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APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAq STREET•EVERETT,WA 98201•257•8810 <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDIN6 ❑ MECMANICAL ❑ pLUM81,�:G O SIGN <br /> PROJECTADDRESS 3�29 <br /> �EA � V�l�Wil[$6 CIIY jp p��F <br /> \ /,/I �R�1C*�o <br /> *Eruwt u�aeoon[ss trtr xm M�t <br /> ♦RCNItEC`Ip/(��OEb/4 nR^. NMMp1E65 CItY 1p A�� <br /> ��$�ll� �/�Y.c� <br /> E /vy' ..,,...�.cm crtv <br /> {i// // TP A1012 6f�2LICENSf� <br /> v <br /> M[CN.WILµCOHfNAGiOR YAM1App1C59 LIIY ZR Ap1E 6i�1[11L[NSE• <br /> RUMBrzqC011iRALiOfl Yµ�ppqE69 CItY IN 141p1E 6M1[lIC[MSE• <br /> LONf11A�}p(10E Of KVqlf I <br /> HEATING SYSTEM: ❑GAS ❑ELECTR�C ❑ <br /> ocuni wonKumswu�crooueemvavm eox ra[nsorvumi+urvEra <br /> � IZI +J <br /> `� 'OZ 925— ZS9-31v! <br /> . I NEREBY CENTIFY TMAT 1 HAVE RERD AND E%AMINEO TNIS <br /> mw�os[o us6� auwir�o APP��CAT10N AND NNOW THE SAME TO OE TRUE AND CORRECT.ALl <br /> ( PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> «�"���A��a�aPA�A*�'15nvm+enowCn�rte�rvpca�i[5� H'anK WILL OE COMPUED WITH WHETI:ER SPEQFIED HEflEIN OR <br /> NOT. THF GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iar oioce pr_ RUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STAT[OR LOCAI LAW REGULATINO CONSTRl1CTION OP THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTMOFIZED�V TNE <br /> OWNER OF TNIS PROPERTV TO PERFORM THE WORK FOfl WNICM <br /> RPPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> n�nce�ruiio.rrtiue[a CONTRAC LAWIB. RCWAND296.200WAC. <br /> CqN51AUGfqNLO.W IENDER.�pp1ES5.lEtERq11f NyM9Cfl / i/�� '/ 'U� <br /> '•���_ oue <br /> cineuswcssiKCHs�ra. <br /> PLUMBINC MECHRNICRL <br /> NO. TYPE OF FIkT11RE Oq IT[M FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILE7) i NC—AMNOLGUNITS <br /> BATMTU� ' FORCEDAIRSYSTEMS <br /> LAVATORV�WASH CASIN� HEATPUMP <br /> SHO WEfl UNIT I{EATERS <br /> KITCHEN SINI(8 DISP CLOTHES DPVEBS <br /> DISHWASHER I RANGE NOOD <br /> LAUNDRY TRAV � WATBR HEATER i <br /> CLOTHES WASHHR Wppp STOVE <br /> URINAL METALFIREPl4CE(WODD6URNING) ! <br /> DRINKINGFOUNTAW FlREPLACEINSEAT�WOODOURNINO� � <br /> FLOOq ORAIN GAS PIREPLACE <br /> DACKFLOW PREVENTERS � GAS RANGE <br /> SINK(SERVICE—BAR,ETC.� GAS PIPING • <br /> I <br /> � EkHqUSTFAN � <br /> —_ 1 <br /> i <br /> <UBTOTAL S � SU�TOTAL E i <br /> PEhn;IT 5 PEFMIT E <br /> TOTALFEE S TOTALFEE b <br /> FOR OFFICE USE ONLY: <br /> FP00i5[1B�CK RWR6ELB�LI( S�pESEIBACN 1'Lµd1ECtl11N10[ i(E PECCII'f1E�. <br /> usezor2 toineEe wcu�i6ih FEES VALURTION FEE <br /> ❑r[5 ❑xo ��� <br /> N[IGNI\IMIf/�iqN uqtCFpµ[LL11q SIZ[piglpry�l !q r <br /> �.S )y.r �. RUM91fq <br /> Q CUPANLY 1q65RINE5 OCCWANiLOW 615EYENi MECNI.MIC/y <br /> N'/� o.E� ,� <br /> rmcscawn�[nnEo'o n�nsow wortan�uw.wcnECK <br /> J OMCq <br /> {FlL�LAqMOWD p�ASpry <br /> V� <br /> i �� S � x'S 1�. s*ttc euaowc suacrunce <br /> rmec�covs* cunsu� coar CITYOFEVERETT nreicwortics <br /> �' _ ., / /� LOCAL SALES �. <br /> _. ' V o.rE f - I j - ' TA%CODEISJ105 TOTAL <br />