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APPLICATII�V FOR CONSTRUC�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> f� DEMOLITION f1 COMBINATION I-1 BUILDING I-1 MECHANICAL � PLUMBING f1 SIGN <br /> PROJECT ADDRESS ��� :� � /' � i /J , <br /> r � �" i <br /> J- . <br /> oWNEq MUL�oDnEss �Irv ��r r�iorl[ <br /> C� J.� o� �f�t �i 32u i CsJ�i� zr'.�.cr /i 9�Yo 3 3 <br /> TEN�NT MRILROOPGSS CIIV piP P��ONE <br /> .SvDi�c�w��+ �o ��c� Spt-i,w� p 7 / I Z2 ! S� �ur.c ��. /�/ <br /> RRLNITf.GiORDE5IGNER MRIIApORESS CITY )IP PIIONf <br /> GE/�/ERRLCO4iMC10R MAIIADORE55 ❑tY )IP P�IONf S1Ai[UCFNSE� <br /> (�ODS Tv/a}µl I�DJNCno¢. <br /> MECNIINICRLCONTPACTOP MAIIApORE55 GTV 7iP PIIONE $TATEUG[h$E� <br /> PIUMBING COMRAfTOR MnR A0URE55 LILY ZIP PNONE STATE LIGENSE• <br /> /� I i <br /> .U1- 17MfF1- 1 • �Lils..�� 963- 6"S�'. �."�i� 11icIL�,t�,t.� u. ' V7-134VU �u�iiFilL�IID w� <br /> cor+ra�cr raicE or wonK <br /> �po0. U p HEATING SYSTEM: I i GAS �I ELECTRIC f 1 <br /> DF. FIBF.WORK ANU;OU�RE FOOi�GE INVOLVED CON'i CT oER50N nN0 PNONF.NO <br /> u.�G,,,r. 5 s � r�-n cd .� �iv7-�vuu <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PRO�LEDUSE OF BUIIDING PROVISIONS OF IAWS AND OROINANCES GOVERNING THIS TYPE OF <br /> -{"� d.L' S17'M�lttiti- WOP.K WILL BE COMPLIED W�TH WHETHER SPECIFIED HEREIN OR <br /> IEG�LDESGRIPTIONOFPROPEiitt�SNOWNBELOWORATGGNTWOGOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT_ BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAT N IS MADE AND I COMPLY WITH THE STATE <br /> PARCEITA%IO.NUMBER CONTHA T RS LAW 182� 7 RCW AND 296.200 WAC. <br /> CONSTRUCTION IO�N LENDER.RDDRE55.iELI PHONE NUMBER x �� �/—��7 �/ <br /> SIGN�TURE DN[ <br /> CITV BUSME55lICF.NSC NO <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF Fl)CTURE OR ITEM FEE NO. 7YPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNRS—H.P. � <br /> BATHTUB � FORCED AIF SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i HEAT PUMP � <br /> y SHOWER UNIT HEATERS—B.T.U. M <br /> � KITCHEN SINK S DISP CLOTHES DRYERS _ <br /> � DISHWASHER VENTILATION FAN � <br /> LAUNDHYTRAV RANGEHOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WC�nD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN FIREPLACE INSEPT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> Z "(r�.Wu+ di1iV 1 GAS PIPING <br /> 3 ;r �r /� i EXHAUST FAN i <br /> i � <br /> SUB TOTAL $ ,� i SUB TOTAL $ � , <br /> PERMIT S i� PERMIT $ <br /> TOTAL FEE S /7 - TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> fRONTSFTPRCN PEARSFiBACK SIDESETBaCN PIANC11FChN f(��J/ fFF �[f.fIPiNO. <br /> 7 LI <br /> uSEZouE tornnen w^aNtSrte FEES VAWATION FEE <br /> IIV[5 i1NO ppIL01NG 1 � <br /> IIEIGIITUMIiAT10N HOOPpWELLING SIZEOFpLOG��1 <br /> IINIIS PIIIMOING — /7� <br /> __�= <br /> OGGUPANCY NO 0!SIOm[5 OCCUPRNi 104U BRSEMENt A+FGIRNIC�L � ' <br /> GROUP � _ <br /> IISES ii NO <br /> FIRE�LARAIREOD RP�5p4 AII�IIIONMPLANG�f.CK i <br /> ��-- <br /> O1HER j <br /> FIf:FSPRINqERPEQD RF�SON i <br /> STA[OIIiIOMC.SUIICNMFE � <br /> —_ �"— <br /> tmEorr,or+si rinNSnrvnpvEnAr CITYOFEVERETT runncwnnKs <br /> LOCALSALES — / — <br /> �,ntE TAX CODE IS 3105 70iAL <br />