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� //� � <br />�� � APP�ICATIO_, FOR CONST�3lJCT1.rN PERlVIiT <br />CITY OF EVERETT • DUILDING DIVISION <br />. 3200 CEDAR SIREET • EVERETT, WA 98201 • 259-�810 <br />Q DEMOLI'I IaN O COMBINATION p' BUILDING O MECHANICfiL �] dLUM01NG O SIGN <br />PROJECT f,L`DRESS: /U✓ :- �- - ,f � " ..�� �,' <br />i� <br />owr�En u�c.A�nnEss <br />� CIiV ZIP PIION[ <br />ypNsi A �Q'Nc^u, ' /SL//�"ZS"<AUt�ci /�i///�G'fv/i y<U/t - . H,�G. <br />�iG � <br />ierurn T u�iiennness r.rtr rir rno��e — <br />r� nui�� <br />Dy l.) P I �, n. <br />cor+rnec r rnice ci <br />M�11. AO�OE55 <br />J�,a tr c� <br />u.0 eooness <br />C �Ahac� /r� <br />unit nounEss <br />3 �09-30'' ° <br />CIiY <br />��1�IMA/.1� <br />G�v <br />�e t� s � <br />r.in <br />r ��� <br />cirv <br />9�1 `�r t �'� � • �r � '�' <br />]m nunra. ` <br />���' �'nUnE S�Aif IICEN$E <br />ii/�P a�(o <br />yflb� t� yYL- 3iv9 �S%e� <br />zm ruoriE su�GlicBr�sE <br />� <br />u�°7�Ls� 'v�r-��,�s �ya,-�tip� <br />HEATING SYSTEM: C'YGAS Ll FLECTRIC ❑ <br />�_��•���_.,���� ����, auunrm rex�rnce wvoiveu cornncr r OSOR�NDPIIONE NO <br />-��U � -- Yi�i 35�-�,_ <br />^nOPOSED USE O' 13UI1 nINO <br />��r�eu �! <br />.e ,�� oescrairna: ov rnori <br />, or �__ niocn <br />`-' / / V " <br />�nNSInIICtIOy_lonN ll <br />�,'�ow.Rao� <br />neicwon n.c�iiwo <br />_ or� <br />I' <br />-1 A''f c-' <br />�. p z — <br />70nE55.lE1 <br />� . 4,i � <br />_UMtlifila <br />NO. TYpE OF FIXTI <br />� WAT[''� CLJSET jTOILE <br />Z- BATI'.IUD <br />LAVATC157Y (WASH BASI <br />SFIOVlCH <br />/ KITCFIEN SINIC 8 OISP <br />/ DISHN:.qShIER <br />LAUNURYTRAY <br />� CIOTFtES WASHER <br />URINA:. <br />�FiINKING FOUNTAIN <br />PI.00FI DRAIPf <br />BACKFLOW PREVENTE <br />SINK (:iERVICE - BAR, <br />—O D U/ <br />uncn <br />-SJ�"J LUri <br />OR I'i EM <br />SUBTOT�L S <br />PERMIT S <br />TOTALFEE S <br />FEE <br />0 <br />OR OFFICE USE ONI_Y: <br />�or+r sernnr._K �/ nEnn seToncr _� sme stro�cr. � <br />%/ '� 'I.O <br />SE TONE '� l0i �f1FA � � VAC�NI SIIE <br />Lrj � ❑VES ❑ NO <br />�� <br />� <br />r <br />I HEREOY CERTIFY THAT I HAVE f7EA0 AND EXAMINE� THIS <br />APPLICATION AND KNOW THE SAME TO DE TRUE AND CORFECT ALL <br />PROVISIONS OF LAWS AND ORDIIJANCES GOV[RNING THIS TYPE OF <br />WORK WILL �E COMPIIED WITH WHETHEFl SPECIPIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTI-IOfiITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CUNSTRUCTION. THAT I AM AUTHORIZEG DY THE <br />OWNER OF TfiIS PflOf'ERTV TO PERFORM Th{E WORH FOR WtiICH <br />APPLICATION IS MADE AND I COMPLY WITfi TI1E STATE <br />CONTRl.CTO LAW 1827 RCW AND 208.200 WAC. <br />_ � <br />/ � �(�=�ic �. ' L ' i � <br />sic �ru� oe�e .. <br />CITY flU51NE55 UCENSE NO <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT <br />NC -MiNDLG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT ti[ATEF7S <br />CLOTIiES �RYEPS <br />_� MNGE 11000 <br />WATER HFATER <br />WOOD STOVE <br />MET�L FIREPIACE (WOOD �URN <br />FIREPUICEINSERT(WOOD �URP <br />_� G�S FIR[PL.l�CE <br />�_ GAS RANGF <br />� GAS PIF'ING _ <br />U EXI IAUST fAN <br />cnr.cer�uuncn Iree <br />— <br />r-/v.�<, <br />e�cmuuirai r+ � ✓ mmnn+r. <br />+0 (X nwF.ItING SR[ Or nl UGq I <br />mms riu�.miNc <br />(�IZ 4sl SF. <br />CCUPANCY 1qOt510NF5 OGWP�NIl0�0 9ASEA�EN� <br />f10U AIEf.HANIGI <br />f'3 �l- Z ❑vEs Hn — <br />ne POINNLEOflEO'D nresor+ �nnnior�ei.riRr�cncce <br />on�ce <br />ireninnr.�neo�o �— nrnsn�+ <br />suie nunoir,r, sunuunce <br />rrF.ovr,pNSr �-- ntnnSMr�npvEnor — <br />FEE <br />0 <br />q <br />0 <br />SUB TOTAL S � <br />PERMIT S —r— <br />TOT�LFEE E �_ <br />nfr.r�P� uo <br />� , <br />LUATION FF[ <br />_. —____'__—_ <br />�,QJ��O ���/:� i �,-:% <br />_� � ' <br />,) ; 00 <br />—�� ' <br />/: O 1.=�� <br />CITY OF EVERETT runnr.wonns _ �.,�� v�_ � <br />LOCAL SALES �_�— <br />.��{_ _ neiE I 3✓ 9 TAX CODE IS 9105 TOTAL � 7(�; `�"Q <br />