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. ..— <br /> ,-•�� <br /> /�PPLICATI�,N FOR Cl1NSTRUC'r .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> ❑ OEMOUTION ❑ COMBINATION �BUILDING p MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS:__Z�I� ��T��,'�/._��_Ey1�'�T <br /> «� <br /> OMMER M�IL�pOfIFSS CI�Y Ji� Mlpl[ <br /> 11 _� i Nvt3�tmeNT' P.o �c �455_�J�e�T q�ZoC _ 2S°� �14SS <br /> �E� � uui etwar55 utr �m p�� <br /> � � P�INOP�?l�l s� ,qa�� <br /> ♦f1LMItCTd11IE516Nf0 M�tIM0�E55 (iry T��� -- �.� <br /> �-�J,Cl/ C�E Gll�awt�wl� Ilbbl s��'r_sTx,� P�u.0u,�9 ' zab 4 y�i <br /> ceN eor�m.eTa�l / w�u ''onnEss // arv f' - mx�F �7 s��iei rwsc <br /> 2 Q '�L [ � �:� ��i hl�-P✓ iwov /�- ��� -�p� ��/ps <br /> MECNFNI����pqTMClOi1 MMLq)ORE55 LITY 711` PnONf SUIFUGENSF� <br /> t7 7 <br /> ��� - �--� C'r?��=c� or i y i ��- <br /> RUMBMGCONIR�f,t01 M�II�ODNE55 flfl' ]IP------- p110NF SGIEIICFNSE� <br /> �-ai -5�� . <br /> CONTR�T PRI�E OL YKNIK -- � <br /> � �,�p'�p HEATING SYSTEM:/�GAS ❑ELECTRIC ❑_ <br /> OE lEMqI11tANUSGU�REi007�0EMVOlVEO C(N11�LfM1150N�N�Plq11F.1p <br /> S <br /> �P� ai - �3 5 <br /> I HEREBV CERTIFV THAT I HAVE REAO AND EXAMINEO THIS <br /> rnoroseo usc a Buidro — AP�LICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> iea�uoeumrrroNarnor¢an�srrovmee�owaa�n�cNrwocori¢ 1 — W�RK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> ior J_LJ�_eiocK.��ar AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> ►TLD( �I O OTNER STAiE OR LOCAL lAW qEODUTINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAi I AM AUTHORRED BV THE <br /> ONMEFl OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH TNE STATE <br /> PANCEUNf I D.MIMBEP CONT TORS LA 1B.27 RCW D 298200 WAC. <br /> CONS IO/J/ ENOER.MplE53.TEIEMIdIE MIMIIER x� �� 1� <br /> SIO/�'TU,I�,F�� �E <br /> ��.� <br /> pTY BVSINE55lICENSC NO ' <br /> PLUMSINO MECNANICAL <br /> NO. TYPE OF fl1ITUqE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CIOSET(TOILEn � A/C—NHNOLO UNfTS � <br /> BATHTUB ' fORCEDAIRSYSTEMS � <br /> UVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS � <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS ; <br /> DISHWASHER � fiANGE HOOD � <br /> LAUNDRV Tp11V ' WATER HEATER � <br /> � <br /> CLOTHES WASHER � WOODSTOVE —;— <br /> URINAI � MEfAI.FIREPLACE(WOOD BURNING) � <br /> DRINKINO FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) , <br /> FLOOR DRAIN � (3AS FIR[PLACE � <br /> BACKFLOW PREVENTERS � GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPINO � <br /> ' EXHAUSTFAN � <br /> � , <br /> i , <br /> � � <br /> � , <br /> � � <br /> SUBTOTAL f ' SUBTOTAL f _�_ <br /> PERMIT S � PERMIT f <br /> TOTAL FEE f � TOTAL FEE f � <br /> FOR OFFICE USE ONLY: � ,. -- � <br /> � � <br /> fRON7AFfR�LN RE�qSFTPACII SIOESETB�CIt P��NCI1ECItNU T fFF MCfIPfNO <br /> o _ o o �-,� s 53 ,� <br /> u5E ic im�nre v�c�N�srtr FEES VALUATION FEE <br /> 'Z-- �. � � � .Bres ❑ra nunniNn � JG yJ.�O �.7L� <br /> � , <br /> n¢im�ri�,nteriai ravrnttumo sizewaionni � � <br /> � i °N°s ,�H � � / PIIIMpIN(i ; <br /> ir <br /> IX:GUP�NCr p(N51(MIS OCC1M�NflO�D B�SFNENI ----- _--_- ----' -----�— <br /> 0{UUP ) MFC�UNICM � <br /> �(�,.i �.�� 1.7� ❑YE6 NO _'___ _ _____ '_ <br /> FIf1E SPNINNII N BEO'D Rf�5(k1 �Mll IIONq PI�N 1'��f f.M � <br /> .N�� -- - --=-- --�a0 <br /> omrn I <br /> RRE� N fl[cO 0 RF�5(y/l' -- <br /> �` v l.. �T i (.'\U����'�G� suqnm�mHrsnnc�unaF _—'_' _—. _��� l <br /> irr%ar.or15� mnr�s�rn .yFner CITYOFEVERETT runiicwon�s 1 <br /> `/'_ N � '�"'' LOCAI SALES -- -- -- — <br /> —;-- <br /> __ ,,,,,t - �_ ' TAX CODE IS 3105 TOTnI �� ;� <br />