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�� � P <br />APPLICATIaJ ; FQ�R CONS'�'RUCTI �t�Y PERMfT <br />�� ` CITY OF EVERETT • �UILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 25�J•8810 <br />❑ DEMOLI'll'DN ❑ COMBINATION �'BUILDING O MECHANICAL ❑ PLUMOING ❑ SIGN <br />PROJECTf,L`C7RESS: �J�/�5-- S�'-"� ,�-�a ;jt- <br />owr�rn u�iteooness em zir ruo�+e <br />I r�-sr,� I11AtI-r cn; /S�//%'LS-��AV[-J't �I///LrN�t' SG��i- ' <br />( �/ G% —X , G,/ <br />�E�i��+� u�i��ouness cnr nr Pi1011E <br />nnc�urer.tonoevcr+tn ueu�oaness cm - nr ruor+e — <br />��sic,r��/i/U !l�ldt= 5,�._�?z. �:'i:•f�.�J �- s. �Go_�iZ$-3�/�'li <br />C[NEf1AlC01110A�10(1 NAllAppqE55 (IIY I'� PnONE SIAIEIILFNSE� <br />uC'.,ti.t dflN m c <br />rwuomc cor�tnac,ton <br />�W 1� 1�t.. � a <br />CONiMCI {�f110E CF W011K� <br />uescnme vron� �nnI s�ounne <br />� LIJ�V <br />.eci.�oescmrna:or vnorentt <br />i or 3 m«;K _ <br />'AnCEITAx <br />//AA/!'i// v///o' <br />noonEss <br />�os-3ayo-�U � <br />INVOLVED <br />oe�aw a��� nnecu iwo coriesi <br />nr /CA�i/il L.oua- <br />SP 18=sr <br />'ODG� �!�1 -CJ.'J,i <br />Nne(. ��unness. ieteriia�e r+��unEn <br />1i'i('�... �� � _i� � � `J.1 07 <br />NO. TYPE OF FIXTUfiF OR ITEM <br />WhTE' � CLJSET (TOILET) <br />,Tz BATI'.IUD <br />7 IAVAT(1IlY (WASH BASIN) <br />SHOWcFi <br />KITCHEN SINK 8 OISP <br />DISHN:.4SHER <br />LAUNURYTRAY <br />CLOTFtES WASHER <br />FLOOfi DRn;N <br />SINN I�ERVICE - <br />SUO TOTAL S <br />PERMIT S <br />TOTALFEE F <br />�OR OFFICE USE ONLY: <br />RONf SEIO�CN � f1E4fI5Ei0RCR <br />� `�' % <br />SE ZONE _ / l01'AIiE��� <br />/G «� <br />CIGIII LIIAIUrION � No W OwELLUIc <br />2� " ��„��s <br />CWPANGY Iq Of SIOPiFS OGCUP�N! LOAD <br />nour <br />'•3 �- 2 <br />nesrninK�cnnca�n � nFnsori <br />iirninnrnnm�o � <br />�/ '` IlA1E <br />.—�.i-�/W_ _ ___ --_ <br />SIUE SFI <br />Cltt <br />.v/NV <br />citt <br />�- U V l <br />FEE <br />0 <br />N <br />0 <br />71P PI101lE <br />49n7� ��ei _ <br />iO�.r���J <br />LICENSE • <br />n✓ PuoNE SUfE IICENSE � <br />Ilo 4�d4 3 i3,-c.�aS ;Va.-����CUS� �I3 <br />HEATING SYSTEM: O�GAS ❑ ELECTRIC ❑ <br />coraec� rr sar� eNn ruoNe e+o <br />�✓ ? :—[i_.//.i �,. <br />I HEREDY C[RTIFY THAT I HAVE READ AND E%AMINEO TNIS <br />APPLICATION AND HNOW THE SAtdE TO BE TRUE AND CORRFCT ALL <br />PROVISIONS Of LAWS AND ORDINANCES GOVEFlNWG THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETIIER SPECIFIED fiEREIN OR <br />NOT. THE GRANTING OF A PERMIT 70E5 NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAI LAW REGULATING CONSTHUCTIOP! OR TYE <br />PF.FIFORMANCE OF CONS'riUCTION. THAT I AM AUTHORIZED BY 7HE <br />OWNFR OF 7HIS PROPEHTV TO PERPORM THE WORK FOR 4VHICH <br />APPLICATION�S MADE AND I COMPLY WITfi THE STATE <br />CONTS�LAW 18.27 RCW AND 236200 WAC. <br />X �i< �- L -' - ¢ % <br />c i run UAIE <br />CI7Y 9VSINE55 LICEIlS[ NO <br />MECNANICAL <br />NO. TYPE OF EqU1PMENT FEE <br />A/C - MiNDLG UNITS ' <br />FORCEO AIR SYSTEMS ; <br />HEAT PUMP — —i— <br />UNIT FIEATEFlS ' <br />CLOTHES DRYEFlS i <br />RANGE I IOOD � <br />WOODSTOVE � <br />M[TA� FIREPLACE (W�JU �URNING) ; <br />Flfi[PLACE INSERT MlOJD DUfiPIINGI � <br />GASRANGE <br />GAS PIPING <br />SUBTOT�L S ; <br />PERNIT S � <br />TOTAL FEE 5 —, <br />rier�cuecKnuunrn IrFr Inecvir�no <br />s Un ? -� -., � <br />V�CANf SIIE YCCJ <br />❑ves ❑ rio ounnwr. <br />SIZEOFOtIN;rtl —' -- <br />(�lz S .$F riulmwr <br />B SEA�ENI AIEOUNICAL <br />❑YES NO — <br />nonmoNn� riui cncr.K <br />onicn <br />� suicnunnu+asunciunce <br />/� CITY OF EVERETT rur�icwonKs <br />� LOCALSALES <br />TI1X CODE IS �105 TOTAI. <br />3J <br />/I <br />