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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STFEET•EVERETT,WA 98201 �257-BB10 <br /> ❑ DEMOLITION f-1 COMBINATION fl BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PRO ECTADDRESS T <br /> � /. �ur/� � <br /> ONNEP M4LA�/1[55 • LI1Y ZW I�IION= <br /> E/�, a,..,. 83� c.�-� a,. ,�.,...�r ��rz3 ���sf <br /> �s 1-3G,�3 <br /> 1FN�NT N4LAOCRC55 CIIY ZA RqNE <br /> ♦PCNrtECIOPpESGN[u Mul�ppaC55 CIiY l�v hqN[ <br /> GC141ULCONiR�G10N MNL�DDR65 CIIY IO` PNpI& SUIFLCCNSE• <br /> l<<//�od:�o, Ss�s�R.r-:, L_,f, S.oL,-.� 9varu 3co-sr�-iyu T�/yF�o� y <br /> AIfO��4iC�LCONBULIOq \11i��DM1E5i CIfY ZIP PIqNE Si�1El�LfNSE• <br /> �'LVA��III:.COIIi(11.'.ipf1 Y�ILI.�JNE55 CI1Y IIV MION[ $1�IELICLN$E� <br /> COM9iq.i PRICC Cr NOPn <br /> `�SOpp HEATING SYSTEM: ❑GAS ❑ELECTRIC I� <br /> c[SrninEN �e�Ho50wa�fOOuc v0.v[o coHucircnsot�u�on�affNo <br /> NrU lCvv� <br /> I NEREUY CERTIFY THAT 1 NAVE REAO AND E%AMINED THIS <br /> APPLICATION AND KNOW TME SAME TO�E TRUE AND CORRECT.ALL <br /> ruoaosm usE or Bmmn+a pqOV1510NS OF LA\YS ANO ORDINAYCES GOVERNiflG THIS TVPE OF <br /> WORK WILL BE COI.IPLIED IYITH WHETHER SPECIFIED HEFEIN OR <br /> �[c.�oEStnmiqrvorveoPCPrviS�wwHectowonnrucnrvromw[sl NOT. THE GFANiING OF A PERMIT DOES NOT PRESUI.IE TO GIVE <br /> �Ur aioCK a AUTMORITV TO VIOLATE OR CANCEL TNE PROVISION OF ANY <br /> OTHER STATE OP LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORIdANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZLD BY THE <br /> OWNEP OF TMIS PROPERTY TO PERFORM THE WORK FOR WMICM <br /> APPLICATION IS MADE AND I WMPLY WITH THE STATE <br /> r�mcur�eiorwtimrn CONTRAC� T0�9�-+0 7RC AND296200WAC. <br /> 9�„a?�a -rn� ,� / <br /> CCLf�17JN1 ILCM1DCR.A0011[SS.IREPXONEMI48EP X � (� L� �(J <br /> SqN�NN[ pAI� <br /> ❑tVp115iN[.'u^ 4[NSENO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUpE Ofl ITEM FEE NO. TYPE OP EOUIPMENT FEE <br /> 1YATER CLOS[T�TOILET� RC—A'HNDLG UNITS <br /> BATHTU� FORCED AIR SYSTEh15 <br /> WVATORV�YJASH BASIN� HEAT PUIdP <br /> SHOIVEF UNIT HEATERS <br /> KITCHEN SINK 8 DISP CLOTMES DRVERS <br /> DISHlYASNER RANGE H00�7 <br /> LAUNDRVTRAV \YATER HEATER <br /> CLOTMES WASHER WO00 STOVE <br /> URINAL M1IETAL FIREPLACE(Y�000 BURNING) <br /> DRINNING FOUNTAIN FIREPLACE MS[RT�WOOD DURNING) <br /> FLOOR ORAIN GAS FIREPLALE <br /> BACNFL0IYPPEVENTERS GASRANGE <br /> SINK�SERVILE—BAR.ETC.) GAS PIPING <br /> E%MAUSTFAN <br /> I SUBTOTAI S $UOTOTAL 5 <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: � _ <br /> fPp`QSE106M PURSRp1CM SNESEt6.�CN PUIIPI6RNUMOER I[C RECOO}Iq <br /> vsecue �C��uce v�t�NisiiE FEES VALUATION FEE <br /> nvcs n rro eunowc � <br /> ��i.r,.Hru�nurrorv r�owmvuin+c s�zcaemcn <br /> uwrs <br /> ttuumrm <br /> rcav�mcr iuus�oncs occurwrweo ascMwr u¢n�u�Ku <br /> caouv <br /> ❑YES ❑NO <br /> liHC5MINILLLPRE00 REASON /�COI1qN0.PVllCIIECN <br /> on¢n I <br /> (ili[AUPYREO� Nf/�501M1 <br /> Sle1E BOiIDiMG SUPCIIMGE i±/1 <br /> .—.L(L <br /> �.rtorconst rw�s�rnrrovcoov CITYOFEVERETT i'ueic�mnxs I <br /> LOCALSALES <br /> mrc TAX CODE IS 3105 TOTAL I� <br />