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APPLICATI�►r�l FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT• BUILDItVG DIVISION �C���� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> /P�EMOLITION f 1 COMBINATION r i BUILDING i 1 MECHANICAL i I p�UMBING f I SIGN <br /> PROJEC ,ADDRESS <br /> � <br /> ER M�LL�Dpf1F.5 <br /> r�5�'���1 i37� R m,-,�,,,. � ��rv <br /> Q �/� �.�/�p�� r"' rr�oNc �y <br /> i[N�Nt u�n�nonrss '^`�+��"Y^-L�-L./L�/t'/Xti� 1�.Z�1e2 _�_ 177���C� <br /> � ulr lir rnoNf <br /> �qCMTfGTOPbF51GNfR -----M�II�OUI�Fti�; -- <br /> rnr nr nHor�r - <br /> aEN¢neicor+rn�cron uuieonntss — - <br /> t'itr 7m ri�oN[ <br /> sure i icrNSF. <br /> MFCN�NIUI f.ONiR.1f.T0� M�It A�pF.55 <br /> f�ry ��� PIIONF. <br /> Si�TF LICFNSF• <br />� PLIIMpINGCONiR�f,i(M M�IIR1pqE55 -- <br /> f.�t1' 7�P PIIONE <br /> SiAtF 11(:FNSE� <br /> CON�q�Ci PRICE Of Wpfry( <br /> HEATING SYSTEM: I i GAS ! I ELECTRIC f I <br /> DESCRIBE VY011N�NO Spl1�qF FOpT�GE tNVOlVEO --- <br /> CONUCI P��qSON�Nft PI�ONF NO <br /> '�'�,����,� ��A.�a - <br /> i HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> P�OPOSED USF pF pp��pryp - A{'PLICATION AND KNOW TNE SAME TO BE TRUE AND CORqECi ALL <br /> f'ROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br /> �Eoe� $�RIPTIONpipqppEqry�S�pWNPELOWpq�f7�CMTIM;COMES� WORH WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ipt�_ NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> BLOCK °F AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � r0 / PERFOqMqNCEOOF OCONSTRUCTION LTHATOI pM AUTHORI ED BV THE <br /> � A PLIf'ATIONHISPMADETAND PIERCOMPLVHEWI NRKT ER STATE <br /> P�RCEI Tl1k I D MM/BER CONTRACTORS LA 1 .27 RCW AND 296.200 WAC. <br /> �i c��b oao <br />� CONSTt1UCT10Nl0�NfENffEA.�p(N1p55.fFlEf'NONENUMflFP �//� <br /> ._i✓�Tti��TO�y// " <br />� nrr pusNFss i—�cFNs`� <br /> PLUMBINO <br />� N�• TYPE OF fl7ITUqE OR ITEM MECHANICAL <br /> FEE NO. 7YPE OP EOUIPMENT FEE <br /> WATEq CLOSET(TOILET) -- - - <br /> _ BATHTUB � aC-�NDLO UNRS-Ii.F -'—'?— <br /> LAVATORY(WASH BASIN) � PORCED A�R SYSTEMS-B.T.U. M E.A. � <br /> SHOWEFl HEATPUMP <br /> � � <br /> KITCHEN SINK 8 DISP UNIT HEATERS-B.T.U. M , <br /> DISHWqSHER ' CLOTHES URVEFiS -- � <br /> ' VENTIL�TION FAN � � <br /> LAUNDRVTRAV � <br /> CLOTHES WASHER i RANGE HOOn - � <br /> URINAL ' WATER HEATER ��— <br /> DRINKIN6 FOUNTAIN � WOOD STOVE , <br />� FLOOR DRAIN ' METAL FIREPLACE(WOOD BURNING) � <br /> BACKFLOW PREVENTER—$— � FIREPLACE INSERT(WOOD BURNINO) �'— <br /> � GAS FIREPLACE i <br /> SINK(SERVICE-BAR,ETC.) - � <br /> ' GAS RANGE <br /> � GAS PIPINO � <br />� — �-� EY,HAUST FAN <br /> � <br /> ---'�-- <br /> i <br /> � i <br /> � <br />� � T <br /> SJd TOTAL E ' SUB TOiAL E , <br /> PERMIT $ � i <br /> PERMIT E � <br />, TOTALFEE E TOTAL FEE S � <br /> FOR OFFICE USE ONLV: <br />� �RONf SFTp�Ck RFMI SFTP�Ck ;IfrF SEIp�Ck ppp <br /> PI�Nf.11fC�lll.�lfj ffF f1Ff.HPtNO <br /> USEZONE IOUf1F� �, <br /> �"��"�G��F FEES VALUATION FEE <br /> i�vFs ��, uu --T__ <br /> IIEIOpf LIMIT�iION 01111 pING � <br /> NO Of ItWFILING SIdF Of PI06�1 � <br /> IINqS - _ _ <br /> -i- <br /> 1'111MflINO � <br />� OCCUCANCY NOOISIONIIS OCCIIP�NIIO�U q�SFMFNi <br /> anam ------- -------- ---- <br /> ur��rurncei --{— <br /> il�f5 i� Nn -_. _____ ' <br /> FIqE�UAMfiEOP pf�5(Nl RUOi110Nn1 PInNf��ff.F - -_�--_- - _'-�'" ---- <br /> ____ _-__' � <br /> nnesnniNKiFAnFon nr�cor.� -- <br /> nmr n __-----�____ <br /> �uir nuitrnyr sunnunre ; <br /> rrppprcpNs� rinas.nrnovvnnr -----.- __ I <br /> . ___-_—_-_ ._-. <br /> CITYOFEVERETT rumicwnnxc , <br /> LOCAL SALES --- ---- � <br /> _ .--- - '--- <br /> ��.�� TAX CODE IS 3105 ioinL -- <br /> -- ---1-.-.- ---- --- <br /> — --------- -- - - -�— <br />