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CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259•8810 <br /> O DEMOLITION ❑ Cl)MBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PRQJECT ADDRESS: r� <br /> ��� ��{ � ,� � �_ . �� c: ,l _ �/t/�,. ,, =_;�d � _��� �' � / ��� <br /> j .-9r/�/ _ �'Ev/I.�E '%�G'� % ni'_ <br /> owMea .•+n urn�ess— / ar� a�r r��oNr. <br /> iE1UNT 4�ILAODi1F55 CIIY 7�P ���ONE <br /> /�Gc�i✓Ei� <br /> pqLHITEGTdi0E51 NF8 M��I �ONE55 ❑tV li^ Pr�ONF <br /> /�/fA <br /> cENEnucON � IW �I�R�DDnEss O�r 7�r rnoNF 5��1[IIc[NSE� <br /> /V /� <br /> MECN�HI�T MAIIAD�RE]5 Cltt llf� 1'I�ONL SiATF UC[NSE• <br /> PIUMBINGCONIR 10R M�iU00RE55 CIIY 21P P�IOHF $T�IELICENSE� <br /> �p1TMGTPRICEO�WO��K/J L�.;�/ HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> OESCMBE W01iNAND Sd1APE FOOTK.E WVOlVEO f.ONI�CT PE{i50N�NO PH F NO A ��y � C I � O <br /> )u,� �(�«7�i/ V lN � .� <br /> E J��1Jlc�lc'� �'fJ �'i"G f 8(0� ' <br /> I HEREBV CF:RTIFV THAT I HAVE READ AND EXAMINED THIS <br /> _ APPLICATION AND KNOW THE SAME TO 6E TRUE AND CORPECT ALL <br /> vnoros[ouse a'auaara n,� PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> /w� � WORK WILL BE COMPLtED WITH WHETHER SPECIFIED HEREIN OR <br /> iE��x� 7ppppppq+Ep7y�yqWNBElO'MON�T1/�LNTWOCONES� NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME TO GIVE <br /> ior euicK or AU7HORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> (/{G,/ SD, OThI[R STATE OR LOC:i.LAW REGUUTIN6 CONSTRUCTION OR iHE <br /> � �y'T � �' �/7�� PERF�AN OF CONSTRUCTION.THAT I AM AUTHORIZED 8V THE <br /> p���� ,,/ OWN OF Thl P OPERTY TO PERF M THE WORK FOfl WHICH <br /> (�E'U`r/<<�� ��/L�� VO[ I�_ �� � /✓Of/iVI1�J� APP CATION IS MAD� ND I OMPLV WITH THE STATE <br /> pu�ce�ux n. �a CO TRqGT .. W,19. R W 296.200WAC. <br /> 00 �' oao �'� J � <br /> CANSTPUCTId1lON1 LENOER.�DOf1F55.TEIERHINF NUMRER x I'~�"'� <br /> 90N� _' � U�TE <br /> QT`!6UiINES$ll;,l'NSC IIO <br /> PLUMBINO MECIiANICAL <br /> IIp. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAtER CLOSET(TOILET) � A/C—lVHNDLG UNRS ' <br /> BATHTUB ' FORCEU AIR SYSTEMS ' <br /> UVATORV(WASH BASIN) r HEAT PUMP ' <br /> SHOWER ' UNITHEATERS � <br /> KITCHEN SINK 8 DISP � CLOTHES ORVERS � <br /> r-- <br /> DISHWASHER � RANGE Ii00U ' <br /> LAUNDRY TRAV ; WATER hIEATER _ � <br /> CIOTHES WASHER i WOOD STOVE „�_ <br /> URINAL � MEfAL FIREPLACE(WOGD BURNING) _ � <br /> DRINKING FOUNTAIN FIREPLA(:E INSERT(WOOD BURNING) __�_ <br /> FLOOR DRAIN � GAS FIPEPLACE ' <br /> BACKFLOW PREVENTERS ; GASRAN3E � <br /> SINN(SERVICE—BAR,ETC.) GAS PIPI�IG ' <br /> EXHAUSTFAN � <br /> _ ' <br /> i <br /> — � <br /> � <br /> i <br /> __ <br /> SUB TOTAL f _ SUB TOTAL f i <br /> PERMIT S i � PERMIT f � <br /> TOTALFEE f ' TO�AL FEE f ' <br /> FOR OFFICE USE ONLY: <br /> iRONT SETRALK RF�R SFTBACN SIUE SETB�Ck N�NCIIECs HUMOfn ff F RFf.f��f NO <br /> �! .+- / I �'��=i (� <br /> USE IOHE im�ne� V�f,ANI SIIF. FEES ____ VALUATION FEE <br /> �� � ❑YES ❑ NO fllllllllllf — I�/ 7 0 ��� <br /> Y1�_G�1 � <br /> NEIONT IIMIT�T`� / MN110!DWELLING SIZF Of BIOG/TI --- --' "--- � <br /> .S , G Q riuunwa --F-- <br /> � <br /> p�`�'P11NCY 1q(NSIMfS OCCUP�NIIU�U B�SFMENI �� MFC���N�f,M ----- --- _— _ <br /> ❑vE5 LTN�� — - <br /> � �D(NIIONM PI�4CMlf.K � <br /> FIRESRJNNLERNEU'0 RfA50N _ - �-- <br /> OI��FP <br /> iIRE N.WM REO'0 ANS(A+ <br /> Si�IC PIIIIUINf SIIf1O��Of•E �� � � � 7 <br /> irvEorcor�sr ainq5errnov n r CITYOfEVERETT runi�rwnn�s _ _ __ _ ' <br /> LOCALSALES � <br /> �u ��„�E W TAX CODE IS 9105 TOTAL---_-------- _—--- I�� E�� <br />