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APPLICATIO� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR S7HEET•EVEREIT,WA 98201 •(425)257-8810 ��w����� <br /> �� <br /> ❑ DEMOLITION ❑ COMBI ATION ❑ BUILDIN6 �L MECXANICAL ❑ PLUMBIN(i O SION <br /> OJECT RESS: �il/ � V i <br /> �n"l � �� , � 2.�9 o v" �,,P. s,�, ��,-ti� � . <br /> MYL��WE55 LIiY Z�P —�1[ <br /> �_ .t) . �.. _ <br /> IEN�MI uuIYNVIf.55 G1v l�� PIqMF <br /> •I1CMift10��E5 iF�l• nES�� [IIY /i' • <br /> � NnM MPdlD ('QI � /�L P�v S . F1�e0 ��- 4g�Og• <br /> ctN n I coH �cirn uu���ss � nr r�xrrt AO �, �aJ) <br /> �a,c- n5 G�roC/aI P(�� �YOF 1' � <br /> 4F.CM�MpLCO4iMC1U� MLM1�Ud�E55 Ph I�P M�OMf 51�iFUCENSF� <br /> PIIIWMGCW�1N�f,10l1 M4�il�IXN1E55 QIY plp PNOMf SI�1FlKFMSF♦ <br /> L <br /> LONIMLf fIVLE W WOPR <br /> HEATING SYSTEM: ❑GAS ❑ELECTFlIC ❑ <br /> O[$C111Bi W:NIN 1N0$OIIA4[iQp11GC W WIVED CCMi�CI P[4150N�Yp I�MOHF NO <br /> ��_����F���1��i-.L'�yQo�i� <br /> �� I HEREBY CERTIFY TNAT I HAVE READ AND EX�MINED THIS <br /> r1PPLICATION�ND NNOW THE SAME TO BE TRUE AN�CARRECT�LL <br /> vrarosvo us�or ennpNn PNOVISIONS OF UWS AND OR�INANCES GOVERNING THIS tYPE Of <br /> WORK WIIL'BE COMPUEU WITM WHETHER SPECIFIEO HEREIN OR <br /> t[c��ocscninnonorruor[nrv�s�awr+eRowonenecxiwoconev� pp7, 7HE GRANTING OF A PERMIf DOES NOT PRESVME TO GNE <br /> �o� eiocK or AU7HORITY TO VIOLA7E OR C�NCEL THE PROVISION OF �NV <br /> OTHER STATE OR LOCAL I.AW REGUUTING CO TRUGTION OR THE <br /> PEflFORMANCE Of STRUCTION.TN I pUTHORIZED BY THE <br /> OWNER OF THIS PERTY TO HE WORK FOR WHICH <br /> �il��- no� --o �7�-oo� APP �CATION pDE A PLY WITH THE STATE <br /> ruicauRi wr4A[n C O .200WAC. /� <br /> CONSiql6fH1NI0IN1(NJFR.�pfM1[SS.IREI'NOMENUMpEO % — � <br /> onc <br /> nrr wsr,�ss ikFNsc r�o <br /> PLUMBINC MECH�NIC�L <br /> NO. TYPEOFFlMUXEORREM FEE NO. TYiEOFEWIPMENT FEE <br /> WATER CLOSET(TOILET) NC—M/NOLG UNITS <br /> 9ATHTUB FORCEO AIR SVSTEMS <br /> LAVATORY(WASM BASIN) HEAL PUMP <br /> SMOWER UNIT HERTERS <br /> NITCHEN SINK 6 DISP CLOTNES ORYWiS <br /> D�SHWASHER RANGE H000 <br /> LAUNORY TR�V WATER HEATER <br /> LLOTHES WASHER WOOD STOVE <br /> URIN�L METAL FIREPIACE(WOOD BURNING� <br /> DRINNING FOUNTAIN FIREPLACE INSEfiT(VJOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> �ACKFLOW PREVENTERS GASRANGE <br /> SINK(SERVICE—BRF,ETC.) GAS PIPING <br /> E%HAUSTFAN <br /> SUB TOTAL E SUB TOTAI f /S� <br /> PERMIT f PEPMIT f <br /> TOTAIFEE 5 10TALiEE S � <br /> FOq OFFICE USE ONLY: <br /> TONIv1p�CM PF.�HSf1BeCR y0E5E18nCK PUNCIIEC�NUMPfP fFF PffF���NO <br /> 7 <br /> vselovi �oieuEe v�C�xts��E FEES V�lW1T10N FEE <br /> OYfS ❑W qU���. <br /> ��E�GnI I�Miu��OX vO q'OwIIUNO SRE W BIUNf� ' <br /> IINII< pIV4flINC <br /> OCL111VHCY N{1fv51�v��l5 IX:L��ANIl0�0 B�Y4EN1 ' 4ff.M�NK�1 <br /> cnDm� <br /> ❑YFS ❑e0 — <br /> iIP(.SMI!!1KLFIIHC�'0 �F�SM �ppI1�4�I.R�NCIIILM <br /> OIIIFII <br /> (IP[PIAIIMNlO'0 RHFM1 — <br /> Sl��f 9�mamt:SunOunf.[ <br /> nreorr,m+�r rvnxg�rmovvnor CRYOFEVEHETT n�w�M��"s <br /> � LOCALSALES --� — <br /> u.�E TA%CODEISJt05 707A1 <br />