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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAfl STAEET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SION <br /> (�R��1ECT ADDRESS: (O X �c+_�'�'t�-°� �u Q cv.'I"t �I4�o- <br /> `"ar_L F�I�,w.:.s,s'�¢t' �„s"� L2o�s '�:nl>...�s �. '1n Saa{�"�e 4Fr1�3 <br /> owwEn wui�oaucss nn r�r vroNc ,.LOG S'V LQzS � <br /> �IfN1N1 / ' Vu1�fHW155 � �� C(,Iry [��)IG /� AV�e�OMF <br /> ILK_�'i\�QY'.'sf1 �_�.]_3tia3�4GCWW�LY�Y_V—lA �2S �7g20sr <br /> �{ 1fG10�fE5iP�O� I��I�DI1Nf55 Ci�Y P� npn! <br /> C :,v�. ���i„s�..r C,„s�_ 'S�-�..�_ .��6a�Q. <br /> 6Mfn4 f,ph�14('J(M Mul eplln[SS Cil� !�� �'nOYf [41f UCENS{� <br /> 146�I:a]' �.s �' �ra� iZs� ��r .�lm..� �oa� HFsocesoas�k <br /> 4fC���b�c4CDvin¢lUn un��Iqnp55' —On Iir �I�1 �—ruotil' cGlFUCEXSE. <br /> �(N�...b; u '� r ks 5G/6 M7o.2QQ..Q� �.Qmc�.,...;Q.Y. �c� Hzs 4ssG//4 <br /> rniqBir,G[O�nu�r,�� � yoleIXwE55 Grv Iin nHpNF 9�fi�¢FNSf• <br /> CONIII/.C11`IIiC(Uf Vip11R <br /> ��,� 7�7 HEATING SYSTEM: GAS ❑ELECTRIC ❑ __ <br /> nFSCRIPF WORF NI:$OW��f�O�O�Gf INVOIVED CONI�C!I'lHSON 1Np 1'MONf MO <br /> �11�ca��l�� vP� iya . <br /> 1 HEHEBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS <br /> APPLICFTION AND NNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> nnonOsfu usi or pnnnier. PROVISIONS OF�pWS AND ORO�NANCES GOVERNING THIS TYPE OF <br /> WORN W�IL BE COMPLIED WITN WHETMER SPECIFIE�HERE�N OR <br /> �Fcuntsnm�np�orraorpnnisrrovmeuoww�n¢nrxoconcsi NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GNE <br /> �ot Pia:r or AUTHORITY TO VIO�ATE OR CANCEL TME PROVISION OF �NV <br /> „` OTHER STATE Oq I.00A�lAW FEGULATINCa CONSTRUCTION OR THE <br /> l.�-r 3 �'.u�r R.�sr '"'� `�« PERFORMANCE OF GONSTRUCTION TM�T I AM AUTHORRED BY THE <br /> �-� OWNER OF THIS PfiOPERTY TO PERFOPM THE WORK FOR WMICM <br /> APPLILATION IS MADE ANO I COMPLY WITH THE STRTE <br /> renr.n ux i n raiyptn � HAGTORS LAW IB 27 qGW AND 296200 WAG <br /> 3I a�'o� a o,5 000 � <br /> Cn^ISIf11K��[N�IO�N 1 f�1f�Fq.NNxI[55 I[lF1'NONE NUMPFII ���/�� <br /> �:GN11UNf � [ <br /> CIIY BU VNESS lFf NS[NO <br /> PLUMBING MECNIINIC�I <br /> NO. TYPE OF FI%TUXE OR ITEM FEE NO. TYPE OFEOUIPMENf FEE <br /> J WATERLLUSET�TOILET) � A/C—NMNDLGUNRS <br /> �L BATHTUB FOPCED AIR SVSTEMS. <br /> LAVATOFY(WASH BASIN) HEAT PUMP <br /> SHOWER / UNITMEATERS <br /> KITCMEN SINK 8 OISP CLOTNES ORYERS <br /> DISHWASMER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATE(i <br /> CIOTHES WASMER YlOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> DRINNING FOl1NTAM FIREPLACE INSERT(WOOD BUqNING) <br /> FLOOR DRAIN GAS PIREPLACE <br /> BACNFLOW PREVENTERS GASPANGE <br /> SINN�SERVICE—BAR.ETCJ � GASPIPING �% <br /> E%HAVST FAN _�_ <br /> SUB TOTA� 5 SUBTOTAI S <br /> iQ PERMIT E :.{ � PERMR f <br /> � TOTALFEE S TOTALFEE f <br /> FOR OFFICE USE ONLY: !-I��r/Z.r/C(ClL (l,' <br /> ino4to�ln/.r. nnn.r�P'r\ �n SOts(iP4a �•I�vURren'�uxrn rFr p ��fCu No <br /> !d�h"" //� l� r�7 7 / �b�l� _ <br /> nsi :ovr ioi•�a. v.c�asnr FEES VALU�TION FEE/� ;/ <br /> /�'—/ �.cs �,�� nini�.v�. —_� t2�,—�3 _1���1f'� <br /> 1�liC.�l�Iryil�lit�4 JyJ �f.iYI�Wllll� .CIIfO�PIUG�I -y�. � <br /> �v ' Zi.� �/�/ ��� �I��4�'�Nf� _ ..._ . /T'n/ <br /> �. �r _ <br /> _ __ _ �__ <br /> UCta�'n•. r a• �. IXfn�•nN11:��U fl�S�W\I plCwr.ifnl <br /> X[� i <br /> I.IICVI' <br /> � ;�u.� Z m�, ..� -- - ------ - �� - - <br /> i�r.��i,, ..�rvuicu mnnm �oannvun�wortc� <br /> cn�rn --_' —__ _ _____—__ ___ <br /> I'�:.I .i...� . 1 :1•. - 111�<�y .. <br /> .,�w�,,,,.,.�,�„��.,.�::, _4_.'st <br /> �.r�rn-m:a nnvs+rrn����n+ CITVOFEVERETT n'm�cwnn.c // <br /> LOCALSALES � -`0�y—' <br /> _�-/�_ _ ��•�ES 'L� 9✓ TA%CODEIS0105 rou� i /75/o!.C3 <br />