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�'►PPLICATIC l FOR CONSTRUCi.JN PERMIT <br />CIl'Y OF EVERF.TT • �UILDING DIVISION CC� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 � <br />C7 DEMOLITION � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />PROJECT ADDRESS: � M O SIGN <br />S?n7 _ oi-��.�' � vta.J i Ll#� <br />1EN1NT — -�'^"�+"�r. IA/rL �'IXi /1fr��J���� <br />MNi MflnE55 � <br />CIfY 10 lTpqE <br />�A=N�'�, I Ct � DES,GHER Mql ADDqE55 <br />I� A� ��ry l�P PNOHE <br />y�i,��-u.�f� %��� /�I��JSC�I {�/F �j.�,,�,�,, � /� O <br />c¢Hen�icor�in�cron uu��ouness •-`�'—�Q-�—��— ( $Dii77r' //(a� <br />���Y, T�� PiIONE $4fE UCENSE � <br />4EC�Al NTR�C70R u4l��OqE$5 T � <br />��ry ��P P110NE SfRE I�CENSE � <br />PlU4BINGCONIR�C1� 'ZO. �� �"`>— ��'�/ ��l F7�tF-rr %((ZOK i��".�X'� t3[.l��Motirco� <br />OE RIB YpqN 1Hp �Q���� ippTAQE INVOlVEO <br />2� t2 S� '�t�lYIL_ /{(�A <br />_ I � .5� 5� nv,}� / <br />- �°y`1 sF i�oa� m.---� <br />.o� _ � eiocK <br />rHtiEL TIq I D. NU4BEH <br />CUHSIqUGryp��ONILENDER./�ppqE55.iElEPHONE NVMBEB <br />NO. TVPE OF F. <br />; WATER CLOSET(T <br />BATHTUB <br />LAVATCRV(WASHI <br />SHOWER <br />L KITCHEN SINK !1 DI <br />DISHWASHER <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAI <br />DRINKING FOUNTAI <br />FLOOR DRAIN <br />$UB TOTAI S <br />PERMIT s <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />fROHfSETB�CR RE�N SETB�LN <br />70 — �� <br />USk ZJNE 101 �ItE� <br />-� _ 6 7 � <br />NE�GHf 11MIGilOH HO O[ OWEllIHO <br />2a uHirs <br />OCCUG�N�Y Hp (M SI(WFS OC[UVINI �p�D <br />GnW <br />�3U1 Z <br />�iRESPRiNNIEqREO'D flFnGtw <br />0 <br />HEATING SYSTEM: �GAS O ELEC7RIC ❑ <br />f'ONf��f VERSdIN10 PNONE Ip � <br />s - � - � <br />I HERCBY CERTIF THAT I HAVE REA AND EI(AMINED THiS <br />APPLICATION AND NNOW THE SAME TO BE TRUE AND COHRE(;T ALL <br />PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PqESUME TO GIVF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTNER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR Ti IE <br />PERFOPMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED 8Y THE <br />OWNER OF TNIS PROPERTY TO PERFORM TI1E WORK FOR WNICH <br />APPLICATION IS MADE AND I COMPLY WI�H TriE STATE <br />�TRACTOf�151,Y�y� 1827 RCW AND 296.200 WAC. <br />���.,��9 .�� r��,�, o�r <br />� <br />��� rneaa �n�[NSE N0. <br />AECHANICAL <br />N0. TYPE OF EOUIPMFYT FEE <br />NC — NMNOLO UNRS <br />FORCED hIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES �AVERS <br />RANCEHOOD — <br />� WATEH HEATER <br />WOOD STOVE <br />_ MEfAL FIREPLAC[ (VJOOD BUfiNING) <br />FIREPLACE INSE{7T (WOOD BURNING) <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN , <br />i <br />i <br />� <br />r <br />. SUB TOTAL f <br />PEFMIT s <br />TOTALFEE f � � <br />S�OESFTB�CN �IAYLUECNNUMBEII <br />,� � , <br />�Y <br />VAC�Hi r[ FEES_ <br />YES ❑ HO <br />eunown <br />sit[ nv eioan i <br />Z�uL �JJ S F. �IUMBING <br />BA IAENi � 4FCN�MC�L <br />❑vE5 .�Np <br />�00�40H4 MANCHECN <br />O1HEI1 <br />�SGIE BUilOi'+C SIIRf.H�ll(lE <br />CITY OF EVERETT r�iniir.wonKx <br />LOCALSALES <br />TAX CODE IS J105 TOTAL <br />iEF REf.EIPf NO <br />VALUATION FEE <br />Z�/ Z `�� ' � <br />� � <br />r% � <br />Y' �' <br />