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� APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION � BUILOING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: I�I�I LOIY1 rL A�e. tufrG'� WFl � �� <br /> k��r�L . (�r�.�e 1� 14� m�� ���f- E�e�eN 9A101 (c/�i �$5-�1541 <br /> oN^:En vn�eppnF.Ss G�rv br r hC <br /> lf�l�•�1 MMI�IIW�lS[ f.l\V IIP PIIO4E <br /> ♦nC�liifCIOI1�E51G4f11 NAII/�DfIPESS CIfY llf� f'�qNF <br /> (".fI1L(lnl C,ONIII�LIpi MI.IIAppnE55 CIIY I�� f'11lJ4C ���tf IICENSF I <br /> ViC����:IC0.f.�NIP�pOR N�R�CG1F55 LILV )if� iV10Kf Gf��fIICENSE• <br /> PVi�IBi��GCONIH�f,lql N��IAWfi(55 ��n' IIP P110NF 541FLiCENSF• <br /> w��rn�unmceorwnnn HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> crscnioe woaK�r�n souen�roo*�cr n+m�vco r.ouuc�rrnsa�i.xn ruovr rw <br /> ��' . o f cl r. <br /> 8 e. P ��o"�' � <br /> I HERE�V CERTIFY THAT I NAVE READ AN� EXAMINED THIS <br /> APPLICAiION At�O NNOW THE SAME TO OE TqUE AN�CORRECT ALL <br /> vnorosvo us[ov nmmiHc pROVI510NS OF LAWS AND ORDINANCES GOVERNING THIS 1VPE OF <br /> WORN WILL BE COMPLIED WITH WHETHER SPEGIFIEO HEREIN OR <br /> icw�o[scemnoriarriwr¢nnmawnnaowone*uc��*wocon¢9 NOi. THE G�pNTING OF A PEPMIT �OES NOT PRESUME TO GNE <br /> io� oiocx or AUTHORiTt TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TME <br /> PEPfORlAANGE OF CONSTRUCTION.TNAT I AM Al1TMOR12ED OV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICM <br /> APPLICATION IS MAOE ANO I COMPLY 1VITH THE STATE <br /> CONTRFCTORS LAW IB27 RCW AND 294 200 WAC. <br /> P�BCfI ll.x I�NtIYPER <br /> o - � - � -OC - 1/ (\�/ ' l - 1a -98 <br /> LON4IIIIL110NlOANICNpE�1.IfId�ESi.i[IUMONENUVPEP 1—i� s ` �� <br /> . �.NI.111IIL U�1C <br /> LRY 6USME$llCEt6C NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUNE OH 17EM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) P/C—P/HND�G UNITS <br /> BATHTU� FORCFD AIR SVSTEMS <br /> LAVATORV(WASN DASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISP CLOTVIES ORYEFS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRVTRAV WATER HeATER <br /> CLOTHES WASHEi7 WOO�STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING� <br /> DRINKING FOUNTAIN FIREPLACE INSERT(VJOOD BURNING) <br /> FLOOR�HAIN GAS FIREPLACE _ <br /> DACNFLOW PFEVENTERS GASRANGE <br /> SINK�SEFVICE—BAR.ETQ) GAS PIPING <br /> —— - EXHAUSTFAN <br /> SU�TOTAL 5 SUB TOTAL . <br /> PERMIT 4 _ �EAMIT 5 <br /> TOTALFEE S TOTALFEE E <br /> FOR OFFICE USE ONLY: <br /> innr�rmn�rz nrensrro�cs sioes¢�e�ca rur�cn[c+xounrn rep nanrrr�o <br /> usr�o�a io��n[e veGv�sn[ FEES VAIUATION FE_ E r_ <br /> ❑ves ❑�:o nmmwr. <br /> ��riranivrteuou monuwuui+c: szEoreioc�i ---___ —�— <br /> uvns viuunwr. <br /> C`ll:llf'A'.I:Y M^.���If.��l5 VCC.111`I.NIIU�V 01iF4fK1 MF(:II�Mf.11 � <br /> �.11:)Ilt` - <br /> ❑\Eti ❑NO <br /> — PDDiIiON�I.PUNLI?CK <br /> i-:�t�:rmrixaAnco-o n��so.0 _- - — —" <br /> ov¢n <br /> iZ:rn�annineoo nr.sov �} � G�/� <br /> surtaunowr.snnnunr.e _'..' 2—A./L� <br /> �rr� crcova rin�.s�riwpvrnm CITYOFEVERETT rnxucwni+�c <br /> LOCPLSALES —� -- - -—�— <br /> ��a�E TAX CODE IS 3105 TOTAL _ _ <br />