RF�$ON - ---- <br /> ---i--_ <br /> i <br /> ou�rn ' — <br /> --- —� ' <br /> - nf nc�a -- ---- ; <br /> f Ir1E NAnM PF90 SGIF PIIII D����SI InriuqGE <br /> '__ -_ _�.�� <br /> _._ -- �_ .� - � <br /> rvreor�or+sr rinHs�rrnovrnnv CITY'JFEVERETT runnr.wnnKv __ ___.____1-- <br /> IOCALSALES tOTAL ---�--------- -�--� ---�-- <br /> „�,E TAII CODE IS 3105 ___ <br />