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APPLICATII.� FOR CONSTRUC7 .JN PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •25%-BB70 <br /> . DEMOL�TION ❑ COMBINATION ❑ BUILDIN6 O MECHANICAI ❑ PLUMB�NG ❑ SI6N <br /> PROJECT ADDRES , �� /_ <br /> -t¢�-�. <br /> OwMER YM�OME55 GiY ZV %�plE <br /> ��,� ���4% �,.�•�� �J 9�f2n1 `��s�zs'4�-�7?7 <br /> iENNIt M�M1MOI�E55 GiY ZV PIqNE <br /> Mp�i1ECId1DE5pNEP Mul�00RE55 CRY IP RpME <br /> f R/.tCONTP�LtOP YNL�pONE55 .` GiY ip %qNE STAiEtCFNSE� <br /> /�� CT7 (1 AJ <br /> uEIN�N�LALLO � 0 MeM1AWRE55 QiY iC Rpl{ SiA}QppENSE• <br /> 1'WYOOq(ANIPALRM MIJLALORE55 CIiY ZP Rp1{ SiAtELqENSEI <br /> com�ucrrnneorwana HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> � RIpEWG�K.W05CUMEfOOTAGE11N0.lED CONIK.TPEPSpINqRIqIEHp. <br /> I MEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS <br /> MPLICATION AND KNOW TNE SAME TO BE TPUE AND CORRECT.ALL <br /> rnoroscouse or eunou.a PpOVI510NS OF UWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIEO WITH WMEiHER SPECIFIED HEREIN Ofl <br /> 1EG40E5LPNIpNOFpipPER1Y�51qWNBELOWOf1AiTACN1MVCOF25) NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> mr���2�3 eiocK aSt `�. Z AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINQ CONSTRUCTION OR THE <br /> PERFORMA4CE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TME <br /> OWNER OF TMIS PROPERTY TO PERFORM THE WOPK FOR WHICH <br /> Q�3 APPLICAT ON M � pN0 I COMPLV WITH TME STATE <br /> reAcci rec�o.uuMeen CONTR O .27 W AND�Q�AC. <br /> � s� oi� ov i�� 6 � <br /> CONSIRULIqNLOMIlE1W[0./�ORESSJFIERqMENUMOEfl z ���� <br /> 6px1 E O�iE <br /> CIiY BUSMt55 UCENSE ND <br /> PIUMBING MEGH�N�CAL <br /> NO, TYPE OF flXTUflE Op ITEM FEE NO. TYpE OF EOUIPdENT FEE <br /> WATEF CLOSET(TOILEn NC—NHNDLG UNITS � <br /> —i <br /> BATHTUB I FORCEDAIRSYSTEMS ! <br /> LAVATORY(WASH BASIN) HEAT PUMP � <br /> SHOWER i UNITHEATERS j <br /> KITCHEN SINN 6 DISP � CLOTHES DRYERS ' <br /> i <br /> DISHWASMER i RANGE MOOD ! <br /> LAUNDRYTRAV ! WATERHEATER ! <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL � METALFIREPIACE(WOODBURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(WOOD OURMNG) i <br /> FLOOR ORAIN OAS FIREPLALE <br /> BACKFLOW PREVENTERS ! GAS RANGE <br /> SINK(SERVICE—BAR,ETC.) i GAS PIPING � <br /> � EXHAUSTFAN i <br /> f i <br /> t t <br /> i <br /> SUBTOTAL S i SUBTOTAL S <br /> PERMIT S � PERMIT S <br /> TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: DCOOFi—C. <br /> fRONI5El0�LK PE�PSCIBACM Slp[SEIB�LK P4NCIIEC MIYBER fF[ AfCEroilq <br /> _ C�� <br /> useza�e WiAREA vecu�tSnE FEES V�LURTION FEE <br /> OVE� ONO ��� <br /> NEIG11ilIMlt�iqN IqOFpWELLIIq SIZEOFBLDG�t�. <br /> U�n15 RWB�wO <br /> OCCUC�NCY WKSIORFS CCCIII'.WILOAD MSEMENi 4ECIUNIC/�L <br /> Gfq�P <br /> OYES ❑NO <br /> iif1E5PRINNlCR11E0D 11EASOM '�R'�'LLM'W�E« <br /> OMEN <br /> PREAWINOEOD REA50N <br /> $fAtE B�IMq SURCNMGE <br /> irrr.orcor�sr RNIS�v�POVEOBY CITVOFEVERETT ruucwouns <br /> LOCALSALES <br /> D�IE TA%CODE IS 9105 70T�L <br />