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APPLICATI�1 FOR CONSTRU��N PERMIT — <br /> CITY OF EVERETT•BUI�DING DIVISION � <br /> 3200 CEDAti STRF:ET•EVEFETT,WA 98201 •257-8810 <br /> fl DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING i"' SIGN <br /> PR�ECTAp9RESS�.�L�CTT� /7 (�� <br /> � f— <br /> owr.c u.x� rss cnv zv rxoNc <br /> � ' �✓ // 7 JUG5l3v .(�1' �GU � '��/ <br /> .E� L� � Gy�`_��s_ �L-e���,. =Q R�� <br /> enO�pEC)OnoESGy�P u�ReWPES trtr � lw m,ONE <br /> .vz .)�7ri i�(� �0 /�X 39 7 7t'a u/bf� !c�/� �445 <br /> GEN[R�>L/011iRAL10A M�II�DIXVE`.$ CItY ZM I+NON[ $I/.tEIKEN$f• <br /> G/f h� �G3/J 6�f�./�'��J ,�.Zc1�� 9�/%J (I-,x�F`f7'679�`"y 6l<'A/�0�/J/T��G <br /> umH ucoeie cro u�ii oncss atr zw w�a�c s*•*eiKer�se• <br /> �e, e .,s�,La �ii�o�.�a. �'rRAti�9N/ZSkr_ <br /> rwuoiwcarta�cion T1a�ooaEss rnv zm vna�E s�rci�c[nsc. <br /> torrtaect [�ry.cen <br /> �/-_�l J HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> ocs +m�wor+n u:o sown[roo.wc nrvavco ca�*+ct rcasorv u�p r�e rq <br /> �uc l�v� c u f <br /> .fs��/U� z ii<�U�,��� �vb �`t"L G �`I� <br /> I MEREBV CEFTIFY THAT I NAVE READ AND EXAMINED THIS <br /> APPUCATION AND KNOW THE SAIAE TO BE TRUE AND COHRECT.ALL <br /> rnorosED use or Bmmn+o PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE LOMPLIED WITM WMETNER CPECIFIED NEREIN OP <br /> �cwio[unroiqHorpuorcervrswwNeaowoae**ecM�wocorics� NOT. THE GRANTING OF A PERMIT DOES NOi PPESURIE TO GIVE <br /> iot o�oCe o� AUTHORIiY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TME <br /> PERFORMANCE OF GONSTRUCTION.THAT I AM AUTMORIZEO DY THE <br /> OWNER OF TMIS PPOPERN TO FEPFORM TME WOPK FOR NMICH <br /> APPLICATION IS MADE A4D I COMPLY WITM TME STATE <br /> v.ncuuKio rovorn CONTRACTORS LAW 1827. W 29fi200 WAC. <br /> LOfKIRUC1qN-OANICtNER.A0q1E55.lE1Ch10NENUAIOCB y� � ���%� J �/� �� <br /> iSw' +t nc wic <br /> CIIY BUSiN[SS LILCNS[NO <br /> PLUMBING MECHAI:'CAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAiER CLOSET(TOILET) NC—AHNOLG UNITS <br /> DATMTUB : FORLE�AIRSYSTEMS <br /> LAVATORV�WASH OASIN� HEAT PUMP <br /> SHOWER j UNITMEATERS <br /> NITCHEN SINN 8 DISP CLOTHES ORVERS <br /> DISHlYASNER RANGE HOOD <br /> LAUN�RYTRAV WATERHEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAI METALFIREPLACE(1YOOD BURNING� <br /> DRINNING FOUNTAIN FIREPLACE INSERT(WOOD DURNWGI <br /> FLOOR ORAIN GFS FIREPLACE <br /> BACKFLOW PREVENTERS GAS RANGE <br /> SINK�SERVICE—BAF ETG) GASPIPING <br /> E%HAUSTFAN <br /> SUBTOTAL 5 SUBTOTAL 5 <br /> PERM17IT 5 PERh71T S <br /> _I_ TOTALFEE 5 L TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> lPONISElO�LN PGPSLIB.�CN SICESEiB�CN 1'V, CMICGMNIBCR iCE PdE1PiN0 <br /> use:ove mr�n[� �aurvtsrt¢ FEES V�LURTION PEE <br /> ❑vcs n�a emiorza B � <br /> �rt�errtiiurt•iion eaorowuurm sucoro�oei� <br /> uxrts <br /> nuue�rvc <br /> IX:CU�uKV IACfS 4$ CCCUF�NllO�D B�SLM[ryi MECII�NICAL <br /> OUOVP�Y� <br /> ❑YES NO <br /> HPp$PRINXICPRE00 PEA� �']���/I MD�f10N41RANOICCN � <br /> NCJ `��' " OiN[N <br /> i���C�U11MP(pD 11FASON '(I' l <br /> /�ia � �C���(/V Si�tEBURDiNGSUaC���RGE � � '�I <br /> ivPcacm�sr v�u�s�Pfpavcoor qTYOFEVEflETT ruoi�cvroa.s <br /> �� <br /> LOCALSALES <br /> / ��� �.�� ( �� TAX CODE IS 3105 TO7AL � � <br />