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APPLICATI�1 FOR CONSTRUC'�N PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERFTT,WA 9BG01•257•8810 <br /> f�l OEMOLITION COMBINATION ❑ BUILDINO Cl MECMANICAL Il PLUMBINO �� SI(3N <br /> PROJECTADDRE53 ��,` A �n�n� .D��-�'�' �VPirf� �IS7�-'3 <br /> awxEn / uu�.00ncss l <br /> .[�'li7 /-�O�(1t'�� hC%I � �rlillt+ �/rcnrElr'r�•�� :v �/.�S7Ci_i ��z=12�Z" '�SS"'�.f( <br /> IFN�N� 4�K��CPE65 CI1Y lb p41E <br /> �uCUR[C�IN�DLSR:�4N WiI�CbP(55 LI\Y IV �11�Irt <br /> OLNEP4Lp�IcnC10n Y i�WnGS Ci�1 IW pUb[ 6OtElC[NSF• <br /> �<" �7.' l"� • r'i il�i r•. !� Cl�� <br /> 4ECM�RN:�LCON� ION 4IiL�CIN�L55 C111 lb p✓��d SI��EIK[NSE• <br /> ItUVBi4(it.`n11Ph;tlM Y��UOJNF55 LOY IW MUME SI�tElKlNSE• <br /> cMUUCI vacF Of M'OBe <br /> HEATINO SYSTEM: I10A3 �IELECTNIC I : <br /> n�s<r.�eEMa+. wsou�n[roor�cEi�y�avFo cwuc�rEn�.w.r�rqr no <br /> /,�: ��c' �P 'vi�-,l�n�� r-��� "� Jr�hn f�r�/�N'r� �/7i-7iZ-'A5'/,Y <br /> I''�I a s � , .- ;�-,j.l�'�.. <br /> I HER6dY CERIIFY iH�T I H�VE REAII ANO E%�MINED iNIS <br /> APPLICATION AND NNOW THE SAME 70 OE 'PUE 1ND CORRECT ALL <br /> veoconov.c a eoao�µ� 4� ^ pROVISI0N5 OF LAWS AND ORDIN�NCES l3UVERNING THIS TYPE OF <br /> ✓ I� WORK W11�DE COMPLIED WITH WHETHEf SPELIFIFD NEPEIN OR <br /> �o-.-�u� iv�p��cs rnor[un�s�qwr�ef�owrn�mc�iwocanRsi NOT TNE GRANTIN(i OF�PERMIT DOES IIOT PRESUAIE 70 GWE <br /> a� � ,�'�b��F i'� ('. a AUTMOPI7V TO VIO��TE OP C�NCEL THS PROVISION OF ANY <br /> OiMER STATE OR LOCAL UW PEGUUTIND(ONSTRUCTION OR TNE <br /> PERFORM�NCE OF GONSTRUCiION TNAT I�N AUTMOPIZED�Y THE <br /> OWNER OF THIS PROPERTV TO PERFOHM T 1E WOfiN FOfi WMICH <br /> APPUCATION IS MRDE AND I COMPLY W:TH TME SiRTE <br /> WNTRACiOP5LAW18 ANDP96200N:�1C <br /> GUK�fLl��lp 1XIMblR <br /> -{'/C._1 - C'C'C' C��`7 -<��(''(?�, , <br /> ro��s�uu�riuu�o.x¢noen� eiss �a[wa�[xuue[n ��I".l ' (� .�'/d�'00 <br /> _—_ / anw¢ o��a <br /> �ci rausnussiKius[ra <br /> VLUMBINO MECNANICAL <br /> NO. _ TYPE OF FIMiURE�N ITEM FEE N0. TYPE OF EOIIIVMENT FEE <br /> WATER CLOSET ITOILETI AC—0.NNDLO UNIiS <br /> BATHTUB FORCED A�R SYSTEMS <br /> LAVRTORY�WASH BASIN� MERT PUTAP <br /> SHUWER � UNITNEATERS <br /> NIiCNEN SINN 8 DISP GLOTHES ORYEFS <br /> DISHW�SNER ' PANGEHOOD � <br /> UUNORY TRAV W�1ER HEATCR <br /> CLOTMES WASMFH � WOOO STOYE <br /> URINAL <br /> �— METFL FIREPLACE�WO00 BIIRNING� <br /> DNIlKING FONITRIN fIREPIAGE INSERT�WOO�OURNIIlG� <br /> FLOOP DFAIN ' r_ GAS FIREPIRCE <br /> OACNFLON'PREVENTERS GASR�NGE ^ <br /> —i— <br /> SINN ISERViCE—DAR.EiC I GAS PIPIN6 <br /> E%NAUSTFAN <br /> SU�TOTAL S SUBTOTAL f _ <br /> PERMIT S °ERMIT S _ <br /> TOTRL FEE S TOTAL FEE S _ <br /> FOP OFFICE USE ONLY: <br /> !I 1�'.f�p�[n Pf�RSClBK� SYKS[�B�L� R�N�11[CYHUMBEII ffE'^ /f(/)/ ��(CFIV�M <br /> . �� --, ; :3cacca-o33 .� , <br /> ,�i�.`y , iot•m� •c•rv�v�e FEES VALUATION FEE <br /> f' � �r[s ".iro wnoixa � <br /> i•1��r.1�iu.1�1�J1 1Y101UWCLlir�"� SltfqPltx:ll <br /> �„��s 3 5 f o�e,c a��e�� <br /> �.��v�rK. wius:.�u cwcwuniwu e�xuvn u[nuHwu <br /> UV � r[5 q <br /> �wESVwiu.�[nnt00 aGOON �W��✓JN�IPI/.NG16CM <br /> o���tn <br /> In�lIL�1�41i(�]1� NLI.St✓1 <br /> � S���F BNID��S�uLu�nOE <br /> ��i�eoico��>� iv��a��,o��.,.it•x� ' CITYOFEVERETT vvemw[w.s <br /> LOCALSALES <br /> �- � �,.,FS /p TAX CODE IS J105 lOt�L <br />