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APPLICA'TI�..N FOR CONSTRUC'. �ON PERMIT <br /> CITY OF EVERETT• �UILDING DIVISION � <br /> 320"v CEUAR STREET• EVERETT, WA 98201 • 259-8810 <br /> � OEMOLITION COM8INATION � BU IDING MECHANICAL PLUMBING � � SIGN <br /> PRO ECT DDRE$S , — � � �S � ���� <br /> ovMFn Ven enonrc< �rtr r�r runrn <br /> -fY,Y?c� 4,/���)tr;� � � =��/y-5�'Iy S LL�� � �S 7y3-��/3� <br /> f=_--- �--�11�r� Lr�c--t8.� <br /> reN�qr nu �nnnrss r nr �m n�nr�r� <br /> AqC111iF.GTOPpE51fiNEf1 M��I��p�F55 Lliv �io i�qONF <br /> 6fNERM CONfp�Ci(M Mql PIXMESS (:�Ir !�f P��qry( ST�TE LICENSE� pL�.,r <br /> e/na� <br /> ��2L/ �/c-�rr�� ?r��. /�3i�/-y�°�l��J �udL�c-v �t�'�75 9y3 3y�loFaQz x ioi,us <br /> MECN�NIC�ICONTR�CTOtI MAII�ODRF55 CrtV JIP P�ION( St�TEI10ENSE� <br /> Pl11MBINGCONfA�CTOR M�Il11DOAE55 f.liV IIP PnONt S��LF.IICFNSE� <br /> CONiq�CT V�ICE OF V/OPK — <br /> HEATING SYSTEM: dLdAS � I ELECTRIC I 1 <br /> DESCRIBE W011 �N� lN1MF IfN AfiF INV01 0 CONI�fi PFRSON�NDPr10Nf NO <br /> �' . _ <br /> I HEREBV CERTIFV iHAT I HAV^ READ AND EXAMINED THIS <br /> PP 5Fo use ur p�nqrx� APPLICA710N AND KNOW THE SAAIE TO BE TRUE AND COFRECL ALL <br /> Z�i� � . / �` PROVISIONS OF LAWS AND ORDINANCES OOVERNINCi iN15 TVPE OF <br /> f�G• �^� WORK WILL BE COMPLIED WITH WHETHER SPECIFIF.D HEREI� OR <br /> �.eauoescnivnor�o NROPERttI �vr+nei or�!!e��r �y,H�prwo�- c�-o''rie N07. THE 6RANTING OF A PERMIi DOES NOT PqESUME TO OIVF <br /> ior�aioc� _.ov� AUTHORITV TO VIOIATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> a�(l/��j�j) PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> ONINEF OF 7HI5 PROPERTY TO PERFORM ?HE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> Pnncci u■i o suMeea CONTRAC?ORS LAW 18?7 RCW AND 296,200 WAC. <br /> Q�O,� -G�2� -[;C� ,� x ����2t//'���-CJ /� <br /> 5 TIONI IFNOf.R � pPF.�iFIF^IONf;1{�p�t � SION� 1RF. 0�E/ /�-y� <br /> 7 J <br /> � ('ITY BUSiNESS LM,RISE NO <br /> PLUMBINU MF CMANICAL <br /> N0. TYPE OF FU(TURE OR ITEM FEE NU. TVPE C:Fi�?OP.E OR ITEM FEE <br /> WATER CLOSET(TpILET) � NC—A/HNDIp UNITS—H.P �— <br /> 'a. BATHTUB � FORCED AIR SVStcNS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) i HEAT PUMi' i <br /> � SHOWER � UNIT HEAT6RS—B 1.U. M <br /> KITCHEN SINK 8 DISP i � CLOTFIES DRVERS i <br /> DISHIYASHER � VENTILATION FAN � <br /> LAVNDRV TRAV � RANGE HOOD � <br /> CLOTNES WA3HER WATER HEATER <br /> _— •i_ <br /> URiNAL � WOOD STOVE ' <br /> DFINKIN� FOUNTAIN i METAL FIF�PLACE(WOOD BUNNINO) i <br /> FIGOR DRAIN � FIREPLACEINSFRTIWOOD BURNINO) � <br /> BACKFiOW PREVENTERS ; � QAS FIREPLACE � <br /> SINK ISEFVICE—BAR, ETC� OAS RAN4E � <br /> 1 OAS PiPPIG — — <br /> � EXHAUSTFAN i <br /> �— <br /> i i <br /> — i i <br /> _ _ ' i <br /> — '' i <br /> _ SU9 TOTAL S � SUB TOTAL S ' <br /> PERMIT E i PERMIT S � <br /> ?OTAL FEF S ' TOTALFEE E �_ <br /> FOR OFFICE USE OkLY: <br /> LRONTSFTPAf.N PF��SF P�f, SIpF5E1 LN PUNG CkNIIMNFR iEF - RFCFIPTN9, <br /> °� IoJP� � S� — [����av ���' /07�I3 <br /> ��se zor+ i o�nnre vnrun=nF FEES VALUATION FEE <br /> �' � P� �O ��.F� �. �n� evn.niN� 7 O Z ��i.1_'�� <br /> r�Fici�ruwTnnn�, No ornwF�.i�Nc cirr �r n1n��r�l � <br /> � UNItS �� ={"�ss�n�y pl11MNINfi C j — <br /> .� <br /> (H:SUP�N�'.v M�ni}Iru�l+ �A.��.uV>H�10<❑ P�SEMENI / MFCN�NiC�I /�� <br /> �:,�3 2 N/r� -- /�. �_.— <br /> f1VF5 �NO � <br /> RREQ�PMPFOU RE�SON �OpIf10N� PUNCNECI( � <br /> N o or„FA ' G?�N _L _ <br /> fIRF.SPRINNLERRE00 pE�50N —� <br /> 1 1 n 51�1E BUII➢�N(i SVRCII�RCE / <br /> � <br /> TvvEovca+st ru�+sarvnaionr CITYOFEVERETT runucwonKs i <br /> �} �� LOCAL SALES — — _ <br /> JL' I.J D�TE L G TAX CODf. IS 3105 T07AL _ -J � <br />