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APPLICATI� FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•259-BB10 <br /> f-I DEMOLITION ❑ COMBINATION �6UILDING i� MECHANICAL ❑ PLUMBINQ fl SION <br /> PROJECT ADDRESS <br /> Lr.�f" < J /N/K��- ,�Yii T IC3U ��A� <br /> �E��.E�ll�U� ���l{�����lP�,f?�- ������'�/� 3o�f;IC II �igO17 <br /> ' inAlU DRFSS � � LIIY ZIP PI'ONE <br /> �RCII�ICCiORIlES�GVEB M�ILADpR[55 f.ltt I.IP {'NONE <br /> I f-, i - v i� Cnc��`�2ucTlr�..� �7SFZ- Z��l2 <br /> cevmucorvmnc.�on u�i�eooness cnv nr mwr+e s*e*eucErvse. <br /> � Gan�nsc ,�nFs LG� <br /> kECHdNILPLfONtPASIOP MP':<�OPE55 CIiY IIP PIIONE SiRiEUCENSEI <br /> 1'WNOIbGCONIP�CiM MML�OOIiE55 Clry iIP 1`IIONE STAtELILENSE� <br /> COYlPACTP1110EOfW011Y. ��� <br /> HEATING SVSTEM: GAS ❑ELECTRIC ❑ <br /> 06LNBL WORRPNO SOUPIIE FW�AGE INV YICU CONUCi FERSON1Np PIIONE NO <br /> , �`I�IP�J g[�.5� ---'-, OUJM/Ll <br /> I HEREBV CEPTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> -- APPUCATION AN�KNOW THE SAME TO BE TRUE ANO CORRECT.ALL <br /> aroiroseouse o�emmi'+a PROVISIONS OF LAWS AND ORDIIIANCES GOVERNING THIS TVPE OF <br /> tYORK W!LL BE COMPLIE�WITH WHETHER SPECIFIED HEREIN OR <br /> itcni oescnianorvorrnorenm�s��'�vmecmwowrrncrrtwoc es� NOT. THE GRANTING OF A PERMR DDES NJT PRESUME TO GIVE <br /> io* � macK oF �- � �� AUTHOBITV TO VIOLATE OR CANCEL THE PROVISION OP ANV <br /> OTHER STATE OR LOCAL LAW REGU TIPlG CONSTRUCTION OR THE <br /> PERFORMA E OF CONSTRUC HAT I AM AUTHORIZED BY THE <br /> OWNER O IS PROPERTY O P RFORM TME WORN FOR WHICH <br /> APPLIC 10 IS MADE� COMPLV WIfH THE STATE <br /> PAnCELtA%ICNIIMOER - CONT CT RSLAWIB. R D2962OOWAC. <br /> CONS1i111LPONlOANIENpER.A0d1E55JElE%IONENOMBEO X � /Y� � I� / <br /> �/O• �� 51 E ! URE <br /> _ j <br /> CI1Y BUS�NE55 LIC[NSC N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl%TUflE Ofl 17EM FEE NO. TYPE OF FlXTUflE Oq ITEM FEE <br /> WATERCLOSET(TOILET) /J A/C—AMNDLGUNITS—H.P. <br /> � BFTHTUB �/ FORCE�AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH dASIN) /// HEAT PUMP <br /> J SHOWER ' UNITHEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP CLOTHES DRVERS <br /> DISHWASHER VENTILATIOM FAN <br /> IAUNDRYTPAY RANGEHOOD <br /> CLOTHES WASHER WATER HEATER <br /> URINAL WOOD STOVE <br /> DHINKING POUNTAIN META4 FIREPLACE('NOO�BURNING) <br /> FLOOR DPAIN FIREPLACE INSERT(WOOD BUFNINa) <br /> BACKFLOW PREVENTERS GAS FIREPLACE <br /> SINK(SERVICE—BAR.ETC.) GAS RANGE <br /> GAS PIPING <br /> E%HAUST FAN <br /> SUB TOTAL S SUB TOTAL $ <br /> PERMIT 4 PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: y/07 G/ <br /> fPONiSEiB�CN RER�15Ei0ACK S�DESEi9AyN PIANCIIECNNV��� fEE y0 RECEIPiNO. <br /> 20 � ZG � �7 � L _7 <br /> usEzor+e �or�aen vecervrv�c FEES V�LURTION FEE <br /> � 1 �007 �s n no eun�itir. .tj / <br /> ��eiartuMi*an9H �+oaowEwrvc szeoreior.m <br /> ZB unns � � SF L�vM4+ vmvnwc / 'QD <br /> J Gnrte4' <br /> OCNPANGY NJOlSIONES CCLVP�NIW�D BGSEMENI M(CNI.NIGI � � � <br /> Gfl011P <br /> a� . 2 A °�E� �° <br /> FIREUAP4PEOD flE�SPY ADpI11WeL%�NCIIECK � I O/ <br /> i.l <br /> nI(� OiHER <br /> FlPESFRIyN�EPRE00 RE�SON <br /> ,\/� Si�IE 9111L911.G SUPLN�IIGE T <br /> C/ <br /> neeoFcorvsi ruvsnrvn v1¢Loer CRYOFEVERtTT P�ie��cxrones �D'��� <br /> �p LOCAL SALES <br /> - /.� oere TAX CODE IS 3105 TOTAL ;�� <br /> � <br />