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APPLICATI�1 FOR CONSTRUC�N PERMIT ' <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT.WA 98201 •257-BB10 <br /> f� DEMOLITION I� COMBINATION C] BUILDIN6 ❑ MECHANICAL r7 PLUMBING I� SIGN <br /> � pROJECTADDRESS <br /> l/ / �_ GL ".,i %�r�iti wA . y�o3 <br /> rnv�¢n u.nwa�[ss un rv R�ar[ <br /> � /�=Ja "iN l7 /t�v�Rson� �l// fGccti !)R 1=wJ1�=ii 98Z+ 1 Y2S-1tD -3f�J2_ <br /> 1[rvWr uVl�Wn[ss c�lr IO` h101.E <br /> MCIII1tLiq1UE5RNLP MMI�WP[55 CI1Y IX' Aq11E <br /> GCNC11RCp114LaC�q1 Y�M1�pp11[55 COY SP Aq�2 541ELICCIK!• <br /> ("Il l�Q� <br /> NCG�UNC4CONIO�Clq1 4�R�Cp165 CILY IV RCME SI�ICICURE• <br /> 1'1UM01tqCpl�11�C1M YAh�UpflC$$ CI�1 SI' 11XNF_ SI�ICLILLN.[� <br /> �pimectrn[Eawwa HEATINGSYSTEM: f�GAS I-IELtCTRIC I1 <br /> k - <br /> oc;cmnc won��rro sa�anc roouce wvaw�o caivt�rinuw um r+ror�rq <br /> *. c'�lL N�w EA< F�.,eNACti i0�iu F <br /> J 1 •F TO F uRNAt�._ v.v - o w T�' <br /> _ I NEH[�Y CERTIFY TNAT I IIAVL R[�D AND EkAMMED TIIIS <br /> HF.JR'.��ZR �✓6N n/� APPLICATION AND NNOW THE SAMF 70 OE TRUE ANU CORPECT.ALl <br /> vnoros[o s�/[�oromioni PqOVISIONSOFLAWSANDORDINANLESGOVflRNINGTHISi1'PEOF <br /> 5 F t� _ WOPK WILL OL COMPLIED WITH WNETH[R SPECIPI[D NEREIN OR <br /> ii�e�oc;�nm�qriorrrprcnn�vrominuowoneneonwocan[5� NOT. TNE GRANiMC OF A PEf11AlT DO[5 NOT PR[SUME TO GIVf: <br /> mr Biocn or AUTHOPITV TO VIOLATE OR CANC@L THE PROVISION OF ANY <br /> OTNEfI SiATE OR LOCAL LAW REGULATING LONSTRl1CTION OR THE <br /> PERFOR�AANf.E OF WNSTPUCTION.THAT I AM AUTNOPIZE�0Y iHE <br /> OWNER OF THIS PROPERTV TO PERFORIA THE WORK FOR WNICH <br /> APPLILATION IS MAOE AND 1 COMP�y WITN iHE STATE <br /> v�ncc�u�m rniu^cn CONiRACTOP.SIAW 1827 RCW AND Y96200 NAC. <br /> co�is�nuciror�io�nicr�ucrt�ooncss.ni[nroncNuuecn y���o�� �'�'2� / <br /> 1aH�iunc o��c <br /> CIIY OUSIM.SS IICpIN 1q <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF FI%TUPE ON ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEi) NC-A'HNDLG UNITS <br /> BATHTU� FORCEO Alfi SYSTEMS <br /> LAVATORV(WASM O�SIN� NEAT PUA'P <br /> 5110WER � UNITHEATERS <br /> NITGNEN SINF 6 019P i LLOTHES DRYERS <br /> DISH WASMEA RANGE HOO� <br /> LAUNDRY TRAY WATER HEATER <br /> CLO7HES YJASN[R WOOD STOVE <br /> URINAL RIETAL FIREPL�CE�WOOD DURNING) <br /> DRINKINC FOUJTAIN FIIiEPLACE INSERT(WO00 OURNING) <br /> FLOOR OR�IN G45 PIFEPiACE <br /> OACNFLOW PREVENTERS GASRANGE <br /> SINK�SERVICE-DAR.ETCJ GAS PIPING <br /> EXHFUSTFAN <br /> SUDTOTAL 5 SUOTOIAL 5 <br /> PERh117 5 PERMIT 5 <br /> TOTALFEE S TOTAiFEE 5 <br /> FOR OFFICE USE ONLY: <br /> rnoxrs[rwcx nc�ns[rar.cx vocsEtn�cn au�ortcxrr�uecn rcc ��cctmrrq <br /> moio i-c�b <br /> usetwrt mi�nu vecuasnc FEES VALURTION FEE <br /> mFs n r�o emm�.vo �— <br /> uumrtuuneuon rmaovrturtn s¢ca'oiocn <br /> uMrs nuuown <br /> IX:tvrp6r IqR510aS5 OCNr.WIWM B�SEucNI u[C�UNiL0. <br /> r.r�Wv <br /> nres n rro <br /> rx�esrnw.anneoo neuson �oonawuuHartcn <br /> otn�n <br /> rmc�ununmo nwsoH — - <br /> S1ME BU4DM(i SVIICIIMGE <br /> i.n:nr�pr�s� nu�servnwcoer CITYOFEVERETT niaiawo�ns � <br /> LOCALSALES � <br /> ��„��_ TAX CODE IS 8105 7o7�L �_ <br />