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APPLICATI�1 FOR CONSTRUC�ON PERMIT� <br /> CITY OF EVERETT•BUILDING DI�ISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MECNANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT A�DRES:i �,b 2Q � CAP�Tar.L �.Y� E��oZ�'C�� <br /> / 4�1�00PE55 ��-�y� A C�fY 1p ��/��� p / \ <br /> ,�!?�O�C �� V"�/S/'yVC� �E1c(tCl�� yT�IOU 1�17� <br /> �L�� qu�AWf�E55 LI1V Z4 RIOIIE <br /> �[NANi � -s <br /> ��\� ~ <br /> I.PCNIi[C�Di1pF59NL� MAR�001�E55 ���Y 7if ��E <br /> Gj�..n�. <br /> 4[r�ER���n� �µ£ M�����[i5 G*/ Iw �YqN[ sGtE4:FN5E� <br /> �� <br /> �ILCN�NCy'CWIIP�CiOR 4��L�D0165 C�IY Ao MW'K 9uClIGVISE• <br /> RUuB�� �MIn N�O� �AAIl�Jp1E55 UIY I�✓ %KK:[ S1A1[LILCNSC� <br /> �rn� � <br /> °`'N1i01"""""1°�"��[� XEATING SYSTEM: ❑GAS ❑ELECTPIC ❑ — <br /> 6�G�P[��/EnMK� D OUA�Ltfql L1tllO�O CCW1�C\PEPSONuqRqNC \ <br /> 10 m ( `t <br /> t ac 2�6 7(c8-S 2 <br /> � I HEREBY CERTIFY THAT AVE READ AND EXAMINE� THIS <br /> APPUCATION AND KNOW TME SAME TO�E iPUE AND CORRECT.ALL <br /> rawrosm vse o�uwminr PPOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITM WHETMER SPECIFIED MEHEIN OR <br /> IEGKDESCR>IKYIC�'oFJttR1Y15M1WN0[LCWC�AIiACuiWOCdME51 NJT THE GRANTING OF A PERMR OOES NO7 PRESUME TO GIVE ' <br /> ior e,ocn a AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY I <br /> OTMEN STATE OR LOCAL UW REGUIFTING CONSTRUCTION OR THE . <br /> PERFORMANCE OF LONSTRUCTION.TNAT I AM AUTHORIZEO BV TNE <br /> — OWNER OF THIS PROPERTY TO PERFOFM TME VlORK FOR WNICH <br /> ppp�ICATlO MAOE AND I COMPLY WITII 'HE STATE <br /> vncc�u�io rar�e[n CONTPA ORS LA 1 711 ND 296200 WAC. <br /> O'O <br /> G:NstR�lLipN.ou�tEnMP.bMF55.T[lF1`rM1EM1Y0E� �( <br /> SIGtUNl1E 0�� <br /> pfYBUSWE55LtEN5C WJ � <br /> PLUMBIN6 VECHIINIC�L <br /> Np,7 TYPE OF FI%TUNE ON ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WpTER CLOSET(TOILET� A'C—A-'HNDLG UNITS <br /> BATHTUB FORCED AIR SVSTEMS <br /> LAVATORY(WASH BAEIN) NEAT PUMP <br /> SHOWGR UNIT HEATERS <br /> KITCMEI!SINK 6 DISP CLOTMES DRYERS <br /> DISITYIAGHER RANGE HOOD <br /> LAUNDRYTRAV WATER HEATER _ <br /> GLOTMES Y�ASMEH WOOD STOVE <br /> URINAL METAIFIREPLACE(WO00 BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACKFLOW PREVENTEPS GASPANGE <br /> SINK�SERVICE—�/R.ETC.1 GAS PIPING <br /> E%MAUSTFAN <br /> SUBTOIAL S SUBTOTAL 5 <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: — <br /> IPM.`_LiB�Cx PGR_EiBtCa 90ESflB�CM ttN�LNECRNVMBFII fCE PCCflPiNJ <br /> ps[iart .o���E• _�nrsrt[ FEES VALU�AT/�ION FEE <br /> :�ES '.',NO W0.P� {!�� <br /> NFIGNIlIN11A1C�: �Q1��WTllY1G $I�:/LC�bIL\"11�,�j� <br /> '1GOO 1�'� G111M0WG <br /> CCf��nYiCv N�tlSi;AtS CCCUV�IRIOYI OCl4I.f 4CCI�41iC4 <br /> �„Wo c�6 v� . <br /> ��,�s , � <br /> �OpIiqN4PlANCNELR <br /> fN�ESGPWGIEPPE 0 N�a�WN <br /> Ho < .S�A� o.��A <br /> ��,:�.:.,,u„��� aE�SbBP�✓ �- <br /> SI�fE WrtpNG SUPCMMGF. <br /> irveor<a�sr riu�s�vvaononr CITVOFEVEflETT wPiKw�'"s <br /> V ��1 �(Z LOCALSALES <br /> ��� onc QJ TAX CODE IS 3105 TOTAL <br />