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APPLICATI�I FOR CONSTRUC'1�N PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8870 <br /> DEMOLITION G COMBINATlON ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING i._i SIGN <br /> PROJECT ADDRESS <br /> �oZ wR <br /> avxcn u�rtbontss crtr zc rrqv; <br /> �b'ps�( �L qoi w Mk�N AuB�[.W 9P�1 Z53-351 -5opf <br /> �cn+r�r uuiwrncss crtr zm nro�¢ <br /> (OVER-S PRCKhf.F �� `� `� r� <br /> •RGNR6LORpESqtM1P MMl�:qrC55 Clry Ii PnONC <br /> 0[MRqCONtPICiq1 M�M1I.pCPL55 Cli� IN RIOII[ SiI.lEL1CCNSL� <br /> WES 6uPf Cr�uST z9445 2;ZriD &KK OI�Noub 98010 zss 83BOG3o W�SguL,,�ovac� <br /> MCCN�NCqLONiOALiOR N�II�W^I�E'vS Clb IV %1GNC SUIElKO4F� <br /> ttVUB11qtOHiMCIM Y4tA0.MiE55 Plv Z� PNONE c1R[LrCBR[. �_— <br /> CONiRI.GTPRKEOiN ���� <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> ocuaiecxonxu�osau�nc oor�ccrv:avco cpn.crrEasonr,Hoewr.Er.� No� <br /> nE,n_ o� R�P��� - e-ot,�o <br /> uJS1��0/J��N FL'r�NT � . �� �j <br /> �Z I HEPEBY CERTIfY TMAT I HAVE READ AND EXAlAINED iN15 <br /> APPLICATION AND NN01V TNE SAME TO DE TRUE AND CORRECT.ALL <br /> rnwvsm usE or ouuDrta PROVISIONS OF LAWS AND ORDINANCES CaOVERNING TNIS TYPE OF <br /> ` WOPK WILL BE COMPLIED WITH WHETHER SPEQFIED NEREIN OR <br /> im+�ocscewiror�avnoMnrvQ1sw1�wre[�owone**ec�H1rv.ocor�[s� NOT THE GRAN7ING OF A PERMIT DOES NOT P7ESUMF: i0 GIVE <br /> io*�_o�ae_�_VIS�Ur V AUTHOPITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORIAANCE Of CONSTRUCTION.THAT I Ahl AU7HORIZEO BV THE <br /> OWNER OF iH15 PROPEPTY TO PERFORM TNE WORK FOR Wr11CH <br /> APPLICATION IS MADE AND I COMPLV WITM THE SiATE <br /> vu¢cuu i Hou � � C T ACTORS LAW 1827 RCW AND 296200 WAC. <br /> corrsrm�cna��o+�vicr+ocu.�.�wacss.*cicvr�p��uuetn �,j� ,� ZS� �� <br /> �lU. D�I[ <br /> CIIY OUS�N(SS IiLEYSC 1q <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF FI%Tl'RE ON ITEM FEE NO. TYPE OF EOUIVMENT FEE <br /> WATEFi ClOSET�TOILET) A C—h NNDLG UNITS <br /> BATHTUD FORCED AIR SVSTEMS <br /> LAVATORY pYASH BASIN) HEAT PUAIP <br /> SH0IVER UNIT HEATERS <br /> KITGHEN SINK 8 DISP CLOTHES DRVERS <br /> DISHN'ASHER RANGE HOOD <br /> LPUN�HV TRAY WATER HFATEH <br /> CIA�NES P�ASHER WOOD S70VE <br /> URINAL METAI FIREPLALE pY000 BORNING) <br /> DRINKING FOUNTAIN FIREPLACE INSEflT(WOOD DURNING) <br /> FLOOR DRFIN GAS FIREPLACE <br /> pACKPLOW PHEVENTERS GAS RRNGE <br /> SINK'SERVIGE—�Aq.ETC.� GAS PIPING � <br /> E%HAUSTFAN <br /> i <br /> SUBTOTAL 5 ! SUDIDTAL 5 <br /> PERMIT 5 I PERA7IT 5 <br /> TOTAL FEE 5 ! TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> IHp�iSOE�CR PS[10A�N SIpE5G10AC6 IRWC NNVIIB[P fEE PCCOViNJ <br /> r�- <br /> useuae p� .�cu�i5ire FEES VALURTION FEE <br /> :;res n uo eunoinc � <br /> tiii����•.iu. an ra�ru owciuna s�car azoc���Q <br /> UNIIS <br /> ftUUOmG <br /> ttCI���Kv Ir'JL[SI:B£S OCCUCIJ11lOnD l � 0�5[4ENt YCC4�NCAL <br /> GNW� ' <br /> VJ nr[s <br /> iWES%1'MLCIINEOD PE�SCN �Ld�KKN�R�MCNfiN <br /> G C �� '� ot��n I <br /> rmc�ununiao nE�sor+� <br /> ✓10 �8 sen:owtwr�csuaa+at.� ' <br /> nttorcu�rst n�r�s.>v �mor CITYOFEVERETT �vmcwancs <br /> V _N LOCALSALES <br /> n��E ,S G� TA%CODE IS�105 TOTAL <br />