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� <br /> � APPLICATI�..� FOR CONSTRUC7 .ON PERMIT <br />� CITY UF EVERETT • BUILDING DIVISION � <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br /> 1 <br /> f 1 DEMOLITION �Fj COMBINATION I � BUILDING i � MECHANICAL ' PLUMBING I ! SI <br /> PROJECT ADDRESS ��/�O ��ey Re �'✓�k'� <br /> .� <br /> o_inr+en u�n �nonrss arv nr r�ro�+c <br />� �oNN Q. �Nal,¢S /Sy=o Micc teFEK BA✓d."`u�a/ ,Iliu�Qe�(���Z ao6- 7y1-A96G <br /> 1GN�NT �mn �nunvss crtv tir <br /> �RCNRfCf0�OF5iGNCR M�i111P0�F55 <br /> --- _-- Gllv /R�_"——19m4! � <br /> i�A✓�tfSA,CsicN /�y3 �li 2� S,�Afrte--9P/sS _. __a°6• 362-z?42 ---- <br /> ;��. ��,,,,,�< <<��� ��«vs�. <br /> �FN�`�p,A�oN,���,� M�n �nnnr55 So°� it.c��eE�K 9PogL .2a6•�yt-89�QS�a�a97�2 <br /> 7�J `� Re� deX �a99� � --- :i�rriicrr�cF. <br /> �IFCN�i11U1 CONiR�f.TO� M�II Pf1I1fIF55 CITV Ii� P�IONf <br /> ���,�r�Afi�/d RD..BoX 336 .1��(E�EN.i_9P2SP .?dd�33 •y/// PU4ft�{,26y_Y D— <br /> H1IMPINCf.ONiP�f,tOR MA�I �ODPE55 <br /> fllY 71r r110NF SrRiP IACFNSF. <br /> W�AtiAM ADA�S N�. 2G- ���A✓E.[J• .CYNNNAo4 J�o����'�-�6•�27 WI�tIRI • H 47 __. <br /> cowrnecrrmcfurwonK s��C• __ HEATING SYSTEM: I � GAS �ELECTRIC ( � _ <br /> S�.RIBE WOpN�ND S011Af1F FOOUGF.INVIXVFD <br /> r.oN*�c�rr nsou nNn r�ronr vo <br /> �e�ir,e�cr Si,v�te �� iDENtF — — <br /> ,cir�as i�93 S r 6AQA� �Y/� S.� - <br /> "-,�'/ ` C I HFREOV CERTIFV THAT I HAVE READ ANO EXAMINED TH�S <br /> D�G/f S I�Q J r APPLICATION AND KNOW THE SAME TO BE?RUE AND CORRECT ALL <br /> ��os S/NG�IE'j��,�y p�,ac�cE WORHSWILL BC C MPLIED WIT�H WFETHER Sf'ECFEDHHEREPN OF <br /> iea��.oescnirtior.o�rnoPeA*risNowr+neiowon�rrec��iwomriesi NOT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �p/ZOL�I6� AUTHORITV TO VIOLATE OR CANCE� THE PROVISION OF ANY <br /> ioi z pLOCK ° OTH[R STA1E OR LUCAL LAW HEGULATINO CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.iHAT�AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPEiiTV TO PERFORM THE WORK FOR WHICH <br /> APPLICAT�ON IS MAOC AND 1 COMPLY WITH THE STATE <br /> CONiRAC LAW 18 27 RC AND 296200 WAC. <br /> ru�ce�u�ioMiMeeR O2o /,2- 'f�'S <br /> y00o- OiDO• 03�• <br /> ��GONSTRUCtON10�NIF.N0ER11 �FSS.TFIF.PHONENUMPFf1 x - DAtf <br /> e; a •b4� .tYNAldlIIG,��6 51CN �,�� �a�e <br /> w / �a�- ^��� t��� f.IIY flU5MC55lIC[NS!4U ___ _ _ _- <br /> P• � � — <br /> PLUMBIN6 MECHANICAL <br /> FEE NO. TYPE OF ECUIPMENT FEE <br /> NO. TYPE OF Fl%TURE OR ITEM � -------- ���- <br /> WATERGLOSET�TOILET) ' � A/C-A/HNDLOUNITS-H.P. .-:—�- <br /> � FORCED AIR SYSTEMS-B.T.U. M E.A � _ <br /> BATHTUB ' � HEAT PUMP � <br /> LAVATORY(WASH l�ASIN) � UNIT HEA?ERS-D.T.U. M - <br /> i SHOWER —� CIOTHESDRVERS ' <br /> KITuiEN SINK 8 DISF _ ' -- � <br /> DISHWASHEFl � VENTIIATION FAN _ � <br /> � � � RANGE HOOD ' <br /> LAUNDRYTRAY � <br /> CLOTHES WASHER � � WATER HEATER � <br /> WOOD STOVE <br /> URINAL METAL FIPEPLACE (WOOD BURNING) � <br /> DRINKIN6 FOUNTAIN � FIREPLACE INSERT(WOOD OURNINO) _ . j/J; -" <br /> FLOOP DRAIN � <br /> GAS FIREPLACE _ ' <br /> BACKFLOW PREVENTERS ' � <br /> GAS RANGE -- <br /> SINK(SERVICE-BAR,E7C.) GAS PIPING I <br /> � EXHAUSiFPM � <br /> _ i <br /> - � - <br /> � �r peo S � " <br /> � <br /> , <br /> SUB TOTAL S I�T <br /> SUB TOTl�L E � � i — PERMIT S � <br /> - PERMIT S � — � <br /> TOTAL FEE E _ <br /> TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: rrr nrcnri Nn <br /> nr�ncnn�ck ,�t�sern�cK rimia�r��knuunrn \ <br /> ff10NiFFTP�fN �-` � /-� � 1 �� �� '`� _ <br /> V ✓�---- FEE <br /> (� ' - FEES ____ VALUATION _ _.�- <br /> USr 70NF Inr�nE� 1eL�Nt SnF . ____ /� <br /> �n /14[c � Ilu 1111111)Inl�: �/� �� �_ ���_G.L- <br /> — V< _ Y� _ <br /> YI'.6 nNi cx owciuNc sirr or m�FGA�AG _ - —_--- - -�-- ---- / <br /> ueimauuir�tia 17 D�F - � 4 1� riuuniv, ____.1 .{-_ <br /> E <br /> ' �CCIIP�NCV tM�Pf cp`ai15 IX:CIIv�Ni IOnD H�SFMFNI / MIl'MNIG�I .__.__ _ _"_`�L1�-- -7 <br /> i.nour � ���ts �n - __-___- _-._-__-___- � �J.0 <br /> R_� � 2-- h /� ---- nnnnio.�niri.•.c�ac� ___---- — — .. — <br /> nrE�unMnron �-- �nrnsov __— - — <br /> � <br /> nmrn � <br /> ' ____— '_— <br /> — _ -_.__ _ . -� i <br /> nnFcrniNKicnnenn nrnc� � ��:1L� <br /> �u�r nunorv,=unu�nno[ _ _____ _ <br /> —.__._ _ _. _ <br /> -_ —__--_--- ) <br /> _—_ � <br /> �r�F�;roNci rinNsnrrnnvrnnv CITVOFEVERETT �"�n�'�`� "" .-_— - -�� <br /> ----�-- - - - � <br /> J } LOCAL SALES -_ � �, <br /> r- TOTA� -- , C��,_�_�- <br /> u.,t �z t� SS TAXCODE153105 _ ___ -- <br /> _�N- - L�- - - <br />