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APPLICATI� FOR CONSTRUCT�N PER119111T <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ OEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: 1�f,�i-1 .c.uR'�d"+'� <br /> S���Jp�� P�' 190�til �6 .St' S�o��i,Fv 9l�'la3 �aG�- L� �{� <br /> b�r7En-7 ��t�wu� �rv nr vnon[ <br /> .,, �t,ttdrr ae�� !S{�sE F,.P� F-��es,�� 9J��'ol :�03—/S�� <br />�� rzvu� u �uwncss � cirv nv v�roM¢ I <br /> i <br /> AIIp�iICiO�0E51GNC� M�ileMME55 U�Y )m I`NONF � <br /> GfN[1UtL0'Rp1Clp1 N4l�UU�E55 LIIY IiP P�q4[ [t1�tllC[NSF• <br /> MFCIUHKMf.0.Y1NCtOl1 N4l�W�E55 f.lry IIP PIIONf if�lilICENSE• ' <br /> P1111IBINGCONIR�f,lq1 N�IIACqIF55 CIfY I1P PIIONF S1�IFIICENSF� <br /> CONIMC!1'l1�Cf O!YA11R <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> o[ nioFwOnn NI�sW��Ei00��c[wvalvco �W��citt�5dl�rorHO�+Erq <br /> I HEqE�V CER7IFV TMAT I HAVE READ �ND EXAMINED THIS <br /> pPPLICATION ANO NNOW THE SAME TO BE TRUE ANO CORRECT ALl <br /> rnoroSFDusE or Pminiw: PqOVI510N5 OF LAWS AND OR�INANCES GOVERNINCo THIS tYPE OF <br /> WORN WILL BE COMPLIED WITH WMETHER SPECIF�ED HEHEIN OR <br /> itcuoescn�rup�orrirorcnn�srrowNe[iowrn�j rv.c��moconts pp7. THE GRANTING OF A PERMIT DOES NOt PRESUME TO GIVE 1 <br /> m�_�_oioc '�s� or l.0 � AUTHORITY TO VIOLATE OR CANCEL TME PROVISIGN OF ANY � <br /> ��/l� � OTHER STATE OR�OCAL LAW REGUUTING CONSTRVCTION OR THE <br /> ����7' PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY iHE <br /> ' OWNER OF THIS PROP=_RTY TO PERFORM THE WORK FOR WHICM � <br /> �/. (� ! - � p _ D D� APPUCATION IS MAOE AND I COMPLV WITH TNE STATE � <br /> nencrt u i miuoen CONT ORS UW 1B 2�RCW AND Y96200 WAC. <br /> cais�niwiiwio�x�r.mEn.�pncs5.incr+�a'EMuuxEn 1� c� -a�- � i <br /> .ue� �¢ o.¢ ! <br /> ( <br /> Clry W4NISSLICENSf NO � <br /> PLUMBING MECHIINICIIL � <br /> NO. TYPE OF Fl%TURE OR REM FEE NO. iVPE OF EOUIPMEM FEE <br /> WATEF CLOSET(TOILET) NC—MiNDLG UNITS <br /> BATMTU� FORCED AIF SYSTEMS <br /> IAVATOFY(WASH BASIN) HEAT PUMP <br /> $MOWER UNIT NEATERS <br /> KITCHEN SINK 6 DISP CL0T11E5 ORVEPS <br /> DISHWASHER RANGE HOOD I <br /> L�VNORY TRAV WATER MEATER <br /> CLOTMES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE(WOO�BURNING) <br /> ORINKING FOUNTAIN �IREPLACE INSERT(WOOD BURNING) <br /> FLOOR UFAW GAS FIREPLACE <br /> OALKFLOW PREVENTERS GAS RANGE <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> E%HAUSTFAN <br /> $UD IOTAL S SUD TOTAI f <br /> PERMIT S PERMIT S <br /> TOTALFEE f TOTALfEE S <br /> FOR OFFICE USE ONLY: <br /> �nrn+*vm�c. nr�nsFie�cK vocsr�n�cR n�Hc�rtca+uwnrn/ r[r mtrmrr�o <br /> ustrovf �ounrn v�cex�sn[ J FEES VAIU�TION FEE <br /> _ -�— <br /> OrEs ❑r.v euin�vr. d� <br /> ��FiG�rtl�viGlp� HO O«w[ltiNG 92E W 81OW1 — � <br /> V4�1[ MU4RiMp � <br /> ___ �}— <br /> IX:Clll'��C� Ml`15�M,!$ IX:CII�MNIlO�(1 BtSFVCNi yfC11�MiC�I <br /> arour <br /> ❑Y!$ OM7 <br /> (IPESPPiN�1E�PC0'0 �F�Sfn �MFIi040.%�NO�(CK _ <br /> (I111(11 <br /> fi11ENAPNPCO'� 11fA<pV <br /> vnreunmvr.snnc�urmt _ _ � C7) <br /> i " <br /> �rrcnrcov<r nnns�rmovrnpr CITYOFEVERETT rnni¢wnnec � <br /> LOCALSALES --- <br /> ����E TAX CODE IS 3105 Toi�L (p � ,� <br />