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APPLICATI� FOR CONSTRUCT�N PERNIIT� <br /> CITV OF EVERETT•BUILDING OIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-BB10 <br /> �1 DEMOLITION p COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: GL.[I cu.e � � �'/? t 7/� ' W� <br /> s3iie 5!po� u.xd 7� ur ��� <br /> oJ�En uy�css �s n n� � .wnE <br /> /iyG � j����/< /%���Ka�7�( �uefe --��aQ3 0�10 3_SS-5�7o1S <br /> 1 Nlt uulMMR55 Cpr l�r ripryE <br /> •11CI�1[ClpipESiGv[11 u111I11p1E55 Clry j�l: ..— ry�OryE <br /> GCNE��LCON�f1�LIq1 M4��dN'._$$ fllY )11' ryqNf. i��l[lK[NSF� <br /> MECIIANILKCONilUC1p11 MNlApp11E55 Qh }IP - P110NE SIAIFUCENSE� <br /> P�u4P�G[OnIMC�q1 M�iIPOpP65 Lirv b�� pIqNE SiA1EliLENSE• <br /> CW�IUG�Pl1KE Oi NW�x �� <br /> IiEATING SYSTEM: ❑GAS ❑ELECiRIC ❑ <br /> ocscaecwon.u.vsou.ncroo��.ct�uvavco cn.,u trrnsa�umr�ari o �C O� 3C�'�,�� <br /> � ,��ci <br /> C'+//E .5G°/`/ /GYI <br /> I NEREOY CEflTIFY THAT I HAVE READ AND EXAMINED THIS <br /> rnoroifousE a amiaHo APP�ICATION nN0 KNOW THE SRME TO BE TRUE�ND CORPECT ALL <br /> PROVIa:ONS OF LAWS�ND OHDINANCES GOVERNING TNIS TYPE OF <br /> WORK WILL OE COMPLIED WITN WHETMER SPECIFIED NEREIN OR <br /> �Fato[semntrorvorrna�[nmvrormenowrneneernwoeon[s� NOT. THE ORANTIN� OF A PERMIT DOES N0T PRESUME TO OIVE <br /> ior eioce or AUTIIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE JR LOCAL L�W REGUUTINO CONSTRUCTION OH TME <br /> PERFORMRNCE OF CONSTRUCTION.TMAT 1 AM AUTMORRED BY THE <br /> OWNER OF 7MIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> /01 ��57 O O�I/ O/o/ APPLICATION �S MAOE ANO I COMPIY WITM THE STATE <br /> ru¢e u�i .wuue[n CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> i� .�vs oou o vv cd� �� 3�j�7 <br /> cWstnuG�id�Ipu'l[MpEn,�pp�[5s.iE1EAqME HuuqCn <br /> nf o��[ <br /> � <br /> cTh num+css i�ccns[rro <br /> PLUMBINC MECIIANICIIL <br /> NO. TYPE OF FlXTUPE ON ITEM FEE NO. TVPE OF ECUIPMENT FEE <br /> WATER ClOSET TOILET 'T— <br /> ( � P/C—M1NDLaUNITS <br /> BATHTUB FUf10ED AIR SYSTEMS <br /> UVATORY(W�SH BASIN) HEAT PUMP <br /> SMOWER UNIT NEATERS <br /> KITCHEN SINK 8 OISP CLOTHES ORYERS <br /> OISH WASHER MNGE HO00 <br /> UUN�RV TRAY WATER kiGTER <br /> CLOTHES WASHER WOOU STOVE <br /> URINAL M6fAL FIREPIACE(WOOD OURNING) <br /> ORINNING FOUNTAM SIREPLACE INSEflT(VJOOD BURNING) <br /> FLOOR DRAIN �AS FIRGPIACE <br /> �ALKFLOW PREVENTERS GAS RANGE <br /> SINK(SERVICE—BAR,ETC) GAS PIPING <br /> EXHAUSTFAN <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT f �— <br /> TOLAL FEE f TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> fOONi5E1PI.CN RGIISF�flACN SIpCSFIB�C� M1�NCI�CCRMI411f11 � f[F OFf.flPIMO <br /> ,��usFla�c m��nu veteH�sn[ FEE W1LU�TION FEE <br /> pY[5 O rq �— <br /> ommmr. <br /> 11f�G111UMI�A1qN NOO�pw[WNG 54EOiB�DGR� I <br /> IINII[ �IIIV111Nf. <br /> CCCU1'ANCY Iq(MSICI4(S CCCUPANIWW 0�5(MEN� y���qN�f.N —{— <br /> G�WP <br /> pv[5 O�q — <br /> RRESPflINRLfPFE09 �f�SOv �Op�1cM4ry�NC111LK <br /> owrn <br /> rincu.wuncon nE�uw <br /> siat niinunm vmr.n�nn[ <br /> rvr[orr.oNsr rinNsenmpvmar CITYOFEVERETT rum¢wcn.e <br /> LOCALSALES - — — ---- <br /> out TAX COOE IS 7105 TOTAL <br />