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APPLICATIO�1 FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION �/ <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> I l DEMOUTION f I COMBINATION p�f BUILDINO I 1 MECHANICAL i i PLUMBING I ! SION <br /> PHOJECT ADDRESS ����,— � � �� , � � _� � <br /> owHrn M�il MN111F55 cm r��� /� � rnovr <br /> � Cu�H,,.rS Trva ,�� �s /,� C.9��,va QD�` /a.aL�.�a/T c�.R T�zo � <br /> IfN1N1 M 11�O(MF55 f,ItY 7in PnoNl <br /> A�ti��ot5 ��s t•�. C�4s ,�0 2� 7c i,��s,c�T _/c�A Sdar��l— ---- <br /> Af1fNIlFC�090F.5:ONF11 MIII�O�nE55 atv ]m t9�UNF <br /> ec,�r '.S nS,CIN i�21/ ia/_�T. � �✓� .St r"' 70 ,6'Cc�l/ui7_ c..,4. <br /> --1--a--- -- <br /> aer+ena eoNrnnercm Mnn�o�mess �nv------�� nr rnav� sren ncrNsr. <br /> ���cu G���a:, �c�.s i�rc `iD5 s3....7 ST, �„�:.rK.T �U.�. �S1 -S�o� <br /> MFCNANICq f.ONTMCIOR M�it ADf.(1E55 GTV )IP PIIONF STAif IICFNSF� <br /> --- _�LMCOS/ 77 �-!'N _ <br /> niurmn+r,r,nNtn�r,ta� Muien�ness urr tin mar+F su�e�.ic�use. <br /> coNrn�cT rmr.e nK HEATING SVSTEM: I i GAS � I ELECTRIC f I <br /> �"�-� � <br /> UFSCIIIBE WIXIK�Np SOIURF f(NJT�OE INVdVEO f.ONT�C t PfPSON�NO PIIONf NO <br /> Tic.��nT /r�P,evLRn�,c,rT ��aa o s r� — — <br /> I HEH[BV CERTIFV THAT I HAVE REAO AND EXAMINED THIS <br /> PROI'OSFOUSE OF PIOlINNO APPLICATION AND KNOW THF SAME TO BE 7RUE AN�CORRECT ALL <br /> DF/�iC ri / GtJA-�C NOt.S� PAOVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH VJHE'hEfl SPECIFIED HEREIN OR <br /> iFae�oescmrna+orrnorennisrrowrieeiowwerrecniwocomesi NOT. THE ORANTING OF A PERMIT DOES N�li PRESUME 70 C,IVE <br /> wr____aiceK _or AUTHORITV 1'O VIOLA7E OR CANCEL THE PHOVISION OF ANV <br /> OTHER STATE Gq LOGAL LAW RE6ULATINO CONSTRUCTION OR THE <br /> PERFORMANCE GF CONSTRUf.TION.THAi I AM AUTHORIZED BV THE <br /> OWNER OF THIS PNOPERTV TO PERFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> v�nc¢i ux io r�mueEn -- CONTRACTORS LAW 1P27 RCW AND 298200 WAC. <br /> CONSTRIICTIONIO�NI�NOEf1.�DItRE55.TF1EPNONENUMpFR x //(`(��fj �� CO" �G '! S� . <br /> SICN�TIIR� _ � O�IF <br /> - �3a5 s� <br /> fIiY0U51NF551H:fNSC NO <br /> PLUMBINO MECMANICAL � <br /> NO. TYPE OF FII(TURE OR ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/G—AIHNDLO UNRS—H.P. ' <br /> BATHTUB � FORCED AIR SYSTEMS—B.TL. M E.A. � <br /> LAVATORY(WASH BASIN) HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KIiCHEN SINK 8 DISP i CLOTHES DRVERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAV � RANGEHOOU _�_ <br /> CLOTHES WASHER WATER HEATEP � <br /> _ � <br /> URINAL � WOC�D STOV[ ; <br /> ORINKING FOUNTAIN METAL FIREPLACF(WOOD BURNING) i <br /> FLOOR DRAIN FIREPLACE INS[RT(WOOD BURNINO) ! <br /> BACHFLOW PREVENTERS ; GASFIREPLACF. � <br /> SINK(SERVICE— BAR.ETC.) GAS RANGE _ _ <br /> GAS PIPING +_ <br /> E%HAUSTFAN � <br /> --- — <br /> _—___-- � <br /> ' --T.— <br /> SUB TOTAL E SUB 10TAL E � <br /> PERMIT S i PERMIT f � <br /> TOTAL FEE S TOTAL FEE E _ ' <br /> FOR OFfICE USE ONLY: <br /> fRONTSFTP�CN Rf�OSRP�f.M SIpF5F1p�fY PIANCRfCMN11MOf� f(1 � PfffIPT O <br /> L �1�� Z� ��� �U �/ �O�O <br /> �-- — <br /> usr roNr ioi�nr� vec��N�srtr FEES VALUATION FEE <br /> _—_ __—_ —. ____A_— —�— <br /> : rvrs i�� Nn nunniNc 2 L�� � 7? ;� ��_� <br /> HF1611I I�MIU110N NO Of UWI'LLING SIIE Of flLl%i'il/3. -' � <br /> IINII$ I'oo _/� ,. /, 1'li��'NN� � <br /> _ __--__'_ __ –_ <br /> __ .. __" _'__—__–_--_ �__. _ <br /> (KCt1P�NCv IN�M NOai15 IX:(:UP�N110�D B�SFMFNI � <br /> 6f10111• MI fn�MGl � <br /> I 8 I �,IS kN,l ____ __ _ _ __ _. <br /> rinesununFon� � nr�snr� _-- nnwunwirv•�+cnrcK I <br /> �/y �j� ---�-- � - - . _. _ . .. - . - —-; <br /> GE'�,�1 rin�Gl� ��- ����__.— ����irn ' <br /> .. _ _ . ____ —___' _ __ <br /> rmvsrmru��pirnnrnn nrnsov -----�--� �- --�---- - -� / <br /> � <br /> YI�'7 1( I/ Ftnl! Pu!IUiqu 51inr:r�Aqar �/ <br /> � i <br /> _–__—- "_______. __._ <br /> .. . . _ _ _(_ i–: . <br /> irrvorcor+s� — rinr�cerrnovFnnr CITYOFEVERETT �'���i��-w�����` ; <br /> -�/7� � JM �LOCAL SALES - ------ --- - - f <br /> _`�'v u�rF_ _(p�?('/`IL3+ TAX CODE IS 3105 TOTnL � <br /> � <br />