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APPLICATl1..�1 ROR CON�TR�1C1 �OR! PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />f� DEMOLITION COM8INATION I i BUILDING f 1 MECHANICAL �� PLUMBING I I SIGN <br />PROJECT ADDRESS , ) <br />,� � � �� -� �!� j r <br />owr+cn u�n eoonrss arv nr r��o�+c <br />7i�J-�r �'` .�sr Irr ld�/n,' �/��r� /Q!�' Cf- F✓'•'i� �f7c�( 7`''' '!Je' <br />.rN�Nt uu� �noacss r.irr nr r�wNe <br />�ncm*rctont�swN[n uenennness crtr �m — rHonF <br />Ofl/ M1�II�UUltE55 Ci1V <br />!I�•-• %7tM��J �Gw�C <br />MFCIUNIULCONTR�CTO� M�II��[X�F55 <br />PLU�ABING f.ONTp�f,tqi M�II FDDRE55 <br />iYl Ov� <br />pE}CPIBE W09KI1Np. P <br />C41� r�' �t r <br />��n���� _ <br />�i�� _ <br />i.Er,�ioF, mTia+ar�,�i <br />LOT BIOGk <br />�rnxi <br />Y� <br />or�cF wvaveo <br />-� <br />�J_�6' <br />INU —_— , �/�. . <br />—� <br />��SIqVM BELOW qi �f� CH iNp�OPI <br />or � �r� <br />� ,` -�;J <br />)�NIENOER �f%NiE55.TElEPNONE NUMBEfI <br />'ri �IJO)9t <br />OF FlI(TURE OR ITEM <br />BATHTUB <br />LAVATORV�WASH BA� <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASH'cR <br />LAUNDRVTRAV <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVENTERS <br />SINK (SERVICE — BAq, ETC <br />SUB TOTAL E <br />PERMIL S <br />TOIALFEE E <br />FOR OFFICE USE ONLY: <br />fROMS�F7Tp��f.� RFA115FiP�CN <br />!�v D <br />IISF I[1NF I O1 nnFA � <br />_/2." �quS <br />IIFINI11�Mrt�L10N NOIXUWHUNf. <br />28 „N,�� � <br />OI:CUr�NCv M� M ti�nnqc IN:fUv�N110�P <br />p 3�J-I 2__ N A <br />HRE�I�fydflF00 �i�tiON <br />UAIt <br />� <br />Slpf SFTpMN <br />f.ltt <br />� �ti ntir . <br />i . � i.i i <br />7�P PIIONF. S1RFI�CEN5E1 <br />i1P PIIONE SiRF.LICFNSF� <br />HEATING SYSTEM: �GAS f 1 ELEGTRIC I I <br />coND�T�nsa+�r;�,�chr 7�12 /�OrP <br />��-� I HEREBV CEPtIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICAtION AND MNOW THE SAME TO AE TRUE ANO CORRECI ALL <br />PROVISIO�'S OF LAWS AND ORDINANCES GOVEPNING THIS TVPE OF <br />INORK WILL PE COMPLIED WITH WHETI�ER SPECIFIED HEREIN OR <br />NOT. TVIE IaRANTIN6 OF A PERMIT DOES NOT PqESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHEN STAiE OR LOCAL LAW REGULATINO CONSiRUCTION OR 1HE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUiHORIZED BV THE <br />--- OWNEF OF THIS PROPERTV TO PERFORM THE WORK FOR WNICH <br />AP TIO IS MADE ANO I COMPLV WITH THE STATE <br />C NT1A 27 FlCW AND 296 00 WAC. <br />� <br />x <br />SI NQURE ���� <br />CIfY BUSINF55lICFNSC ND <br />FEE NO. TYPE OF EI]UIPMENT FEE <br />A/C — AMNDLO UNITS — H.P. <br />� 1 FORCED AIR SVSIEMS �=BJ U_ M EA. <br />-�— HEAT PUMP <br />� U41T HEATERS — B.T.U. M <br />� CLOTHES DRVERS <br />� VENTILA �ON FAN <br />! / RANGE ilOD <br />WOOD STOVE <br />METAL FIREPLAGE <br />FIREPLACE INSER' <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING // <br />E%HAUSTFAW / <br />SUB TOTAL S <br />PEHMIT S <br />TOTALFEE E <br />rieNr.urcxr�uunrn rn � nrcvirtHo <br />.�i/i�L�i- .'^5'%�'� <br />V�1:11NI511( •�co •nw.....�.. <br />� .rs � N�� nunnrt+r -7�� <br />OI PlfX��l <br />H SF L�v�tirG + riuunwn <br />-0 sF < A�s. ---- ------- <br />P�SEMFN� � � MfC�1�NIG1 <br />I��fS 'vNn — ---____ <br />--- ��IIION�II`IRNGI(CN <br />011ff11 <br />9.1I[ 011119iN6 SIInf,lUfi6E — — — <br />CITV OF EVERETT ����n��� �'+��"�° <br />LOCALSALES -- - — --------��- —� ----.. <br />TAX CODE IS 3105 70TAL <br />�i�� � <br />�- <br />_ _...—�—�F�}__ <br />,� <br />-- �_ <br />__�rc�. � _' <br />__ ./�/1 . ._ <br />� %1 . ( ,� <br />�� <br />