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APPLICATIC& .'OR CONSTRUC19N PERMI04tr <br />CITY OF EVERETT A BUILDING DIVISION <br />32DO CEDAR STREET A EVERETT. VIA 982DI A 257-9810 <br />D DEMOLITION ❑ COMBINATION BUILDING ❑ MECHANICAL Cl PLUMBING Cl SW <br />PROJECT ADDR SS _ - y2,_ yr 6 UE/LL5'[I L A <br />TYb[n YML A. IT. Ol LP 111d1F <br />MAIL <br />LTA ALA& 6uc-ro <br />IP <br />AIShnECT ON atsIoNin <br />MAIL ADp1[55 <br />CITY <br />IP Ag14 <br />NO PL'Ts% <br />X,rITT, T-� <br />OEMRALCCNTR 1011 <br />MARAONE 55 <br />CIT, <br />IP "NONE STATE LICENSE• <br />N 0 tiw <br />'?,-A LL <br />M11.4AWAL CONIn ILM <br />MµLATgRiSS <br />C111 <br />IP Alpr[ STAB ICENS[A <br />%UMBIMO CCNTNACIOfI 4Am ApCNESS Clri )P nY}S STATE LSENSLA <br />canrn.Ci MILE OF Wp1e <br />HEATING SYSTEM: OAS ll ELECTRIC ll <br />MSCninE.. ANO SOL)ANE IWIAGE 0.V0.VED <br />,IL <br />V <br />CnN1ACr P[I"A nl (NO <br />)col o S Ci %i+ s <br />Gt2 IT, <br />V <br />T+arosEc usE ar eu6rnrn <br />I HEREBY CEgTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TILE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />PROVISION AUTHORITY TO VIOLATE OR CANCEL THE OF ANY <br />OTHER STATE on LOCAL LAW REGULAT-110 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS 21 RCW AND 296200 WAC. <br />Lj <br />A, 1 - -Lo - OQ <br />HGAL Or SCnPigNarnaNnn lsNowrLau ow aN UTACN TNO carrcsl <br />LOT 1 TAMIL S7L-L_ Gr 2'�pJ,_Q T u <br />l�L NAJ 1� V Vey t T) 1 V A IA <br />10Aa,,, <br />PARCEL TAX ID NweEn <br />OI -L ou l a�G <br />cGNsrnmTION LOAN IE1grn A(gnCSS. IH[Pllq{MNB[n <br />SXM.Iu E DATE <br />OTIOUSMSS LICENSE NO <br />PLUMBING <br />MECHAILICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />_FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WAI ER CLOSET (TOILET( <br />A/C - ARINDLG UNITS <br />f <br />Z <br />BATHTUB <br />FORCED AIR SYSTEMS <br />1 <br />_ <br />LAVATORY (WASH BASIN) <br />-E— <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />I <br />DISHWASHER <br />RANGE HOOD <br />1 <br />_ <br />LAUNDRY TRAY <br />iWATER <br />_ <br />HEATER <br />! <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />! <br />FIREPLACE INSERT [WOOD BURNING) <br />_ <br />FLOOR GRAIN <br />I <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE -BAR, ETC) <br />! <br />GAS PIPING <br />! <br />Y <br />EXHAUSTFAN <br />_ <br />i <br />I <br />SUBTOTAL 3 <br />SUBTOTAL f <br />_ <br />PERMIT 3 <br />1 <br />PERMIT f <br />TOTALFEE f <br />L <br />I TOTAL FEE f <br />_�- <br />FOR OFFICE USE ONLY: <br />In0"I 6E19AEel <br />SEAT SETeµe' <br />SCE SERAL; <br />IYN1 Cr1EC=MA16[R <br />FEE— <br />MCEYr <br />�// <br />USE 1. <br />IOIAREA VKANT STEE <br />FEE <br />VALUATION <br />FEE <br />� �_ <br />n Yrs nw <br />= AUM[MMI WE O[I, <br />IIiIT'i' v.Ich <br />UM16 <br />Y b1u 5 <br />[,IAdM <br />WONAMCµ <br />MCWANC. <br />Ma STOATS <br />MCWANT InAO <br />6AMMENI � <br />If, <br />nr[s KNo <br />AWNgxµ 0.µ[OKC11 <br />f lnf TMUMIIEn RI00 <br />n[ASMI <br />01 HR <br />IPIEALARMMEOO <br />NELSON <br />SIMF 611epID 6UT10NAM1F <br />11PEOIcm" <br />PlAMSAMIpVLo e. CITY OF EVERETT <br />AXmclraas <br />LOCALBALES <br />TOTAL <br />— <br />GATE % L7 TAX CODE IS 3105 <br />