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APPLICATIOR FOR CONSTRUCTI�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING (�,MECHANICAL ❑ PLUMBING ❑ SION <br /> PROJECTADDRE55:_ �IZB �r,Iliml(1�A A-UC . <br /> pxvtn w�ile00uE55 a�r i�r rrqv[ <br /> 'I�nu 1-1,-�-\nt��cV. 2��0 \ b' 1 F��zr qQ�.c,3 •�a5-�ss-^s_�s <br /> If4�N� � 441 Y%M�6$ CIIY )Ip PiOMF <br /> ♦.iCmffC�O�fK5iG4[P Mu1AP'1RE52 Ci�Y TI' hR1Nf <br /> f�Nlflµf0'��111CIq1 MUTAp�11E55 CIIY )�1` r�xn[ SIAIII�CCNSf� <br /> Uff,luWC0.(OY�MCIO� 4ut�W�F55 (liY $�P CIbNC [i�IFUC[NSf• <br /> f <br /> ' (r�S�n i�u lrBRi la) �rviolc (a.uc �s�/r��P�s2��r�;.�Yi-���rf Ccvndos.�rvi.n <br /> 191n/P�'GCO��I�uf,ipn 4u��pME55 Clh I�� P�+F St�11�15[ 5� <br /> COYIMC�1'IXCI UI Wp�1R ,,-/ <br /> — MEATING SYSTEM: ,ai GAS ❑ELECTRIC ❑ <br /> ascnmrwon��vnwwntroouw[mvoiv[o ' c +�crnnsw��Honro+c.ro <br /> _ .4.�?Sr�-(�f/�'7� <br /> �mn.,.� <br /> I HEREBY CER7IFV THAT I HAVE REAO ANO E%AMINEO THIS <br /> n�ii�E or nmiprm APP��CATION AND KNOW TNE SAME TO BE TRUE ANO CORREC-A�L <br /> �F.� PROVISIONS OF LAWS AND ORDINANCE$GOVERNING THIS TYPE OF <br /> WORN WILL BE COMPLIED WITN WHETNER SPELIFIED MEREIN OR <br /> ifc.i ocscmruorva ri+or[nn�sww�xuowonenacMrv.vcw+csi NOT. TNE GRANTING OF A PERMIt DOES NOT PRESUME TO GIVE <br /> �o� oiota OI AUTHORITY TO yIOLATE OR CANCEL THE PROVISION OF �NY <br /> OTIIER STATE OH LOCAL LAW REGUL�TING CONSTRUCTION OR TME <br /> CERFORMANCE OF CONSTRVCTION.TI/AT I�M AUTMORIZEO BY TME <br /> OWNER OF iHIS PROPEHTY TO PERFORM TME WORK FOR WHICH <br /> APP�ICATION IS MADE AND I COMPLV WITN TME STATE <br /> rencn iu i o�niuptn CONI RnGTORS l AW 19 2]RGW AND Z^96 200 WPC. <br /> LONSIn1�C110NlO�Nt[NChnl.ft(In[55.1[ltAqNEMNPFR x OAA c) (/ Y�/�7� <br /> $G �IVnL [M[ 1-1 <br /> /�,�{?rY C.(�Z <br /> Clry BU,Lµ551�CINS(NO <br /> PLIIMBING MECN�NIC�L <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. 7YPE OF EOUIiMENT FEE <br /> WATER CLOSET(TOILET) NC—AMNDLG UNITS <br /> BATHTUB fORCED AIR SYSTEMS <br /> IAVATORY(IYASH BRSIN) MEAT PUMP �— <br /> SHOwER UNIT HEATEqS <br /> KITCH[N SINK 6 OISP CLOTNES ORY[RS <br /> D�SHWASI/ER HANGE H00� <br /> LAUNONY TRAY K'ATER HEATER <br /> CLOTM[S WPSIIER WOOD STOVE <br /> 11RINAL METAL FIREPIACE pY00D�URNING) <br /> DRINKING FOUNTAIN FIREPLACE MSERT QYOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> DAGKFIOW PREVENTERS GnSFANGE <br /> SINK�SERVICE—OAR.ETCJ GAS PIPING <br /> E%HAUSTFAN <br /> SU�TOTAL S SUB TOTAL f <br /> PERMIT S PERMIT S <br /> TOTAIFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> innN��.nn+ra nr•nsnn•cv vo[sne.cs mm�i¢Kr+u+mrn r[e m<nr�r�o <br /> nsi ;nu imu��• v�c�M�sne FEES VAIU�TION FEE <br /> _ — �— <br /> OY[5 ❑MI RUIMNf <br /> nUP�ll'WI�IiJ4 NOOUWFIUN� gltdllOG�il .—�— —' _— <br /> uvns naunmr. <br /> _'___ '__ _ ___"__y___ <br /> `.'I..I, `.nl) lXf1iC�NIlU�l1 B�N4IN1 MlI;M�4N'�I <br /> ❑rt5 CMO -- � ' <br /> �'...1 i'i.:'.iU�f(Il� It1�cM �DdI�ON�I%�NC�?CM <br /> OtIMO <br /> i.1... .�I.IUO �IV�tOV <br /> tl�lf R11'IU:N(:SIIf1CIU�E <br /> ��—.on� rievc�rrnov�nn� CITYOFEVERETT ninnr.vrtu�.c <br /> LOCALSALES -- -- ---�------ - <br /> ��.�t TA%CODE150105 TOTAL <br />