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APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-BB10 <br /> ❑ DEMOLITON ❑ COMBINATION � BUILD1ING ❑ MECHANICAL ❑ PLUMBIN(i ❑ SNiN <br /> PHOJ TADQ�f(RES �'��I CO -C_IT�G� 1 ��� f/f^j <br /> ��Q_��U /l1Q�� ww[55/ Cena�r[� an �r tm naHE " ��-" J <br /> tcwHr uuieooxcss ���r nv r�roNc <br /> •11LMRCipqp(SqH[N YYI/.LpiE$$ CIM1 Jin 1NqNF <br /> GfNF11 ONIMCIIXI Y41�CMf5$ CIIY lll` 1`IqMf <I�iC110EN5F• <br /> ��mn.✓ <br /> YECN.W �ICWINCfW MMALORE55 f.liY )II` PIMNF $l4El�CEMSF� <br /> PLU4lMGCONtP1C�O11 uuI�COPf55 tllr )in PIqNE SLfEICFNY� <br /> CWIf4C�P{XCEO�WIXIF / _ <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> o¢scwe[ •�no �nEroalwcx�voiveo couuc�ttnsor�nrrtr uo <br /> �do r;�' ora9P � 3� <br /> I HEREBY CERTIFY TN�T 1 HAVE REAO �ND E%AMINED TNIS <br /> vndo5FDu5E or Mmdrq APPLICATION AND KNOW 7HE SAME TO BE TRUE M1D CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINNJCES GOVERNING TNIS T'PE OF <br /> WORK WILL BE CAMPIIED WITN WHETHER SPECIFIED NEREIN OR <br /> �Eauo[scwo wNamorcnniswywaciowon�rt�cNrv.ocon[si NOT. THE�RANTIN6 OF A PERMI7 DOES NOT PRESUME TO OIVE <br /> iot 22�3.iacK AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOG1L LAW REGULATINCi CONSTRUCTION OR TXE <br /> PERFORM�NCE OF CONSTRUCTION.THAT I M1 AUTHORIZED BY THE <br /> OWNER OF TMIS PPOPERT� TO PERFORM TME WORK FOR WMICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ru¢Elmio rawnc CONTRACTOHS LAW iB27 RCW AND 2%?00 W�C. <br /> �S�S� -a� � x Gt1w.�.ti.�.�5 6_Z�_ 97 <br /> cdsrnucno.'iou1�trroEn.•omtss.rcicn�mwncn <br /> sah�nmE o��[ <br /> arv auvrrtss ic[�u no <br /> PWMBINO MECNANICAL <br /> NO. TYPE OF FlIRURE 011�iEM FEE NO. 7YPE OF EGUWMENT FEE <br /> WATER CLOSET(TOILEn A/C-M/NDLG UNITS <br /> B�THTUB FORCED AIR SYSTEMS <br /> UVATORY(W�SH BASIN) IIE4T PUMP <br /> SlqWER UNIT HEATEFlS <br /> KITCHEN SINK 8 DISP CLOTHES URYERS <br /> DISNWASNER RANGE NOOD <br /> UUNDRY TRI1Y WATER NEARR <br /> CLOTHES W�SHEF WO00 STOV[ <br /> URINAL MEfAL FIREPU+CG(VJOOD BUFNING) <br /> ORINNIN6 FOUNT�IN FIREPLALE INSERT�YVOOD BURNINCa) <br /> FIOOR OR�IN GAS FIREPUCE <br /> BACRFIOW PREVENTERS C�AS fiFN�E <br /> SINK(SERVICE-BAR,ETCJ �- GAS PIPMG <br /> IXHAUSTFAN <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT 2 <br /> TOTRIFEE S TOTALFEE S � <br /> FOR OFFICE USE ONLV: . <br /> flqNiS(IPACN PEMSf184LR SICfSfIB�LR R�NO�RRMMf11 flf �J/ Wf.FMiNO <br /> 3 � <br /> "Ln � Zo �� 77 � � ` <br /> usElonF lo���Fe vweei9rt FEES V�LWITION FEE <br /> '�--Z n. '!yo�/F o.�: o� A��: o� /d- �� <br /> I�EIGIIilIYIl�ipN i NpIXlMtltlMO 4I[C�BtIXYII � <br /> � ����� i ao sF. M,,..�, � <br /> OCCVV�NCY NJpSR9(S OCCU��NIlO�D S���M� YF[IUMCN <br /> G�ro�T � <br /> v-( ❑r[5 <br /> i11�F."iMiNi(1f11RE0D 11flCpV - ��ri1��lAAMC11(CK <br /> ObH'1 <br /> !W[NMMOEOp uf�5(n - <br /> SI�1C111RU'MSIrt1C1U�t i �"� <br /> nnar.p�sr r�nvs�nrrovcnar CITVOFEVEflETT n�mr..�rr�.< <br /> LOCALSALES - — — <br /> _�L -hJ onE TA%CODE IS J105 TOTAL <br />