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APPLICATI� FOR CONSTRUC�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STAEET•EVERETT,WA 98207 •(425)257•d810 <br /> ❑ DEMOLITION ❑ COMBINATION `� BUILDIN6 ❑ MECHANICAL ❑ PLUMBINO ❑ SION <br /> PpOJECTADDRESS: '�1DI ELM 57R.EE'r <br /> ��� Pmnc {� cm2l�.ku.-yfa 6u4 sr. Errxa�l4Psm �fss-3o3-�.f�b <br /> fn uiwwfss cm !�r oraM[ <br /> IEN�NI 4M MIP455 ���� )�� ���� <br /> o,..iaEtz <br /> •nc�«ttc*a�nfvc.cn uuiMmess ' - cnr nr n.rnr — ' <br /> �F{Ti 0 W nI f�fL <br /> f.fNf��lCO4�0�L1q1 4MI�IXM[55 C�IY li� RF)�I 44q14fM9� <br /> ?�'1 Qh�� <br /> VF � 4iC11C.(1Y1�1�fiU� Y��l�f1L F55 Cltt ]��• 1'1✓J4( <l��fl�CEN(E• <br /> ��lA <br /> PIUMBMGZp�IN�C�M 4��l4MWE55 CiIY lin 1'NOM( � S��IFIIL[MSf� <br /> ti la <br /> canmu'rmci ur wrn+ HEATING SYSTEM: ❑GAS O ELECTRIC ❑ <br /> ��//lo <br /> pf5�nierwJaw�w50unr�oo�wEwvq�2o cw��crwnSOM�rmr�qvrw Lf <br /> �N�„�E �i+*i � �dkP�CT�RRM� BW�T- !H O -1 � <br /> �•��=33GitL Nc 9ne 0 x C�r2x¢u, w: 691-5131 <br /> �L� � `n S� T 1 HEREBY CERiIfY TH11T I NqVE RE�D ANO EX�MINED THI$ <br /> Y <br /> APPUCATION/JIU KNOW TIIE S�ME TO BE fRVE ANO CORRECT ALL <br /> � ct utt or nvn nn PROVISIONS OF�AWS AND OAOINANCES GOVERNING THIS TYPE OF <br /> pn,I.fD f4UYRqt.R Wbl-KSNIV t SfenuJ'� WpRK Nnl L BE COMPLIEO W�TN WMETMER SPEGflE�MEREIN OR <br /> tcc�iotscmm�onar nrvivroxnenav9n m¢w*�wtm6i. ppT. THE GFRNTING OF�PERMIT DOES NOi PRESUME TO GIVf. <br /> FMC,T/wRK pDinO�/ AUTHORITv TO VIOUTE OR C�NCEL THE PPOVISION OF ANY <br /> ioi /0 ux.__w <br /> OTIIEF STATE OR LOCAL LAW PECULATIN6 CONSTRVCTION OR TME <br /> PERFORMANCE OF CONSTRUCTION TM�T I�M AUTNORIZED BY THE <br /> OWNER OF TMIS PR07ERTY TO PERFORM THE WORk FOR NMICH <br /> APPLICATION IS MADE AND I GOMPLV WITH THE STIITE <br /> ruar,n.w io Mrumn � CONT ORS lAW IBP RLW 0 Y96200 WA <br /> Yy95-rt00-lo�-00(0 _ <br /> COM[II111LtttIMIWNIfMfIfP AfNM1f5f 1[If1�lONEMhMF1� �_ <br /> _y�t_ n'� X �un. KiM sIG nut <br /> b�` ..' <br /> rr eu�r<ss unNst vo <br /> PLUMlIN6 MECNIINIC�L <br /> NO. TYPEOFFlNNREOf11TEM FEE NO, TYVEOFEW�PMENT FEE <br /> WATER GLOSET(TOILET) NC-MINDLO UNITS <br /> B�THTUB FORCED AIR SYSTEMS <br /> L�VATORY(WASM BASIN) HEAT PUMP <br /> SNOWER / UNITHEATERS _ <br /> KIiCHEN SINK d DISP CLOTNES ORVERS <br /> DISNW�SNER RANGE MOOD <br /> LAUNDRV TR�Y WA7ER HEATER <br /> CIOTHES WASHER WOODSTOVE <br /> URINAI. METALFIREPLACF.�WOODBURNING) _ <br /> DRINKINC FOVNTAIN FIREPLACE INSERT�WOOD BURNING� <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACNROW PREVENTERS GAS HMlGE <br /> SINK�SERVICE-BAR,ETC J GAS PIGING <br /> E%NAUSTFAN <br /> SUB TOTAL S SUB TOT�L S <br /> PERMIT S PERMIT f _ <br /> TOTALFEE S TOTRLFEE f <br /> FqR OFFICE USE ONLY: <br /> rnnwrvm+r. nr.nsnn.c• Z�� vasrnuc. n�wi�.ncc.�.��«ra l rrt nrttm�.q <br /> 2.O ���; N S � ��'dL� � <br /> us�trnr io�un+ wov�s�ir _ FEEs VI1LU11TION FE__7Err__ <br /> �I 7eXZ2��=�S4QJ ❑.ts � nwnv: .a <br /> ��t�m��nv�uiro� �.o a nwnvwc srn a�e�ocv —'-' _ p <br /> q� inns ruionm; <br /> z-�CJ � 3.SI/' __- ___ _ '__ _ "_'__{-._ <br /> xcvr��,::r r�rv.r,�n�s mnm�H�m�o e�vut�� wn:w.uru - - _ <br /> f.11W�' . �� <br /> A-I m�s o — <br /> nts�+avncnncvo-- nnsa+ �muorn,nwoxc. . _ <br /> m��[n <br /> IwE�U11MPLOD 1K�[fJV ' r <br /> 41�1�RIx1IHh':S�IIK���nt:f <br /> _ iJ� <br /> orvoreaier nevc�rm�v�nnr CRVOFEVERETT rneiitwrv�+e � <br /> J , I - 1 LOCALSALES � <br /> �1 i,.�� S!� TAX CODE IS J105 TOT�I _ -- — �� ;'IS <br />