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APPLICATI�1 FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAF STREET•EVERETT,WA 98201 •257�8810 <br /> ❑ DEMOLITION ❑ COMBINATION fl BUIlDINO ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS <br /> �.b'/D /=UQL-ST d/E/r� U�. �Uf.�cET"f !Y/;. <br /> OWN[P M�M1�OpPC55 CIfY 2T �'��CN� <br /> ,�'ist< ei�p1is7cuupci�aF `V`FfrT �ob'OA' ���5 ,E=/�fAE77 u�C g/In3 !N�/l�.y",i.36.�.�0 <br /> I[N.WT M�R1CpPf55 CItY Zp A�ONE <br /> /.f�CNItCC1MIIESILI�[l1 �A�R�Wf�E55 LIIY !N A1CNL <br /> WhQ� <br /> C ♦ CONiMG�G� MI.RAWPE55 GiY !A R1.i'MC Si�IEIICCNS[• <br /> ucour��cucorrtnecioa u�rurones: cirv rm r�ror¢ siuciKuac. <br /> PWYpiHGCONiB�CtIXi Y1M1ApCRE55 CIIY ZV R�IR Si�1LLK1115E� <br /> wma.c.veceo�wonK r�(7 HEATINGSYSTEM: � GAS ❑ELECTRIC G <br /> �l � — <br /> oESCuinE wOnK u�n sOu�nE i001�c[irr.'av[o cON1+�Gr vEnSa�uN Rtlrrt x0 <br /> i' G I'!- ,C.•.�� �; - � ! �nf ' ?/�Gi o(i /ci/L/UL- �/zSl J37 3/��� _ <br /> ��r.�� I.l <br /> I IIERE6Y CERTIFY THAT I NAVE READ AND EXAMINED TNIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br /> rmovoscousE ov ouno��u pRpVI510L5 OF LAWS AND ORDINANCES GOVERNING TMIS NPE OF <br /> ,f' /. S WOFK WILL �E COMPI.IED WITH WHETMER SPEGFIED NEPEIN OR <br /> tEc.icewuivrpxorrao�ce*r�sr�awvectrnvan�rucnrvrocwies� NOT THE GRANTING UF A PERMIT DOES NOi PRESUA!E TO GIVE <br /> i�r �y �aK pr I�.C�<�Y ��IE�� ���� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW PEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSiPUCTION.THAT I AM AUTMORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WHILH <br /> APPLICATION IS MAOE PND I COMPLV WITM THE STATE <br /> wacc�m i o ruuet'n CONTRACTORS LAW 1 B27 RCW ANO 296.200 WAC. <br /> CqlSiRULiI(NIlOV1LFNIXP.I.OMES�if.[XONENU4B�O /�C� � <br /> x 1l�- �� 00 <br /> s�c�uiunE wrc <br /> crtr ou;w[ss ucu�sc r+o <br /> PLUMBING MECHANIC�L <br /> NO. TYPE OF FI%TURE Ofl ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET QOILET� P1C-ANN�IG UNITS <br /> BAINTUB FORGEO AIR SYSTEM1IS <br /> LAVATORY(WASH BASIN) HEAT 7UhIP <br /> SMOWER UNIT HEATERS <br /> NITCHEN SINN E O�SP G�OTHES DRYERS <br /> UISMYlASMER RANGE HQJD <br /> LAUNORYTRAY WATERMEATER <br /> CLOTHES WASMER \YOOD STOVE <br /> URINAL 6�ETAL FIREPUCE(WOO�BURNING) <br /> pqINKING FOUKT�IIN FIREPLACE INSERT(WOOD BUFNING� <br /> FLOOR DRAIN GAS FIPEPLACE <br /> B/CKFLOW PREVENTERS GAS RANGE <br /> SINN�SERVILE-OAF.ETC.1 GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL 5 SUBTOTAL S <br /> PEP6IIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR UFFICE USE ONLY: ���� �� <br /> iPO�R5Ef04+ PVPSUB�LK SNCYIP�CM PlA4Cn[CMINNBER fEE A[CEIPI�q <br /> ,`. ��, • , � ��o���a - D�, ��o S� <br /> osc:r.i I �o�•Au v.umsnc FEES V�LUIITION FEE <br /> ` nres nra eutwr,c SZjJ <br /> ��[a�nuwu�or� wns oanurr s�.rcora�ocn <br /> Z�g nwa�Nc <br /> � <br /> a:curu�v roas+acs accw�Nr�o.o e�s�ucr�r ucCNu�t4 � <br /> cuour <br /> ❑res � a i <br /> i�n�mr���cnaEao nE�sox w�rpwanu�cN[cx aQ <br /> OIMCR <br /> n[+F�t�nvnWO PEe5IX1 <br /> 541E Om��rtq SuuC��MCE <br /> ��rcpca�sr niws+wnn�c�e. CITYOFEVEflEIT �d���"�s <br /> LOCALSALES — <br /> �- n.�i 'j � DD TAX CODE IS 3105 TO7AL <br />