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APPLICATI�� FOR CONSTRUC'AJN PERMIT� <br /> CITY OF EVEREIT•BUILDING D�VISION <br /> �S��Q�/�G9n/_ 3200 CEDAR STREET•EVERETT,WA 90201 •259-BB10 <br /> 7p��(u <br /> ❑ �EMOLITION ❑ COMBINATION p BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDR[SS:�70d EV4KCdP��"`���`� - � <br /> SiJoUoNt�S�+ fUc I�Z'15�+ Sf SW EvFA�(�" 90203 �Z5' �1-43�10 <br /> ovm[n uui.aoncss an xm �nuc <br /> Jsw�S(wlkl.E55 45o U6f� avr NEN.',�9 bE•�,��E 9AR�Y 2do•?73-I aY7 _ <br /> ttruxt u�nr.00ncss uir no v�kwc <br /> kGti/hrLGt-t 2ViIVi 211-MSt' S� •--�J '79b36 4"5-I.rlo-2�d51 <br /> •II6�1LLIp1OE5qNER M�NMOnF55 , [iiY t�� PHME <br /> OFNFMIGW�IUG�ON YMAppnF55 [IIY I�P ��E SPIEICFNSE• <br /> VFCIIAMWCON�MLIqI YIA�OMl55 fi1Y l�l` I4�OME GIA�ElKfNSF• <br /> PIUWWOCONI(1KIp1 Yu�Apd�F55 GfY Ii0 A�WE S���EIXEMSE� <br /> COM�MCf PM10E IX Y�O�R <br /> �O�DO?7 HEATING SYSTEM: ❑GAS ❑ELECTRIC O <br /> pF5C1YEE Y.V�M�wU SW��E f001bE wVOIVFD LOuf�CI1K1150NM'0 PlqxE MO <br /> �} r-�.� rci �.i.cP 3 �..I�,Awr�t�.u�s oN� S DJ 1 �';oG)']Ri— la—I'7 <br /> � <br /> A 100-D�'SNnt1aH�SN- wN•s�+ <br /> u 11 f E �� � I HEREOY CERTIFY TNAT I HAVE READ AND E%AMINEO '(HIS <br /> ' APPUC�TION AND KNOW THE SRbtE TO OE TRUE AND CORRECT ALL <br /> rnoroseousc or euiara PROVISIONS OF UWS AND OROIRANCES GOVERNING THIS TYPE OF <br /> (y1R1cL(SS SE.Y2PNSG���lC2 'ST�`T��'+' WORK WILL BE COMPLIED WITF� WHETHEfl SPECIFI[0 HEREIN OR <br /> icwioescmr�rono�rnorcnmisra�eeiawrnenncumvcones� NOt THE �RAN11N6 OF A PEFMIT pOES NOT PRESUME TO GIVE <br /> io* eian or AUTHORI7V TO VIOUTE OR CANLEL THE PROVISION OF ANY <br /> OTIIER ST�TE OH LOGI�L LAW HEGULATING CONST� JCTION Oft THE <br /> PEFFORMANCE OF CONSTHUCTION.THFT 1�M AUTNORIZEO BY THE <br /> OWNER OF THIS PflOPERiY TO PERfORM THE WORK FOR WHIf,N <br /> APPLICATION IS MADE AND I COMPLV WITH TNE STATE <br /> PMCFliAl10.M14BFP COMRACTO LAW I .27 flCW AN '�ig6300 WAC. <br /> a 2�-000• a- �-or x �, �� i��q�— <br /> CplSfllVGilpIIOAN lExpEM1�OOnF55,tflfl'�iOME MNBE11 <br /> y�,y��� Cw�E <br /> CIiYBU51NE53L�CFxS[1q � <br /> pLUMBIN� MECM�NIC�L <br /> NO. 7YPE OF Fl1fiUNE OP ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WA7EH CLOSET�701�En A/C—AMNDLO UNRS _ <br /> �ATHTUB FORCED AIR SYSTEMS <br /> IAVATORY C�yASH�ASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK S OISP CLOiHES DRYERS <br /> DISHWASMER RANGE HOOO <br /> LAUN�RY TqAY WATER HEATER <br /> CLOTNES WASHER WOOD STOVE <br /> URINAL METAL FIREPIACE(WOOD BUFNING) <br /> DRINKING FOUNTAIN FIREPIACL INSE�7T(WOOD DUPNING) <br /> FIOOfl DHRIN G!S FIPEPLp^.E <br /> BACNFLOW PREVENTEFS G/S FiANGE <br /> SINK�SERVICE—BAR,ETC.) GAS PIPINQ <br /> IXHAUST FAN <br /> SUBTOiAL f SUBTOTAL S <br /> PERMIT f PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> ipOx15E�9�CK �EMSEtBKM SIDESFIO�LF �l/�dl nM1�0[11 fEF GEIPIxO <br /> 7 <br /> USESOME �ai�n[� VI.CAHIA�E FEES VAlUAT10N FEE <br /> ❑YFS OMO ����M�y 27 � <br /> IIE�611IlMIlAION NOClUWEtUMO SIIEOfBIOdlI � <br /> uNns rwuouxi <br /> I <br /> OCNPu4v MO�TIMlS OCCUVN11l0�D B�YNENf y�����yK�� <br /> C��� � OrFS NO <br /> i1PE5flUMtLE1111EOD �EAi0r1 Appll(W�IR�HG11i.GM <br /> r o o,�,E� <br /> rrt�r nco'o n¢�cp� j� . <br /> � suic ouiomn simaun�F fJ� <br /> nr[ot<ovsr nuHsu� oor CRYOFEVERCTT ruar.wonRs <br /> LOCALSALES <br /> _ I,,,, /2 . �y . � TA%COOEIS�105 TaTA� 28o jG0 <br />