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APPLICATI�1 FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257•8d10 <br /> ❑ DEMOLITION /<YCOMBINATlON �9UILDING C4-�IECHANICAL �-PtLMBING ❑ SIGN <br /> PROJECTADDRESS ,s� � L) C f <br /> ���e 5� .-l�ir f�/L JC <br /> OWNEP MMLAOpPE55 LRv ZW PIIONE <br /> l'er-Fr2-cv N(�P[� �� ��»v �� „�p.. �Faw�' 9&2osr N�s37'� Sz)3 <br /> TEN�NT MALL�OOHE55 d� GRY ZiP RqNE <br /> AFLNITECTORDESqNEP V�ILApOPE55 ��N 1i� �����E <br /> �� <br /> GENE /�ILOM iOP YAILAppilES$ CIIV ZW PHp�E Si�IELILEN$E� <br /> % .�c,n�i'ZFN ,(�('iLd� '�ttr `i�c� 4d20'R 4a5- 3275'Z'75 CaOFdHIQ=Y <br /> MEGN�NIULCONifl�LIOR NAi�1pDRE55 T C'IY ZIP FHONE Si�1FLICEIRE• <br /> 'A4�(!� d/rt C���/ — <br /> PL MOIAGCUNiRAC10 NArLA�'VPE55 CIiY ZIP PNONE S1AiEL1GEN5E• <br /> L NtPKT �GE• '•YOFM � ALY11�A �r <br /> HEATIkG SYSTEM: ❑GAS ❑ELECTflIC ❑ <br /> OESCN�BE W WK ANU SW ME FWTAGE iNVCIAED LONieLi PEF50��ND VNONE NO <br /> Jl <br /> —�v �"a-�— - <br /> i I HEREBV CERTIFY THAT I HAVE P' -9 AND E%AMINED TMIS <br /> APPLICATION AN�KNOW THE SAME�.�::' �RUE AND CORRECT.ALL <br /> cecvoseo use or ow:owc � � 0 PROVISIONS OF LAW 5 AND ORDINANCES GOVERNING'hIS TYPE OF <br /> � __!� �-�l�"��9J�N' �40FlK Wlil.BE COMPUED WITH WMETHER SPECIFIED MEREIN OR <br /> �ece�oescu na+ann A*.�s�«rvnoe�rn+o ene niwo�Ariesl N07. TFIE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior�_eL�K_ 6 � oF O� AUTH�RITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> /� OTHEfl STATE OR LOCAL LAVJ REGULATING CONSTRUCTION OP THE <br /> C // PEriFORMANLE OF CONSTHUCTION.THAT I AM AUTHURIZED BY TME <br /> — '–� OWNER CF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANO I COMPLV WITH 1HE STATE <br /> v�acc�*n�io xu /� <br /> --- CONTRACTORS LAW 1827 RCW PND 296200 WAC. <br /> �� ?_;��'o.SZ�ZZCexr� �/�t/,�, � _ n4 �� o i <br /> LONSIRUGi10N 4YLIiNLcPNy.'1E]S.1ClEFM011GNUMBEi <br /> ' �% SIGNAiUPE U�IE <br /> 1.� <br /> ./ Lrtv BUSM[SS IiCENSE NO <br /> PLUMBING MECMANICAL <br /> NO. TYPE CF FI%TUHE OH ITEM FEE NO. T�PE OF EO:IIPMENT FEE <br /> WATER CIOSE i ITOIIET) NC—NHNOLG UNITS <br /> BATHTUB � FORCEDAIRSYSTEMS <br /> LAVpTORY�WASM BASIN� MEATPUMP <br /> SMOW ER UNIT HEATERS <br /> KITLHf:N SINK 8 DISP CIOTHES DRYER3 _ <br /> DISHWASHER RANGE HOOD <br /> ' LAUNDRVTRAV WATERHEATER _ <br /> CLOTHES WASHER WOOD STOVE <br /> UR�NAL METAL FIREPLACE(WOOD Bl1RNING� <br /> DRiNKINCa FOUNTAIN FIFEPLACE INSERT(WOOD BURNING� <br /> FLOOF DRAIN / GAS FIREPLACE <br /> BACKFLOWPREVE�TERS / GASRAVGE <br /> SINK(SERVICE—BAR.ETQ) GAS PIPING <br /> E%HAUSTFAN <br /> _ � — <br /> SUBTOTAL S SUBTOTAL 5 <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE S <br /> FOR OPFICE USE ONLY: <br /> iRONi5E1B�C AEARS[iDACK SCESEiB�LK PLAN'- C1tNUMBEP FEE AECEiPtNp. <br /> a.� "�-Z� -024 � � <br /> asezoue �o*�nee , wuHrsrt.� FEES VALUATION _ FEE � <br /> rJ� f � :]YES ❑� BWLD�NO b <br /> R <br /> IIEMaMr'i�UMM1�iq!I b15 �N[LL�NL' SREO��1BLWTI <br /> /. ' Z 1�/ S.f. RUM9iNG <br /> CCf.UVANCV MCi51C41{$ OCLUVANiLOAO BASEYLNI YECIIANILK <br /> �Ao�P Z — <br /> ❑vE5 0 <br /> LIPES RINNtERPEOO PE�SON ADCIIION0.PLWCNECN <br /> OLNCR <br /> FiF[QARMPEO� PE�SON <br /> Si�tE BJi��iNG S��M H1AGE <br /> TYVEO�C0161 PLNISAGppOVEDBY CITYOFEVERETT FVOIICWIXiRS <br /> LOCALSALES <br /> �� I���E s/Z/� TA%CODE IS 3105 7C7AL <br />