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APPLICATI� FOR CONSTRUC�N PERMIT <br /> CITY OF EVERETf•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING �SI6N <br /> PROJECTADDRESS: IZ3oJ3ro�of w�,. Eoeiefi <br /> yQl�u �<us of A �+erfr�� N�W �+-�b� ' -�o.✓ /L2o /3i++OL..Av 4t5- 3Y7- 6957 <br /> OWYF11 4��1��U�f55 SIP ! N( <br /> �/] AS /� �o.V <br /> 1[N�YI 4�11�IAYKS$ fJIY 11V I'��M( <br /> qCu�fCiO�fIFLG'�[n 4u11CpnF55 On' A� /'��N <br /> y)S- <br /> /ge... Ne� , cp /��1. /Ier 57�5—L�r�-..O `•$oYt �7P8Y3S /3�..vNce�7u. <br /> r.remu m�arn uui�w+mss nl'' — Tr nxm s��nu �vtt� <br /> 4{C1�1H�[4C.O4I1Uf�UP II�R�fMPF55 f.lry }i� P11pNI [l��fl�C[M$[• <br /> I9u4phGfp�IP�4tIq,� 4�p11%WESS Cllr ll� P�qNf S���fIKCASf• <br /> �T� O <br /> covrn,c� c ur�r+a HEATING SYSTEM: ❑GAS ❑ELECTRIC O <br /> ltf[CRl1f Wy1R14fI5O11�PI�OJ��Gf MVd�EO CpI1�C1 qP5p1�MNKWf Np <br /> :�. - G 31 L2 /• 'r Lo. S SfCoa t�lovy�. _ <br /> � <br /> Ov ci/� 4iS�• 7) G' 8Q�35 <br /> 1 NEPEBV CEPTIFY TNAT I N�VE READ AND EXAMINED THIS <br /> APPLICA710N AND BNOW THE SPME TO OE TRUE�ND CORRECT ALL <br /> �nonosFo ost or nimprn PROVISIONS OF LAWS AND ORDINAhCES GOVERNING TNIS TVPE OF <br /> WORN WIIL OE COMP�IED WITN W�IETHEF SPEGPIEO MEREiN OR <br /> ittunc�o�mrroxpr'qrtnttls�axNeRowdun.curwo[on[si NOT. THE G�7�NTMG OF � PERMIT �OHS NOT PRESUME TO GIVE <br /> �m a:a+ M RUTHORITV TO VIOIATE OR C�NCEL THE PROVISION OF �NY <br /> O7HER STATE OR IOCAL UW REGULATINO�pNSTRUC110N OR TNE <br /> PEPfORMANCE OF CONSTRUCTION TNAi I AM AVTHORIZEO�V fHE <br /> OW4ER Of TNIS PfiOPERTY TO PER�OPM T11E WORK FOR WNIGM <br /> S�c 5•I< �/Ar RPPLICATION i5 MADE AND I GOMPLV WITN TNE STATE <br /> nuK:n w i o mnun� CONTRACTO S lR B 27 RCW AN P9fi 200 WAC. <br /> 3 7z - z39 -o�s- 000z <br /> ca.srn�Krianio�r.irn<rnwmcs�rziu+wMcnwmtn x <br /> •.a� wic nu[ <br /> Oxy 7$6 <br /> o�r euvvczs iK�H•.c uo <br /> PLUMBINC MECHANICAL <br /> NO. TYPEOFFlIRIIPEORITEM FEE NO. 7YPEOFEWIPMENT FEE <br /> WATER CLOSEi�TOILETj NC-M1NOlC UNITS <br /> BATNiUO �OPLE�PIR SYSTEMS <br /> LAVATORV�WASH BASIN) HE4T PUMP <br /> SHOWER UNIT MERTEf15 <br /> NITCNEN SINK 8 OISP CLOTHfS ORYERS <br /> DISHWASHER RANGE MOOD <br /> LAUNOFV TRAY WATER HEATfR <br /> LLOTNES WASHER WOOD SiOVE <br /> UfiINAL b�ETAL FIREPLACF.M1VOOD BURNING! <br /> DRiN1cING(OUNTAIN FIREPLALE INSERT pNOOD BURNING) <br /> fLOOR DR�.IN GAS FIREPLACE <br /> �ACflFL01Y PFEVENTERS GASRANGE � <br /> --i— <br /> SINK�SERVICE-BAR.ETC.) GA$PIPING <br /> -"-" � E%NAWTfAN _+_ <br /> SUBtOTAL S SUOTOTPL f <br /> PERMIT S PERMiT f <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: p - o <br /> I�I�N1V���f� MI.�C(iP�CR SIMSFIB-CR M�NC�ILC4NV4PfR �Ff ,�/ MCI'll'�IA <br /> i�sttrnr io�•n�� v�cw�s��[ FEES VAIU�TION fEE <br /> �j_Z o�ts oru — II1�—�j�' <br /> 11UIMM'. /// � <br /> 1lJ <br /> 1�fIC����l'V:I��IVY NOfYI�WIIIIM SIjFO�BIDG�fI <br /> �wns AnMM. � <br /> _. .__ .__ . _ . _� <br /> IY.;I.iI'�1.� 4��.�"�..q.lf IX-.(IIC�MIIUIII B�Y4[kl VfINI�\N'11 � <br /> I.I�J�II` � <br /> 0�[5 ❑YO "_ ___ __ . . ... _. ..__.._._. _. <br /> �a:i•:r::.,iu�Ffao__' �rc..rn �od�mwinu.o,rc. '__ __ '_ - " _ <br /> - _ omm�- � -- --_- �__ <br /> i�r.T.va�i�uo'- m��m ... � <br /> �.un mr�om� �a <br /> ��r�or.�on� neas�rrnov�n r QTYOFEVEflETT ��'a��,:r�^^�� +(l� <br /> LOCALSALES 1-- - --- - - --- - -�- <br /> ��.�E 1 O TA%CODE IS 7105 Toul _ _ __ <br />