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APPLICATIvN �OR CONSTRUC . .ON PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION GC±��� <br /> 3200 CEDAR STREE7 • EVERETT, WA 98201 •259-8810 �� <br /> ; I DEMOLITION i CO�aB�NA710N y4 BUILDING MECHANICAL ' pLUMBING � i <br /> PROJ T ADDRESS SION <br /> ow,H,,c/n� �7�) �`y.�M-��'n.Ann,n�r<s � .� , ) � C�"�� <br /> / /7l.'ri Y '(+ �/��.] �:irv rir <br /> r�wn¢ <br /> ;F���r -��� _�3��1—y��'�� �u,�'/��� 9x�� s �y�� <br /> Mui enonres ;-�� <br /> rNONF <br /> •qCrlrtrcrOROF51GNCq MM�qM�n[55 - ---' <br /> io�,u.S �st <br /> GIY llp <br /> �NE ��„ ����, �� ��3 �y�% <br /> r,eHFnq cor�m�cicm v n�coness � <br /> �°v nn rru�Nr <br /> J' 7 StAI[LICFNSF� <br /> MECN�NICAL CONTR�CTOq M�II�DOpE9S <br /> f�ry 7�� PIIJNf <br /> tiGfF UCF.NSE� <br /> PWMBIN(3LONTR�CTOR M�Il�00RE34 CITV �-- <br /> l��' PHpNF SiATE LICEkSE� <br /> Cp.fP�C�PRICE Of MYN1N <br /> HEATING SVSTEM: p(GAS f 1 EIECTRIC fl <br /> o�xmaE won u+o �RE FOp1� e iHvoiven <br /> CON�A�T pFN50N�NO PlqqF 1q <br /> �v,�1 ; �, i--1�'�L� <br /> �._ # � lv 7 - <br /> I F+FREBV CERTIFV THAT I HAVE READ AND EX.AMINED THI,i <br /> v oseo use r eimp o -- — APPLICATION AND IWOW THE SAME Tb ffc iRUE AND GORRECT ALl <br /> ��qy` PROVISIONS OF LAWS AND ORDINANCES GOVCqNIN6 THIS TVPE OF <br /> lEOQ0E5GFIP110NPiPqp(�qry�5/p" wripe p��� Htwocorie; WORK WILL BE COMPLIED WITH WHETHEH SPFf,IF1ED r1EREIN OH <br /> LOT PI.Of.M. Of <br /> AUOTHORETVOT O TVIOLATEAOR`AINCE�LE THE PROVISION OF�ANV <br /> U(,�d(�'�j�� OTHER STAiE OR LOCAL LAW qEOULATING CONSTRUC710N Oq THE <br /> -- PEHFORMANCE OF CONSTRUCTION THAT I AA7 qUiHORIZED BY THE <br /> � /'� n�� OWNER OF THIS PROF�ERTV TO PERFORM THE WORK FOR WHICH <br /> � _w T/77— � APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> r� Ei r i o rttma CONTRACI ORS LAW 1827 RCW AND 296.200 WAC, <br /> ����K �ys_s5a3 ��li,�o���� <br /> CONSiq Nl0 NLFNOER E59 t/F.�' � NU� <br /> x i/-i6-9 � <br /> SION1t E <br /> ��lE <br /> f.ITV BUSIME55 L0.1EN5E HO <br /> PLUMBINO <br /> �fECHANICAI — <br /> N�• TYPE OF flIRI1RE OR ITEM FEE NO. TYPE OF flIfTURE CR IfEM <br /> WATER CLUSET(TOILET) � - FEE <br /> 'Z BAIHTUB aC—�NDLp 1 MITS--H.�. � <br /> ' FOFCEUAIRSYSTEMS-- BS.U. M E.A. � <br /> LAVATORV(WASH BASIN) HEAT PUMP <br /> SHOWEH � i <br /> ' UNIT HEATERS—B.T.U. M � — <br /> KITCHEN SINK 6 DISP ' � CLOTHES DRVEHS � <br /> / UISHWASHER � — VENTILATION FAN � <br /> LAUNDRVTRAV � <br /> CLOTHES WASHER ' RANOE HOC�D i <br /> URINAL — ' I WATER HEATER � <br /> -- ' WOOD STOVE � <br /> __ DRINKINO FOUNTAIN i METAL FIHEPLACF.(WOOU BURNING) +� <br /> _ FLOOF DRAW � FlREPLACE INSERT(WOOD BURNINO) <br /> BACHFLOW PREVEMlERS � '— <br /> SINK(SERVICE—�AR,ETC,) ' I OAS FIREPLACE i <br /> OAS RPNOE � <br /> T <br /> ' ans riPiNa — — ; – <br /> i FxHAUS'f FAN <br /> __— <br /> i � <br /> i i <br /> � <br /> � T <br /> SUB TOTAL f �� ' SUB TOTAL § ,/y-5! <br /> _ PERMIT E � PERMIT s ��t— <br /> _ TOTAL FEE � � TOTAL FEE E � <br /> FOR OFFICE USE ONLY: <br /> lRONT SFfN�� �� ..� RF�?G��PA�t�� cI�F SELBAf.N VI�N CI .�n i�I � FEE 3 J qECE1P7 NO�� � " <br />( — � ! <br /> 1 L S �� <br /> usE�oy�, IOi�qEA wreHr re fEE6 VALUAnON <br /> �- I 0 l�G �jZ � FEE <br /> E5 (1 NO <br /> I�EIOIITL�MIT�TIO BUII�IN(1 O� �I� �-�.� _ <br /> Zy � NOOfOWF/LING S1�O�W�I� T <br /> a �,��,5 <br /> O � PIUMfiMA / <br /> UCGUP�Nf,v µ�p SfuaffS OCCUPAN;10�p � S �'~ G� <br /> OROIIP w BASEMFNI - <br /> 3 � '+ f1VE5 F�p �Ef.N�NIC�L <br /> i <br /> lIRE�URM REO'0 qFA30N — �bpT�ON�L PLAN CHECN <br /> �,/o - <br /> FIRE9WMNMlERREOD RF�SON ---__ Oi11ER � <br /> V SI�IE BIIIIf.NNG SUIICIUqpE <br /> � /� <br /> TYPE OF CONSi PI�NS�PPRqVE�P1' - - - — — <br /> 1 CIl'Y OF EVERETT ruxiir,won�e <br /> �_ �`� �l I� I Or,AL SALES — <br /> _ ��tE IZ.�G - 7AX CODE IS 3105 701AL _ � �,7 , � _ <br />