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APPLICATi� FOR CONSTRtJC7�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA B 01 •259•8810 <br /> ❑ DEMOLITION ❑ COMBINIITION O BUILDING MECHANICAL ❑ PLUMBIHG ❑ SIGN <br /> PROJECT ADDRESLS: �� j/E Vl-V -z��� A Ht F In��.�-� f,f� <br /> �a/��++ /�L'M.�ryl .. //,// c'w��'�1 n _�,���i�-A �2� ��6 1 a s 9- 3 S s I <br /> OWNFA ���ES� <br /> n�„� _ � <br /> iEN4Nl 4�IIMp1E55 f.11Y )�� hqHE I <br /> •11CIE1LCId10ESIGNFP YNI�W�IETS CIfY 111. PIIONE . <br /> GEHFf1µCOM�B�C�P� MulM1Y1LSS L�IY li�` P�bMf S���EIICEN$E• 'G � <br /> 1-y1L� u + nf r �ti���, � � 19NY 7��_/L.� .�'l V� .^+�-., c,� IA'b�3 �uf-s��A� <br /> YECN�N:PlCd11F1Gip1 uuir.00ness nn m r�wNc Su�EI�LfMSF• <br /> 14UWWGCp11R1CIM M�II�C�NI[55 [I�Y lln � PIpN[ $l�iEIICFN$F• <br /> cor�rw�ctrmccawyn HEATINGSVSTEM: IlXGAS ❑ELECTRIC ❑___ � <br /> L� m�0 -- - <br /> ocscnieE wa+.•rm saunE rooucE wvavEo cc»n��:�rrns�un nroirt ra �} p <br /> __ ll��M /��/'fAA� �S /�1SYI <br /> I HEREOY CERTIFY THAT t HAVE RE�D AND E%�MINED THIS <br /> RPPLICATION AND KNOW TNE S�ME TO BE TRUE AND CORRECT ALl <br /> �Iqro5E��5E Of EInIPW PROVISIOHS OF LAWS AND OROINANCES GOVERNINO TNIS TYPE OF <br /> WORN WILL OE COMPLIED WITH WMETHER SPECIFIEO HERFIN OR <br /> icc.io[5cmr�roNorn�a�cnnis�ow�+euowrnen.cN�wuconE51 NOL THE aRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> ior p1�M1 o� AUTIIORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY <br /> OTNER SfATE OR LOI:AL LAW REGULAi INa CONSTRt1CTION OR THE <br /> PERF�PMANCE OF CONSTflUCTION.THAT 1 AM AUTHORIZED BV THE . <br /> OWNER OF TMIS PROPERTY TO PERFORM THE WDRK FOR WN�CH <br /> APPLICPTION IS M�DE AN� I COMPIY WITH THE STATE <br /> ruccu�ui o.rwarn CONTRRCTORS L/f�'1027 RCW ANp 29 00 WAC. <br /> cws�nuciion�oent��ncn..nmtss.tEicnwnEmn�e[n X____�' ��(__�4f .� � �� �� <br /> SICN�IVII D�IE <br /> U�Y IIVAM.SS llCE NSC 1q <br /> PLUMBING MECIUNICAI <br /> NO. TYPE OF Fl%TUNE OR IiEM FEE NO. T'PE OF EOUIPMENT F[E <br /> WATER GLOSET(TOILET) NC-MiN�LG UNfTS <br /> UATHTUO FOfiCED AIR SYSTEMS , <br /> lA\'ATORY(WASH OASIN) _ IIEAT PUMP <br /> SMC WER UNIf HEATERS <br /> KITCHEN SINK 8 DISP CLOTIIES URYERS <br /> OISHNASNER � f1ANGEH000 � <br /> UUNJRYTRAY ' WATERHEAIER <br /> � WOOUSTOVE <br /> CIOTHES W�SNER _ <br /> URINAL MEfAL FlBEPLACE�VOOD BURNING) <br /> ORINKING FOUNTAIN FI(7BPLACE INSERT(WOOD BURNING) <br /> FLOOR�RAIN GAS fIHGPLACE � <br /> OACNFLOW PREVENTERS GASRANGE � <br /> T <br /> SINK(SERV�CE-OAR.ETC.) GAS PIPING <br /> E%IIAUST FAN <br /> SUO TOTAL S SUB TOTA� f j <br /> PERMIT 5 PERMIT f /,7� ,� <br /> TOTALFEE S TOTALPEE S � � <br /> FOR OFFICE USE ONLY: a <br /> 1'�ANCIICC�.MI411�11 !�� �fCI��iNO <br /> f11CN1S011�CN PW�SFIPACR S�OCSFIfl�La �JL <br /> _�_I��1 <br /> veceHlv�[ FEES VAWIITION FEE <br /> U5[10`iE lO��n(♦ --� <br /> OrCs ❑� o�miurxi <br /> �rt�cnuoiuncu NaaowcwMc 54EornmGm n��Mmvn � <br /> �nns '___—' - —1— <br /> aar.Ha wnsmw�s acwreetio+u e•scuent umuwc.i <br /> GnWP — ' <br /> ❑v(5 ❑r�0 <br /> - manneunevcma <br /> rn�csmiHK«nncaro nr.sw ---- ' <br /> nmrn <br /> ru¢w.ne�nEo'o nF�cro surtnimu�vrsunc�unnt <br /> rvrcorroNsr rier�s�rrnwtnor CITYOFEVERETT n�����r�'^�'^° <br /> LOCALSAIES --------- - —----— <br /> ���i TAX CODE IS 7105 TOTA� _ _ _ _ <br />