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APPLICATI� FOR CONSTRUC�ON PERMIT <br /> CITV OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-d810 <br /> ❑ DEMOLITON ❑ COMBINATION ❑ BUILOING p� MECHANICAI ❑ PLUMBING ❑ SION <br /> PROJECTADDRESS: /�O�"S �uC$.t�^'ea'r L-�^-i ' � <br /> Q�ti Pca�oc.k wzs �dsew..00r �.n. ��w...�i 9azo� 4zc'- 348 - S`V�9 <br /> rnwrn uui�micss nrv zm r»-,¢ <br /> 1[M�Y� V41�1IMf5$ ry,lY Jlp %qyF <br /> �f�qttP W OELGqtn uu��Mn�tsG cnr /rr — rvp.r <br /> �100 Sb'a'�1�100 <br /> C�N[II��QOYtNf.l(Y1 V4tI.01M65 Ci1Y p� IMMnf Sl�q�i�fNSf� <br /> Cho�u. llowt Sec��caS Po Oor yi`{ nokotii�l� .x� 9$L9� CHo�CF\So33 6k. <br /> 4iGuuiUlrnv�n�qOn uutnLMFss f.�iY t�r nb4f [rufl4[MCF. <br /> �11140MGCONIH��1L`II M�i�1[NY1F55 �IIY I�C 1'NO4F SI��f11�CN5!• <br /> LDNIM11L11'�11[[VIµp11R <br /> .�� Zcoo. �i� MEATING SVSTEM: ❑GAS ❑ELECTRIC ❑ <br /> OFSCNPF W:NIN�NII SW n�f�00�1�E nVO1lTD COut�Ll M IISON�M(�1'�NMf NO <br /> �w�lwd__ qaL L� ��14t1 ��ASa�'E�' — <br /> _ ni lo��s �akJ � �.s 10� i� t,l�.,, <br /> I NEREBV CERTIFY THAT I Nr1VE READ �ND E%AMINED THIS <br /> nmros�o us�.or nonnien AP�'L�CATION RND NNOW THE S�ME TO 8E TRUE�NO CORRECT ALL <br /> PROVISIONS OF�AWS AND OROIN�NCES GOVERNING THIS TYPE OF <br /> WORN WIIL BE COMPLIED WITH WHETHER SPECIFIED N[REIN OR <br /> iccun[scmrnavwnnorcnrv�vqwnpuowp�eneu��con[s NOi THE GRANTiNG OF A PERMIT ODES NGT PRESVME TO GIVE <br /> io� aioca pr AUTHORITV TO VIOUTE OP CANCEL TNE PROVIS�ON OF ANY <br /> OTHER STATE OR LOCAL L�W REGULATING CONSiPVCTION OR THE <br /> PEFFORMANCE Of CONSTRUCTION TNAT I nM AUTHORIZED BY THE <br /> OWNER OF TNIS Pf10PEFTV TO PERFORM TME WORI( FOR WYICM <br /> APPLICATION IS MADE AND I GOMPIY WITH THE STATE <br /> r•ncn uv�o re�uni n CON�RRCTORS l AW 1 B 2�RCW�ND 296 200 WAC <br /> .� /�� <br /> cor��nucnmi�o�x�r.mFn uimcss�c��nawEwwxtn x l.0 9-i S-99 <br /> $•fN�lUfl U11f <br /> C11YpU4NC55lCENSC Np <br /> PLUMBING MECM�NIC�L <br /> NO. TYPE OF fll[TURE Oq ITEM FEE NO. iYPE OFEWIPMENT FEE <br /> WATER CLOSET(TOIIET� MC—NHNDLG UNITS <br /> BATH7UB FORCED AIR SVSTEMS <br /> LRVATORV(WASM BASIN) HEAT PUMP <br /> SHOWER UNIT HERTERS <br /> KITLHEN SINN d DISP CLOi11ES URYERS <br /> D�SHWASHER RFN3E NOOD <br /> L�VNDRY TRAY ll'AiliR NEATER <br /> LLOTHES WASNER 140CJ STOVE <br /> URINRL MEL1L FlREPLACE pY0J0 BURNING) <br /> DtiINNING FOUNTAIN FIFEPLACE INSEAT(WppO BUPNING) <br /> FLOORDRAIN ( GASfIREPI.ACE <br /> _ UACNFLOW PqLVENTEPS GASRANGE <br /> SINN�SERVICE—BAR,ETC.) GAS PIPING �— <br /> E%MAUSTFAN <br /> $UB TOTAL f SUB TOTAI f <br /> PERMIT 3 PERMIT S —r— <br /> TOTA�FEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> IIVIH1Vl11�fN 11fM5f1p�C�I $IC[5(IR�CR ry�N[II�{',RNVVPfR I(F 11(f�lt'�Np <br /> _m9�D D/3 <br /> �"��ti�� �o�"n^ v�c+a�sn[ FEES VAW�TION FEE <br /> ❑rrs ❑rx> __ '__ __T__ <br /> Ri�irvvr. <br /> IIIIf.11111VI1�110V Np1]II�Wfl114G Sr�IbBIOG'il � <br /> 1i4i1': <br /> %�14P 4f <br /> Ol:llinq::v 4`rv.uw.ry q('�n4M11U11� B�iiVf4� � � �� � —}— <br /> ilqll� Ni111�AN:11 <br /> � O�I$ pNo ' . <br /> nni.:rvrum�n[au_'_ nv.vrn �Ddutwyn�Mnuc� <br /> _ onrtn _ ___' __ _' <br /> I:f:l I�l/�HA1 P100 11�/.fnV _,___ <br /> cl�ll fl�41U✓�I15�111(I��f1C{ <br /> i�r�o�cova rie�s�rrnrnrnnr CITYOFEVERETT .rnnaw�i�.� —�- - '-"" �" '— <br /> LOCALSALES ------ --�— -- - <br /> u.�e TA%CODE IS 7105 TOuI <br />