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APPLICATI� FOR CONSTRUC7�N PERMIT� <br /> CITY OF EVERETT•BUILDING OIVISION <br /> 3200 CEDAR STREET•EVEHETT,WA 98201 •259-8810 <br /> ❑ DEMOLITON ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SKiN <br /> PROJECT ADDRESS: <br /> T��+t R46�NT�IHD. .Z77o Nna¢�seN A.e EvEae)f 98Zo1 2S –06 '�`� <br /> ow�rtn ��nww�css nn nr npr¢ <br /> ttHev� � NEG �"°'N0"�ss un rm nnr1[ <br /> �eNl� �E2 1 c. _�EL(luc I�qYn W /i <br /> •ncMrcc�rnocsKwrn uuiubncss arv n� ^�+��34n) ys7-ry?I/ <br /> F4¢m� NemE STE!( �S�-D4_ 13ri'Z-4 7irt'e4Yu�p�_�_$w�elcTeM Q$Z33 FA'QM H18�sSD1+� <br /> G[M[nuCOM�Mc1M wulMlMtss O�r I�r npN� S�L�U�LYMY• <br /> YECN�MCAICWIP�Cid1 M14AOd1E55 (Iry }1P PIqN( sp�FIK[NSE• <br /> dVIUMRMCICq1111�C1pP Y1iLMpIE55 Uh jN MqNE $���EIIL(HSE• <br /> q ro z <br /> car�r �rmcE or v.onR <br /> ,)� c'�.���' HEATINGSYSTEM: ❑GAS ❑ELECTHIC ❑ <br /> otscnecv�wK�Hosowncrao�w[Nvav�o carn .rrtnswuor��a.[xo • <br /> / X 12 �e +��tE L G - �AQE a� c <br /> b 8 �>� zY�' <br /> 1 HEREBY CERTIFY THAT I HAVE RE�D AND E%AMINEU TMIS <br /> nnd�p�ousc a euioixn APPUCATION ANO NNOW THE SAME TO BE TRVE�NO CORRECT RLl <br /> __'�D FW s�K C 1}L�� S PROVISIONS OF UWS AND ORUIN�NCES GOVERNING THIS TYPE OF <br /> WORN WILL BE COMPLIED WITN WMETMER SPECIFIED HEREIN OR <br /> t[c�io[umrtpr�orimdtnnivqvme[iowon�n�cNirqcon[s1 NpT. THE ORANTINO OF A PERMIT OOES NOT PRESUME TO GIVE <br /> iot aiocK or AUTHORITY TO VIOUTE OR C�NCEL TNE PROVISION OF ANY <br /> OTHER STATE OR LOC�L LAW RE6ULATINO CONSTRVCTION Ofl TNE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM�UiMORIZEO BY THE <br /> OWNER OF THIS PRJPEFTY TO PERFORM THE WORK FOP WHICH <br /> 2 i z 4 - oSR �o�� o o RPPIICATION IS MAOE 11ND I COMPLV WITH THE ST�TE <br /> ru¢a m i o rnnaxn � CONTRRCTOA$UW 1027 RCW AND t96200 WAC. <br /> 562> 449 - a2o � on6 /^ . <br /> COMSIPUCtiWIOANICM�F11,N1ME55.�[lEAqr�ENWllfq X` /� �✓LLh�/"��✓i� 7�'z(Q/(�6 <br /> SIGN�NfI( � D�t� <br /> Cl1Y BUSiNE55lCEN5C Iq <br /> PLUMBINC MECHANIC�L <br /> NO. TYOE OF fl%TURE OR ITEM FEE NO. TYPE OF EOUIPMFNT FEE <br /> WATEP CLOSET(TOILEn NC—MINOLO UNITS <br /> B�TMTUB FORCEO�IN SYSTEMS <br /> UVATORY(WASH BASIN� HEAT PUMP <br /> SNOWER / UNITHEATERS <br /> KITCHEN SINK 8 DISP CLOTHES ORYERS <br /> DISHWASMER \ RANGEHOOD <br /> UUNDqV TPAY WATE(i HEATER <br /> CLOTHES WASNEq WpODSTOVE <br /> Ui71NAl MRAL FIREPLACE(Y':OD BURNING) <br /> ORINKING FOUNTAIN �� FIPEPIACE INSENT(VJOOD BURNING) <br /> FLOOR ORAIN ' GA$FIREPIACE <br /> BACNFIOW PREVENTERS GAS MNGE <br /> SINK(SERVICE—BAR.ETC.) GAS PIPING <br /> E%HAUSTFAN <br /> SUBTOTAL S SUBTOTAL f <br /> PERMIT 5 PERMIT f <br /> tOTALFEE f 70TALFEE f <br /> FOR OFFICE USE ONLY: <br /> rnpu�sr�p�c6 aunsfiPKx 50ESF1e4M RexbKcaMuwrn r[p nrcrir�rq <br /> O c io ��a�1�- 1 � <br /> u:clonp w�en[� V�CAN�yIE FEES VALUATION FEE <br /> '' . .5 Cicii res ❑r.o eunomn , 009.(� �J IC%C7 <br /> ��umn uw��noh Mo a owcwra sue a eiowi <br /> �_— ����� I�7 G� M����.,� � <br /> VLIVC�MC� Mf/SIMIS OCLIII'ANIl0�0 B�Y4[NI ! <br /> 1��1MT � 4If11�NILy <br /> '- i 1 � o,E� - - <br /> nn[5raixa�EnP[ao nt�5pn �OU�N1s�InnwPxtM <br /> NJ --'— <br /> ai�Kn <br /> nacuwnMnmo nr+c�r. <br /> �U sturmnmmr.su�x;n�nr.[ � � <br /> �rrrw�ovc� nnr���rmv�ner CITVOFEVERElT n�nir.�n�c <br /> l / ��� � LOCALSIILES — — --- <br /> ' '�� -J _ b TAX COOE IS�105 ror�i <br /> ��.�� c 3 :5z� <br />