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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98207 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> �PROJECT ADDRESS:�Q�J 5 El YYL S j' <br /> k_F�4�i��_ �Jz+'P. QI�aU3 �.sa-�as� <br /> ovr�rn oui r.amess arv rm r�rouc <br /> 1INAN1 YYII�bdi[SS GfV IIV p1�p4F <br /> •�ICIaifC10n0E5�R1C11 M�II.�[1[111F55 CI�V !0' PNOHF <br /> f.(N[IPlCON1OI,C�P1 M41�W11t55 Ci1Y IiP MqYE 54fL11Cf115E� <br /> #��l�h�� <br /> YFCN�NiULC0Y1111�1OR 4ul�DCnE55 Clry Ii� VIIQYf $1�IFUCENSE• <br /> 1'iauB�aGCONI!�CIOP N��l�dlRE55 Gh tIP PNONf S���FlRFNSF• <br /> ��!nC�1'IIICC O(WJf1M <br /> -�I d��� HEATING SYSTEM: O GAS ❑ELECTRIC ❑ <br /> �F�nx�Yl�soy��rt[tfOt E�uvtvFn CONr�CrntnSONUNr�quF.xp — <br /> � KE CE T CE <br /> l�rz.�-� r r <br /> 1 NEREDY CERTIFY THAT I IIAVE READ AND E%AMINED TNIS <br /> APPLICATION AND NNOW TIIE SAME TO OE TRUE AND CORRELT ALL <br /> y�vnoros�fo usre�orf n�und�x: PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS iVPE OF <br /> T�LJ_I_ WORN WILL BE C'IMPLIE�WITN WHETHER SPEQFIED HEREM OR <br /> ieceiorscmm���+ vrqrcnnivqrmBuowW�ro,ei�rwOton[5� NOT TNE Gf1ANTING OF A PERMIT OOES NOi PRESUME TO GIVE <br /> iot Otacc or AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTMER S7Ai[OR LOCAL LAW REGUUTING CONS7RUCTION OR THE <br /> PERFORMANCE OF GONSTRUCTION.Tf1AT 1 AM AUTNOR12E0 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICN <br /> APPLICA710N IS IdADE ANO I COMPLY WITH iHE STATE <br /> �u¢n ux io m�un[n CONTRAC10R5 LAW 18:]RCW RND 296200 WAC. <br /> C(klSIRIIC11f1N10INIfMlFl1./.[RVIE55.1[l[AIONENU4pF11 %[/��"/�//�{����Jti�� (�/�V(�jfU � 'l lV _ / I <br /> _ SfT�.lU11L UA�[ <br /> V <br /> ❑fV BUVIM1SS lIL(NSC NU <br /> PLUMBINC ME�H�NICRL <br /> NO. TYPE OF FlXTUpE OP ITEM FEE NO. iVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—AMNDLG UNIfS <br /> BATHTUU FOHCED AIR SYSTEMS <br /> lA'/ATOHY(WASH OASIN) HEAT PUMP <br /> SMOWER UNIT NEA7EiiS � <br /> NITCHf�.N SINK 8�ISP CLOTHES URYERS <br /> DISIIWASHEP RANGE HO00 <br /> LAUNDRY TfiAV WATER HEATER <br /> CLOTHES WASNER WOOD STOVE <br /> URI4AL METAL FIREPLAGE(WOOD BURNING� <br /> DRIHKING FOUNTAIN FIREPLACE INSERT h400D 9URNING� <br /> FLOOp URAIN GAS FIREPLACE <br /> OACKFL01'lPREVENTERS GASRANGE : <br /> �— <br /> SIAK(SERVICE—BAR,ETC.) � GAS PIPING <br /> E%HAUSTFAN <br /> SU�TOTAL 5 SUO TOTA� E ;00 <br /> PEFAIIT S PEHMIT 5 <br /> TOTAIFEE 5 TOTALFEE S •Up <br /> FOR OFFICE USE ONLY: <br /> �noNivm�c+ nru�5nn�ca s�D[sna¢K ruun�¢aHuunrq r!e nruimqo <br /> us[ra�.r Io1��F• v�ceNtsnE FEES VRLUR710N FEE <br /> ---+-- <br /> ❑rts ❑vo euitxw <br /> uflGn�U4ltAliOV NOIXUWL14rq 51![OtBlDG91 � <br /> unnz rwuxwn <br /> _ '_—'_"_{—__ <br /> Ut'r�i^�\�Y M'1 rv 51?a!5 Of,C1OANI 10�0 BASFMCM� 4H'14HIf.M <br /> (.1. . <br /> _ _I__� ❑vF4 ONO _ ��_ _" ._ <br /> f�'" ' - ytfiFE00 ,1F�SCH �W�IIDNHIYANC�Rf.M <br /> Olr�[q <br /> Iili�nV�ll�lfl[f�'U IIfAiOV --�' <br /> 5ulf OUM1Uaf.5Un6uOGE <br /> nrtorco�rsr nnns�rmov�oor CITYOFEVEHETT rnnur.wvmes � <br /> LOCAL SALES " — ---�— — —--�-- --- —' <br /> ���q TAX CODE IS 3105 T�TpL _ _ _ i_ <br />