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APPLICATI�1 FOR �:ONSTRUC7�N PERMIT� <br /> CITY OF EVERETT•BUILGING DIVIS�ON <br /> 3zW CEDAfi STREET•E!�ERETT,WA 98201 •257-8810 <br /> ❑ DEMOLRION ❑ COMBINATION �.^'ALDINfi B'MECHANICAL 'B'PLUMBING ❑ SIGN <br /> RROJECTADURESS <br /> l� 7a2� `� 3ico� Q., <br /> OWNEq MULA�ME55 LRY 2iV MKK� <br /> G u�,�r �N N�a,�!�., //7JV 7-3 a �. �.w,r�0` 9sZa� yas�.�3� s z�3 <br /> iENANf MMteDO EX ��TY ��P O�� <br /> IJKMRECTOP�ESpNEP 4NL�DIX�E55 LITV Iiv FHOUE <br /> OENEMLC �A�C M�M1e00NE�`5 �/ ^ LIiY ZW P�qN� 6T�lEUCENSE• <br /> .i9F�C�2H A/ �IC.�[� ✓ir�P _ <br /> MECH�NICALCO�iIRALTOf1 M�I �DORE55� ���� �'� P�E SLAIELICENSE• <br /> /� �OLJL7+� ��/i[ Oia.[�ui <br /> GLUMBIfqCONIRALION � MLApOPE55 � UiV I�� NqNE SiAIELICENSE• <br /> p . J ' <br /> corvtwcrrnce oaK HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> �ESCPI9G WOPN AND SOU�RE FOpi�GE INv0.I LONiACI PEPSG V eN0 PNONE 10 <br /> i9n!'i <br /> -�, <br /> Nzu�/ — <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AN�KNOW THE SAME TO BE TP.'JE AND f,ORRECT.ALL <br /> rAovosen use or oui� rvc PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> WORK YIILL BE GOIdPLIED WITH WHETHER SPECIFIE� HEREIN OR <br /> iecryoesc �P*w aaoreanis�wwHaE� o •**.cnrxocovies� NOL TME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ia.�,_o�xK ur_ � 3 �O/ AUTHOHI7Y TO VIOLATE OR CANCEL TME PROVISION OF ANY <br /> OTMER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOGL�ANCE OF CONSTPl1CTION.THAT I AM AUTHOPIZEO BY THE <br /> - OWNFR CF THIS PFOPERTY TO PERFORM TIIE WORK FOR WM�JH <br /> APPI.ICATiON IS MA�E AND I COMPIY WITN TME ST,1TE <br /> r�nceiuxioHuuoen CONTPAC SLAW1B27RCWAN0296200WAC. <br /> ., �, �: , : �, , . . oy ay or <br /> CONSTRUG➢ IORN ND ADOFE$S.IELEPNON YBEP z <br /> 5q� DAtE <br /> ❑TY BUSMES+LICEHS[HO <br /> PLUMBING MECHANIGAL <br /> NO. TYPE OF FIXTURE OP ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET�TOILET� P1C--NHNDLG UNITS <br /> BATHTUB FORCED AiR SYSTEMS <br /> ta UIVATORY�WASH BASIN� HEAT PUMP <br /> SHOWER UNIT MEATERS <br /> KITCHEN SINK 8 DISP ( CLOTHES DRYERS <br /> DISMWASHER HANGE HOOD <br /> LAUNGRY TRAY WATER HEATEP _ _ <br /> J CLOTHES WASHER WO�O STOVE <br /> URINAL METAL FIREPLACE�WOUD BURNING) <br /> ORINKING FOUNTAIN FIREPIACE INSERT(WOCC BURNING� _ <br /> FLOOR ORAIN ! GAS FIREPLACE <br /> 3ACNFLOW PREVEIITERS GAS RANGE <br /> SINK�SERVILE—BAR.ETC.) GAS PIPMG <br /> E%HAUSTFAN <br /> i <br /> SUBTOTAL S SUBTOTAL 5 <br /> PERMIT S PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> IPONi5Ei0nGM n[nF5R8nCK 9�ESE18ACN FUNfj�(C�NN/�E� ��� GEE � li� AECE�vTNO <br /> 20 20 L � <br /> us¢zoNe �ornaen v�uersi.e FEES VALU11ilON PEE <br /> �-� `.J 303 �vcs n Ho ��ionxi 4�0 <br /> NtIGn"LIMitRipN NCOFOW[LLING SIZEOfBLDGTI � <br /> 'z� ururs DO 3 S vu.�ertr , <br /> CLLUP�NCV Mp510�{5 OLLVF�NIlO�D OASfYENi MEC1UNiLk <br /> GROUP / _ <br /> •3 J-I Z nres ov� <br /> ACDIi10N�LPUNLHECF <br /> FIPE]PqiHRLRPEOO PE�SON <br /> OLMCR <br /> FIRE�UfIA1N[0� AE�SG� <br /> Si�1E BW���MO SURLwWGE I <br /> iYPEOFCON51 PUNf�VGPGYE�BY CITYOFEVERETT �1BLILKOPKS <br /> , 1 LOCALSALES <br /> —N o+i�S � � TAXCODE153105 TOTAL <br />