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APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-BB70 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ 9UILDING MECNAN�CAL ❑ PLUMBING fl SIGN <br /> PROJECT AqDq� S <br /> �i�^ ^ � W l'��2�h�Avenl �f�' (��l� �4.� 9Ka�3 �/��i-30�-�'157 <br /> MER M�R1pp4165 CItY 2N �� <br /> �s�l�as�., ��o��41FN�.��faDa EueRr++� 4gaos �1a5-75v-a�'��Z_ <br /> 1kN�N1 us�uoon[s, cirv tm rw�rt <br /> �np�rtEcioPDcS�GNE ueiteWrES t�iv IV � rrqNE <br /> � N , ��==�o �Q����aA��� �ueee��Pao3 �a�.a54,�9��=�o�NN�cKk <br /> CN 9KCCNiN�Lt�R uul <br /> pECN�NiGLC0111�61pi1 YEiUDME55 CitY ZW PIqNC 51/.iELICENFC• <br /> PWMO�N9CONIRI.LIOR �MUOd1E55 UtY IIP R1p1E S1Ai(LICLNSE• <br /> coma�c*eaKtawa�a ap9 HEATINGSYSTEM:�GAS ❑ELECTRIC C <br /> OCSCa10[wl HK/'�SOUMC i00*/.�[iNV0.YC0 <br /> CONLAC�jty 11 �qN[NO I <br /> e4MT��e�a� � o a�t eou�ces�ou N T <br /> ' � <br /> 1 HEREBY CERTIFY THAT I HAVE REAO AND E�(AMIN�D THIS <br /> APPLICATION AND HNO1Y THE SAME TO BE TRUE ANO CORRECT A�� <br /> rr�oncsm ua or am�onq PROVISIONS OF IAWS ANO ORDINANCES GCVERNING THIS TVPE OF <br /> ' WORK WILL�E COl.1PUED WITM WHETMEfl SPEC�FIED IIEREIN OR <br /> icr,.iocscnivriovaorv.c�mv6�owHos�owa�ei*�cHnvOcoaia� NOT. THE GFANTING OF A PER'AIT DOES NOT 7RESUME TO GIVE <br /> �or B�oCa or AUTHORITY TO VIOLATE OR OANGSL THE PRO\'IBIC'1 OF ANY <br /> OTMER STATC UR LOCAL LAW REGUUQING CONS?RUGTI�N OR THE <br /> PERFORh/AYCE OF CONSTRUCiION.7HAT I AM AUTNOFIZED DY THE <br /> O'NNER OF�)HIS PROPERiy T PERFOHM LHF. WORK FOR WMICH <br /> APPLICAT S.MADE% 1 COh7PLY NITH TME STATE <br /> cwJauM�o rmu�oEn ��N O y1\Y IB W AND �Y6200 WAC. <br /> i <br /> f.ONSiPUCiqNIOWIFNCER,�I%%1CSS,IREP��OMEINNBER ��/� O <br /> JRE Q Y / J 1 / D�IE <br /> � <br /> � CILY 6USM[5$l%.CNSG AV <br /> PLUMBIN6 AIECHANIC�L <br /> N0. TYPE OF FI%TUNE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE _ <br /> WATER CLOSET(TOILET� A'C—AHGOLG UNITS <br /> OATHTUB FORCED AIR SYSTEMS <br /> LA1'ATORY�WASH OASIN) i HEAi PUNP <br /> $HOYJER � UNIT HEATERS <br /> �tITC1'ENS:NKSDISP ! CICiHE50RYER5 <br /> � DISM\4A�HER RAMG�HOOD <br /> LAUNSRV TRAY WATER MEATER <br /> CLOTHES WASHER WWDSTOVE <br /> URINAL �rETAL FIREPLACE�WOOD BUPNING� <br /> �DRINkING POUNTAIN FIREPLACE INSEFT(WOOD OURNING) <br /> ' FLOOR DRAIN GFS FIFEPIACG <br /> —� pACKFLOW PPEVENTERS GAS PANGE_ <br /> SINK ISCiVICE—BAR,ETCJ f.AS PIPING _ <br /> EXHFUSTfAN <br /> I SUPTO�AL S SUBTOTAL S <br /> --+ PERMIT 5 PERMIT 5 <br /> �_ TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE U;'E ONLY: _ <br /> fPOtRSFiBP:B PEAPSCI044 S�OGSLiB�CR �W1b1ECKINYOEP fFF. AECtlPTAO <br /> �;�ia,;i; i�u�¢� v.c.nrsrt[ FEES VRLUIITION FEE <br /> nvcs ❑ra ��irnr�c <br /> �.cro�,uurt.mr+ raosrowu�n�c s¢EaeiocT� <br /> nuuon1c <br /> occuvu¢r wanoucs acc�r�Hrio�o o�scMcnr �,E�,,.�K„y �— <br /> LROUG — <br /> ❑�E. ❑�+0 <br /> �iRE5Pi1MXLCPREOD PEA5011 ���p�P�µ�"�C� <br /> O111EP � <br /> 1iRE�U11A1REOD PUSCM <br /> S��iE BUhWNG SUPCIItaG[ <br /> r�rEerwr�s* wws�wnovcoer CITYOFEVERETT weiGwoaKs �— <br /> LOCALSALES ' <br /> n•�E TA%CODE IS J705 TOTAL <br />