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APPLICAT7� FOR CONSTRUCT�N PERMIT� <br /> ITY OF EVEREl7•BUIL�ING DIVISION <br /> 3200 CEOAR STREET•EVERETT,WA 98201 •259•8810 <br /> �7 DEMOLITION ❑ COM/BINATION ❑ BUILDING ❑ MECIIANICAL O PLUMBING ❑ SIGN <br /> PROJEC7ADDRESS: �j(/� �r � �- 7'/ t /�'J�� W� <br /> r'�ie 5'6 e0� r.��' � 7/,� •cu % �l.ccc.,.-v <br /> o [n u�y�ppn[ss �n rir p.rt <br /> � +.(C /%`J� o'�7(c(a �CJefe /`d— p�o�43 0�10 3SS-�f7o1J� <br /> 1 N�l uuI�OWE55 Ulv lia H�OeE <br /> ♦11C1111[CiO11p(SIGN[f1 MI.II/�O�FSS CIfV )11• PI�QNE -- <br /> G[xCMICON�p41M YulID011E55 1��1 )il• ppOMF $1I.'EIICFNSE• <br /> Y[CIIANiCA��ONIP�C10f1 Y/JlApq1E55 dfY I�P p11pNE S1��ElICEHSE� <br /> 1'IUVBIN4COXIP�CIIX1 4Y�AryJfif$$ CI�Y III� 1�IIONE SI�fELICENSE• <br /> CONIMCI ppi�_E Oi Ndl1K � <br /> HEATINC SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> Mstnie[xUnMurosou�nEr00��GEwvav[a tnH�� rt suriu�0v��ox /� �O� � ��� <br /> � Giy <br /> �(lE .SG°/`� /O]% <br /> I HEREIIY CERTIfY THAT I HA�'� READ AND E%AMINED THIS <br /> rnorosmusc w eunuHo APPLIChTIOH AND KNOW THE SFME TO OE TRUE AND CORRECT A�� <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7H15 TYPE OF <br /> WOf1K WIIL OE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br /> �melocscmntwrrorrnorcnrv�s�iownoFiowon�n.cmwvconcsi NOT. THE OOANTINO OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> io*__oiaa w AUTIIORI7Y TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTMEF7 STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR TME <br /> PEHFOf1MANCE OF CONSTRUCTION.7MAT I AM AUTHORIZED BY THE <br /> OWNER Of THIS PpOPEHTV TO PEflFORM TME WORN FOR WHICH <br /> �o� ��5� 00 O�I/ O/�I APPLICATION IS A1ADE AND 1 COMPLY WITH THE STATE <br /> rnncc �ui .Huuo[n � CONTRACTORSLAW 1827RCWAND296.200WAC. <br /> i� bZ�S 7 �ou o yv cd cr7 � ,�„ / �/� <br /> cor�smucnw io�u icHocn,wonEss.�ciEnw�.�e rivuoEn ,�C��G(1�-- <br /> unc o�t[ <br /> G OIISixE55lKFv5E1q <br /> PLUMBING MECIIANICAL <br /> NO. TYPEOFFI%TUqEORITEM FEE N0. NPEOFEOUIPMENT FEE <br /> WATERCLOSET�TOILET) A/C—MINOL4UNR5 �— <br /> BATIiTUD FOtiCED AIR SYSTEMS <br /> .AVATORY(WASII OASIN) HEqT PUMP —�— <br /> SIiOWER UNIT HE.ITERS <br /> KITCNEN SINK 8 OISP CIOTHES DRYERS <br /> DISHN'ASHER MNGE f100D <br /> LAUNORY TRAY YlA7ER HEATCR <br /> CLOTNES WASHER 1V000 STOVE <br /> UWNAL ME�AL Nfl[PLACE hVOOD BURNING) <br /> DRINKUIG FOUNTAIN FIREPUCE INSERiQVOOD BURNING) <br /> FIOOR DRAIN GAS RREPLACE <br /> OACNFLOW PREVENTERS GAS�iANGE <br /> SINN(SERVICE—DAR,ETC.) GAS PIPING <br /> E%HAUST�AN <br /> SUBTOTAL S SUBTOTAL S <br /> PERAIIT 5 pERMIT f <br /> TOTALFEE S TOTALFEE 5 i_ <br /> FOR OFFICE USE ONLY: <br /> IIIONi$F1B�CY. pE�115E10.�CN $�MSfiB�CM 1'I�NCII[(StM1411f1� f(f (1fCf11�1N0 <br /> j ,�7 J� <br /> uScmxE iounEe vec�Hisirt FEE VALU�TION FEE <br /> ❑YES ❑� p�nlfurvb <br /> n[�Gi1tL�uiletlON HOOiOwEWMO S�:EOf041W11 <br /> IlNl�i I�111411M(i <br /> CCCV��MCY pqS�N�[S OCCUMry�IU�U e�5F4fH� y�����N��y —F— <br /> GnouP <br /> OYES ❑b0 — <br /> FlIIESVfl:HKLEOPWD 11f�iq1 APD1�10119%LNCII((.M <br /> �__ <br /> on�rn <br /> iinENlAUP[ao nE+SW <br /> suq nn�mvm simr.u•nr.t <br /> irr�erco�sr nnr�s�rnnovenor CITYOFEVERETT runi¢wnn�� <br /> LOCALSALES - — - --- <br /> n.iE TA%CODE IS]105 TO7AL <br /> i_ <br />