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Sc' a��LICA�'Ia.J FOR CONSTRUCT►.aN PERMiT� <br />CITY OF EVERETT • BUILDING DIVISION <br />, 3200 CEDAR STREET • EVERE'l�', WA 99201 • 259•8810 <br />❑ DEMOLI'IIDN ❑ COMBINATION �j]iBUILDING ❑ MECHANICAL ❑ PLUM�ING ❑ SIGN <br />PROJECT !.L`GRESS: lU U p�� _ �s''.'" �(� � �: <br />OW11E11 Mu�AfH1qE55 <br />,f cirv nr rnor�E <br />lf�LvS+'ii�Ay ��Nlr cw /54/ --LyYa���� s� /%i�//���er/l i1�::it �iL. r,'t.. <br />1ENql1 �MINIDl1C55 CIIY <br />enCUIT[�TOODE'.�GNFn MAl1.1ppRE55 ��ry <br />1 �-;��.rJA/li•//�/3�- ",r s"j, �'�i, ,.r � 1r <br />r.eNEnetcoinnec�rn u�n.eouness �i�y - <br />11l A jlrs�,� Lo,c,;f d�A O�� vs-/3��� �e i� s/I!� < �� <br />�ECII�NICA��ONIf1.1G70f1 MtALA��f1E55 g�ry — <br />�_ <br />cor+rnecr rnice c= � <br />nescnme vronK um �, <br />�7 <br />C <br />���ioivseo use ov nuitnu�c <br />�r e 5 � d p u�4-i <br />�.ec�� oescnirna; or rnoren <br />I or .3 _ oiocK _ <br />�nn�E� r�x i.o. r+uknEn <br />.3'rl%O,Onn- <br />:dlSlfiUCIIDN IOnH LENOEIi, M <br />�VtoAl'%�,er f <br />s �'L. - � <br />- c> zs - � -i�/�� <br />SInIGIIC[NSE � <br />�i7 l L �' * .1��(. G <br />SterE LiCENSE . <br />IA�IIFpDR�55 . . .. CIIY IIP � — % � r `h o!-O/ 7 i-t '� <br />PuONE SI�IEUCENSE� <br />13�09- oy� L' MAv� . I Sl i�4O =�o�a ���InPGosr,�g <br />HEATING SYSTEM: Q�GAS O ELECTRIC ❑ <br />�r�ce iNvo�veo cor�uc�yr cnsor+eHn ruor�e rio <br />_Y" � '� ' .�S -S �/4 � v <br />OELOW <br />_ or1 <br />s - n � <br />reier��ar�E <br />TYPE OF FI%TURE OR ITEM <br />WATE'�� CLJSET (TOILET) <br />OATI'.7 UO <br />LAVATCI(1Y (WASH BASIN) <br />SHOY��fi <br />KITCFIEN SINK 6 DISP <br />DISHN:.45HER <br />LAUNURYTRAY <br />CLOTFiES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOfi DRAIN <br />BACKFLOW PREV[NTERS <br />SINK (SERVICE — BAR, ETC.1 <br />1 HEFlE�Y CERTIFY THAT I HAVE READ AND EAAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BL TRUE AND CORRECT ALL <br />PFOVISIONS OF LAWS AND Of1DINANCES GOVERNING TfiIS TYPE Of <br />WORK WILL �E COMPLIED WITIi WHETHER SPECIFIED IIEREIN OR <br />uturwocor�esl NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />�/% �c c� �'{ 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 A61 AUTHORITEG BY THE <br />OWNEfi OF TfiIS P(iOPERTY TO PERFORM Tf�IE WOqK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WlTfi THE STATE <br />CONTRACTORS W 1027 RCW AND 276.200 WAC. <br />/ � <br />rE" x ` u���J'lcG'4�.�� /'a� - % 7 <br />�-S'S a7 - -0`r` sm�nrine <br />OAtE <br />QTY OUSWESS LICEHSC 110 <br />MECHANICAL <br />SU� TOTAL 5 <br />PERMIT S <br />TOTAL FEE E <br />OR OFFICE USE ONLY: <br />no�+T sern�r.H � nr:nn sern�cK <br />_�� 7-c7 <br />SE to11E ✓ I lol �nE_ 59 / <br />ElGlli U41iA11011 / NO 0( UWELIING <br />rl �� UlU15 <br />[i(". <br />C�UPANCr rq Or SIONES OCNPANt LOAD <br />�E AlAf11A fiCO'D <br />irE or r.pr�sr � <br />_.l�--N <br />nE <br />J ISIUESEIDACR <br />� <br />FEE <br />� <br />TYPE OF EOUIPMENT <br />A/C — MiNDLG UNITS <br />FORCED AI(i SYSTEMS <br />FIEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYERS <br />MNGE I i00� <br />WATEfl k IEATER <br />WOOD STOVE <br />ME-TAL FlREPLACG (WOOD OURNING) <br />FlREPtACE INS[RT (WOOD OURNING; <br />GAS FIREPL.ACE <br />GASRANGE <br />GAS PIPMG <br />EXf-IAUST fAN <br />SUO TOTAL 5 <br />PEFMIT $ <br />TOTAL FEE S <br />rieucuer.K�+uunm reF necemrun <br />� `/�3/ "' � <br />J <br />� vnc��n sne - FEES <br />Oves O No nuunnm <br />SIZE O� pLU(i�1 — <br />%IZ `'-�'.S/ S,1C rli�unwr, <br />BASEGENI A�ECIIn�lIf.AL <br />❑YES NO <br />nonmorui ri u� curcK <br />pn�En <br />� sreie nunou+c snna�nnce <br />CITYOFEVERETT rumir.wonhs <br />LOCALSALES <br />TA% CODE IS 9105 707AL <br />` <br />_�; S�> <br />r7 1 ' , i <br />— ;— <br />'� <br />r_� j <br />