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/�PPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,lVA 9820t •257-8810 <br /> f� DEMOLITION f i COMBINATION ❑ BUILDING ❑ MECMANICAI fl PLUMBING !i SIGN <br /> PROJECTADDRESS <br /> Owr�=n Mut�DDP[.5 G�fr zp q�K <br /> Fe��A ws�c�� 5�9r3 Der�AQ� 6ve�err 9gao3 �ras- asa-�sa9 <br /> i[NAlli MMt�DM1fS5 q1Y Ib' pq11[ <br /> ��G�IIIICIOIIC[SY+NIIi Y�II�DMC55 CIIY ZV fIq11L <br /> IiCNII1kCO�1�RACIOR Y/.I�rNbiCS$ Cli� IW R101Q Sl�iElKE11iF• <br /> G�eze�t Coas�eucr�o�J 79/yGr� A�1r5e" s�XY,o..�.s9 9pa90 yd5•33y.968y Buczc�-iaiKK <br /> NtOureCatCGN�nnciW ue�l�Dqi65 citr zi✓ �`nOi6 s�at[IiCL':S[. <br /> �'IU�AL�NGC0111N�C10R A1AI�/.aPC$$ C11Y $V h1011C $1�illICL115(• <br /> mrnwcr nnec a wonK <br /> HEATING SYSTEM: ❑GAS rl ELECTRIC ,^ <br /> �scnmr vn�n,.r�o wur.ae roo..r.c nnavm can.c*n�nsm1 uro vwrR r�o <br /> e �- R � e 6�iN�t� <br /> krrcNdxJ wre�.u� P U <br /> I HER[OY CERiIFV THAT I HAYE READ AND EXAIdINED THIS <br /> APPLICATION ANO KNOW TNE SAME TO BE TRUE AND CORRECT.ALl <br /> rnw�o,m usE d ounn� a PpOVI510N5 OF LA1Y5 AND ORDINANCES GOVERNING TNIS TYPE OF <br /> YlO�K WILL�E WhIPLIED 1YI1H WHETHER SPEGFI@D MEREIN OR <br /> tcc.�'a,Lscgw�roxari�wu�tr�vawr�ououra��nen�twocorrts� NOT 7HE GRANTING OF A PERMIT DOES NOT PRESUh1E 70 GIVE <br /> mi��✓ o�acn � or AUTHORITV TO VIOLATE OR CANCEL iHE PROVISION OF ANV <br /> OTHER STAifl OR LOGAL LAW flEGULATING LONSTRUCTION OR THE <br /> CL�Q�� �( PERFORMANCE OF CONSTRUCTION.TNAT I AM AUTHORRED UV THE <br /> OWNER OF TMIS PROPERTY TO PERFORM TME WORN FOR WHICH <br /> APPLICATION IS 1.1ADE AND � COMPLY \YITH THE STATE <br /> r�naun�i o Huuu�n CONTflACTORS LAW 1B.D RC W AND 296200 WAC. <br /> � �oac�oiis� x��-�� �i/3o, 3/ <br /> Cp45�f1uCIqNIOI.NILNDCR.Appq[SS.1ClER1014�NY0EN � <br /> sx. �nr. yd6,3 0� <br /> UfY OV9N65l�LLNSI NO <br /> PLUMBING MECH�NICAL <br /> NO. TYPE OF FI%TUflE Oq ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER C�OSET�TOILET� A'C—AHNDLG UNITS <br /> DATHTII� ! FORLEDAIRSYSTEAIS <br /> LAVATORYIWASN DASIN) NEAT PUMP <br /> SMOWER � UNITHEATERS j <br /> KITCNEN SINK 6 DISP CLOTHES�RVERS <br /> DISHINASHER RANGE HO00 <br /> �AUNDRVTRAY ! \YAIER NEATER <br /> CLOTHES WASHEfl WOOD STOVE <br /> URINAL � h7ETALFIqEPLACE(WOOD�URNING� <br /> DpINNING FOUNTAIN i FIREPLACE INSERT(WOOD OURNIN3) <br /> FLOOR DRAIN GAS FIREPLACE <br /> DACNFLOW PREVENTERS GAS RANGE <br /> SINN�SERVICE—�AR.ETC.� f AS PIPING ! <br /> i E%HAUSTFAN <br /> I <br /> SUB TOTAL 5 SUB TO7'AL 5 <br /> PERAtIT 5 PERMIT 5 <br /> TOTALFEt 5 TOTALFEE 5 <br /> FUR OFFICE USE ONLY: XOfO —DOS <br /> ffIp111LE�0ACR PCAPSL10Al� 5-015C1B.�Cl( PlLNC11ECItM1Y0[11 [[C PKEIPiNJ <br /> us[za+c ioren�� seurviSnE FEES VPIUATIDN FEE <br /> ❑v[5 n�a ounvmc <br /> r¢i�a��ii+�nn�an worowuuru si:co�e�wli <br /> urvns xwa�w <br /> xcuru�cr m�n s*w�s a:curun io�o o�s�uir�r MEouHcu <br /> GROUP <br /> :TCS ❑1:0 <br /> iIFCSMiN�IlRPEOU NE�5011 ��1�4�µ����CR <br /> Oi1RP <br /> IINCILP�NRW� �USON <br /> S1�1E lUiLDrzq SUR64RGE <br /> m�corconsr r+u+s�rvrrov[oor pTYOFEVERETT waicwon+s � <br /> LOCALSALES � <br /> ,�,.� TAX CODE IS 3105 TO7AL ! �I <br />