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APPLICATIdN �OR CO�lSTRUCT�ON PERMIT <br />CI7Y OF EVERETT � BUILDI�G DIVISION <br />3200 CEpAjj STH�Ej,t �VER�jT, wq 98201 r 259•�810 <br />; <br />C] DEMOL�TION COMBIMA7"ION fl BUILpING f7 MECHANICpL n pl.uMeiNg n s�QN <br />PROJEC�j pDDqESS <br />/.��. �5 fi _S-� S �,� <br />��EA MMUOORESS LITY SIA puoue <br />��� � � i . . . . . .. . <br />A1�IL <br />AfIC�pTEGTOflfI�SIGNER MqtAOC%IF55 � ' � �� � <br />Clry IIP PHONE -- <br />PIUMBINOCONTRACTOR M�ILAOOflESS LIJ/ 2�p p�IONE — <br />SiATEG�CENSe� , <br />CONTRAGT PNCE OF WONK � � � ' ' <br />HEATING SYSTEM: Gq$ �l ELECTFlIC f�' ''"' <br />OESyy��I Bk Wy( ANO 5 ApE F T�GE INVOLYEO � • <br />//�..�W /_�•/ ,y , iLr CONTAC P ON�NpV1,10,���/ �/� � . , . . <br />_Sdt�r. Tri�y .y- 'Y 1 i Y l l_.LCL'f�/ .�%i/ /.... r'1.� /_ 1 C.i� <br />S�nqlp _ ;�.. <br />KLEGAL DES/�CiIIp� OF P(IOPEpTf 15HOWN LOW p <br />1�T'��J.__ BtOCK OF_ <br />��� C J'C' " ■ � � <br />� � lb��— <br />i ./ <br />GV . �/3J���./ ��{ <br />PMCEITA% D.NIIMBEp� <br />�.310 7 <br />CONSTPUCTION IO,W �ENOEq, ADDRESS, TfLEP110HE <br />PLUAABIN� -- <br />NO. TYPE OF FIXTURE OR ITE <br />WATER CLOSET (TOILET► <br />BATHTUB <br />y'�_ LAVATOqY (WASH DASIN) <br />�HOWEq <br />KITCHEN SINK 6 Q:S? <br />FoR o <br />FRONT tiEl <br />< <br />IISE ZONE <br />� <br />!�� <br />JCCUPANC' <br />onoUp <br />R•3��-i <br />FLOOR URAIN <br />BA.'KFLOW PAEVE7S'.�rRS � <br />SINK ICERVICE -- gP.q. EiC.j —.-- <br />_ � <br />_ SUB TOTf�L S <br />_, ,._ PEHMIT S <br />_ __ TOTALFEE S <br />FICE US� ONLY: <br />�C� � pEAfi SETB�CN / 510= <br />U • <br />�z �- � <br />V <br />OF�.^.011ii <br />-/J <br />HO Of UWEIUNG <br />IINIfS <br />i�! <br />IIrES �1 NO <br />nrrti _ <br />fIYES 17110 <br />o� -,�v�.r� `-rv�:��z.�iw �.k. aa <br />I FjEREBY CEqTIFY.THAT I►iAVE REAO AND EXAMINEP THI3 <br />APPLICATIOry ANO KNOW THE SAME 70 BE TNUE AND CORRECT• AL�. <br />WORKSWINL BE C MPLIEU WITH WHETHER SPECIF�qHH�REI"ryEOR <br />NOT, THE aRANT�Na OF A.PERMIT DOES NoT PR��UME:jO GIyE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROyISION',OF ANY <br />OTHER &TATE OR LOCAL LAHJ REOULATINQ CONSTP��TION OR THE <br />OWNER OF THIS pR0 ERTY TO PERFORM 7HE WORK'FpR WHICH <br />APPLICATION IS MADE AND � COMPLY �/yITH THE STATE <br />CONTRACTORS LAW IB.27 flCW AND 298200 WqC. <br />��l `Z'u`' � 2-rs-4s" <br />61G � UR TE <br />�iT� c a �f �K <br />CITY BUSINESS IICENSE NO. <br />NECHANICAL '— <br />�v� — wnnu�u uNITs — Ii.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />\TION FAN <br />HooD <br />GAS RANGE <br />GAS PIPINQ <br />E%HAUST P� <br />f I PUN CIIECK NIIMAER � <br />� _�o� �-S <br />�nuunwr, <br />� PII11Ap11lG <br />A�ECI I�NICAL <br />CITY OF EVERETT <br />!_OCAL SAL�S <br />TAX COpE IS 3106 <br />AOOIilON41. PUN Cuf:CN <br />OillEfl <br />SiAIE BIIpOIMO SUfIC1InpCE <br />ruoi ir, wonas <br />TOiA4 --- <br />S�qTOTAL $ <br />PERMIT E <br />TOTAL FEE E <br />f':F. � qECE1PTN0. <br />.��-' <br />�ALUAii:iN I <br />�'7-7 FihO i <br />