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APPLICATIO�FOR CONSTRUCTI�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257•8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �1 MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS:,�411 FOvJ4Eft A Vf�JNC- <br /> $CE�c� QL[r�P� 41c�( Fuw�F1i AVEnu6 EuLREtT"[&3A:S 4�.s-2sz-3J39 <br /> owMEn �i��wncss ptt nr P��� <br /> 1[N�M uul 410�E55 GItY !�V ���OMF <br /> ��CIP1fGip1lppyGNCf1 M1i1�dME55 CIIY li1' ��qNF <br /> fif�R11RLOYID�f,lIX1 NLiI�OME55 QIY !�P Piq4[ S�qLVCfHSF� <br /> 9crc�orrnu � � �4W E�tsoa�N ulk�'�7 4S�L3 416'151-�E91'8 OEA6N IF.4LL40Qi.�J <br /> utouvrPlcovmecwn uMu [ss �r.�n ar rnoa[ s4lpuc[MSE. <br /> IJI�I .l <br /> f911YBMGCO�IIR�CtOR N�IL�W11E55 CIIY IIP PHORE $�AIFIIC[MSF� <br /> wHrn�a rma a wone�, <br /> ,:,� -/',� HEATING SYSTEM: �'�J GAS ❑ELECTRIC ❑ <br /> n�scniecv.oa��wsou��[roo*�c[wvav[o toriuc�nrnsw+��m �ro�r�a <br /> �'NL F�I W c..�' ro a-h.�L- P. <br /> �N9 W 1S"i-�F4 F <br /> I HER[Dr CERTIfV iHAT I lI�VE READ AND E%AMINEO TMIS <br /> APPLICAiION ANO NNDW THE SAME TO DE TRUE AND CORRECT ALL <br /> n�rorosf u usc or emmiva PROVI90N5 OF LAW S AND OROINANCES GOVERNING TIIIS TVPE OF <br /> S _['_ R. WORN WIIL �E COMPLIEO 1Y�TM WNETHER SPECIFIED HEREIN OR <br /> iccuoEscnnnaiorrc.�nnivwx+innawrnenecuiwoca+[s� NOT. TH[ GF�ANTING OF A PERMIi DOES NOT PRESUME TO GIVE <br /> ioi otacK w AUTHOAITY TO VIOLA7E OR CANCEL TME PROVIS�ON OF ANY <br /> OTlIER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE <br /> PERFOR6IANCE OF CONSTRUCTION.TMAi I AM AUTHORIZED�Y THE <br /> OWNEF OF TNIS PROPERTV TO PERFORM 7NE WORK FOR WHICH <br /> APPLIC�TION IS MADE AND I COMPLV WITM TNE STATE <br /> pnrica uK io ruupen COYTHACTORS LAW 1027 RGW AND 296200 WAC. <br /> COYStnUC11DNlO�NLENOF11,IiW��E55.lF1[M�OMEMVMOFII x��,,`A � -��- {-�/4��{� <br /> �_p4�(� <br /> 5 � IVI�[ <br /> CIIY 6114NESS l�C[NSC NO <br /> PLUMBINC NECHANICPI <br /> NO. TYPE OF FI%TURE OH ITEM FEE NO. TYFE OF EOIIIPMENT FEE <br /> WATER CLOS[T�TOILET) A/C—A/HNOLG UNRS <br /> BATHTUO FORCED AIR SVSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SNOWER UNIT HEATERS <br /> NIiCNEN SINN 8 OISP CLOiIlESORYERS <br /> DISMWASMER FAI`GE HOOD <br /> LAUNDRY 1RAV WATER HEATER <br /> GIOTNES WASHER \VOO�STOVE <br /> UPINAI. METAL FIREPLACE pY00D BURNING) <br /> OPINNIt�G fOUNTAIN FIREPLACE INSERT(W OOD BUPNING) <br /> FLOOR DRPIN GAS FIPEPLACE <br /> OACRFLOW PREVENTERS GASHAN3E ' <br /> —i— <br /> SINK(SERVICE—BAP.ETC.) GAS PIPING <br /> EXHAUS7FAN <br /> $UD TOTAL S Sl1B TOTAI E '��l � <br /> PEFG.IT S PERMIT S /:� <br /> 70TALFEE S TOTALFEE S ,i '� ' <br /> FOR OFFICE USE ONLY: <br /> InOV1Nl0¢R IYMSf�B¢K 90f5F�84R flN1CnECRkU4qfR � �FF �(ff�+t110 <br /> ri ;';(, <br /> �cxmvr �o�euu ��cunS�E FEES VALU�TION FEET__ <br /> O�ES O NO BPIMHft <br /> ��Fi.'.��Il�yi���lOV NOC�DWEIIMG SIIEMlIOG�11 <br /> uvn5 nuun:xn � <br /> __ "_____{— <br /> G�1�OUC,�CY Ktrvt�:al( IX:Qi��NIlU1p BASf4(MI MFP�Y1Cµ __ <br /> Ov(5 O Hn <br /> i��RSR�P.nIl11P[OL �F�SON �UD�INMI�I.M1AYOMP _ <br /> OIPF11 <br /> nr�.uH�.inmo nr+snv <br /> [I�If RIIM1I•W(i SIIf1O��nCE <br /> hrrnrrova riers�rrnwmor CRYOFEVERETT nwirt:won"s <br /> LOCALSAlES -� — ---�--------- --- <br /> „��E TA%CODE IS 9105 7o7n1 _ i_ <br />