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APPLICATI�I FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BU�LDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257•8810 <br /> ❑ DEMOLITION ❑ I;OMBINATION ❑ BUILDING O MECkIANICAL ❑ PLUMB�NG ❑ SIGN <br /> PROJECTAD E <br /> '�y ���� r,.-'r�-Y �'�E�z�F� .�d- 98zo3 yzs 7/v Svs� <br /> M�LA�JNE55 CIiY !p pp� <br /> G'7r�N R��G,a2��, r oy £//�o�` w,,ci FdF.re� � ,�9��`1 zs� 7io S v <br /> iEN/.N! VAIL�MflE$$ -CIIY� $p pp'� <br /> ARCHIIEGiOROESpHEH Y�RMp1E55 GlY ZV 1rypHE <br /> GENER/�ltdliMCttNi MI.0.AW11E55 Cltt ZP PI1pNE STAtELICENSE� <br /> ��1���� <br /> /J1iGH�MC LO� �UKApppE55 CRY tN %KKIE S��iEIICENSE• <br /> PW40RqCd1IRALiOF MNL�pp11E55 � pTY SP %qNE SiAtELILENSE� <br /> Sd <br /> rvin.�ct vnce or xroaK <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> ocscnmewom� .wErootiu:earvav[o cart�crvcnsw�umnqrhHo <br /> l: Z Far /I � <br /> wN� ft <br /> I MEREBY CERTIFY THAT I HAVE READ AND E%AMINED TMIS <br /> PROPoSEDUSFOG BUM1WNOS�� APPLICATION AN�KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORH WILL BE LOMPLIED WITM WHETHER SPECIF:ED HEREIN OR <br /> IEGAlpESCPWiKK10iPROPERtY�SNOWNBEIOWpi�iIACNTWC0VIE5) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior �ocrc ar AUTMORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWIJER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAOE A I COMPLY WITM THE STATE <br /> �.n��i� �.,io.nuuoen CONTRACTOR W1B.27 D296.200WAC. <br /> CONSiNUCiiON t0/.N LE11�EP,AOpqE55,IELERqNE NUMBER � <br /> N�NNE DetE <br /> C�IY BUSFE55 LICE115E NO <br /> PLUMBIN� MECNqNICAL <br /> NO. TVPE OF FI%TUflE OR ITEM FEE NO. TYPE OF EOUI%AENT FEE <br /> WATER CLOSET(TOILET) NC—,VHNDLG UNITS <br /> BATHTUB ; FORCEDA;RSYSTEMS � <br /> LAVPTORY(WASM BASIN� HEAT PUMF � <br /> SHOWER i UNITHEATERS � <br /> KITCNEN SINK 6 DISP I CIOTHES OflVERS i <br /> �ISNWASHER RANGE HOOD <br /> LAUNORYTRAY � WATERHEATER <br /> CLOTHES WASNER WOOD STOVE . <br /> i <br /> URINAL � METAL FIREPUCE(VJO00 BURNING) � <br /> DRINKINGFOUNTAIN I FIREPUCEINSERT(WOCDBURNING) i <br /> FLOOR DRAIN GAS FIREPLACE <br /> BALKFLOW PREVENTERS � GAS RANGE <br /> SINK(SERVICE—PA0.ETC.) { GAS PIPING i <br /> I E%MAUSTFAN � <br /> i <br /> i <br /> I i <br /> SUBTOTAL S � SUBTOTAL S <br /> PERMIT S { PERMIT S <br /> TOTALFEE S ! TOTALFEE S i <br /> FOR OFFICE USE ONLY: <br /> fPONTSEiB.�CN REARSEIpALIt $Ip[SEfBACR AANCNEGNNUNB[p fEE RELEIpiNO <br /> 1 <br /> wetor+E iatmc� yku�rsrtE FEES V��U�TION FEE <br /> ons o ra euaowo <br /> r�¢w�rtuu�r•rw� rroaowcuu+a saeorxoarti. <br /> unns <br /> 0.WBiNQ <br /> OLapANCY IqCiS10RF5 aCCUFANIIOdD 9�SEY(NT MECHAMCAL <br /> OYES O NO <br /> LIPESPPiM4CNRE0D REASON �DDRKKi/.LPLANCNECM <br /> OMEH <br /> fN1EMARNPEOU qEA50N <br /> SiAIE WM1OWO SUPCNMGE <br /> rrrEorcw+sr ruHsr,wrwvcoer CITYOFEVEHETT wa�cwwixs <br /> LOCALSALES <br /> o�re TAX CODE IS 3105 TOTAL <br />