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APPLICI�►TI� FOR CONSTRUC7�N PERMIT� <br /> C1N OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> .� DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING G SIGN <br /> PROJECTADDRESS �/�/D� �D �' na�n C�IG7-�- c�8-Z,�( (yZs) ass- aas'y <br /> .i" /% � <br /> cm to rr�a 1 p (' <br /> OWNER MAiL�WRE55 r_ Y} `Ib"�1 /��SJ ZrU_ � 'z �J <br /> ��� C(�j� (�(,U-� 310 I Io H hn�S UCrG 1 � t� p�E <br /> IENIM1T <br /> Mu�.00 c�ss <T <br /> RRGNILfCTO11OfSKrNER NRiLA00PfS5 <br /> GILV Z�� PNONE <br /> ''TM l� qpN� SLAIELILENSE• <br /> GENEAKLON1flALlOR n NAIL�OORE$$ I � �-J �Jzi� ,�yy Z�'G <br /> �/U;rr� •. 1333 5� ,uLGt�T c.�a-��l�c.ti�'`�.',--- �0=."�a�' i <br /> µS� Md'C _J ���� � E 9I.IELIGENS <br /> �M[craw c�xrnAcroa uui�o�r+css (U� f �SItKD�I(03�� <br /> YWMdINGLO11iR�CTOP ���U�DPRS <br /> CIiY Z�� %10NE SGIELICENSE• I <br /> LOYIPACi PPILE Of WCfl6 HEA7ING.;YSTEM: ❑GAS ❑ELECTRI� ❑ <br /> DESCHi9E WORN MO SOWRE����G[nn0.VED <br /> CONLACT FERSON/J10 PWNE fq. <br /> 1 HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> pppLICATION AND KNOW THE SAME TO BF.TRUE�ND CORRECT.ALL <br /> rnocwED use oc aunnua PflOVI510N5 OF LAWS AND ORDINANCES GO'JERNING THIS T�'PE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIF.D HEREIN O(7 <br /> i[w�oescaiarro1�oFPnoveatt�snowHeeioN�neerrucerv:ocowe5l NOL THE GRANTING CF H PEAMIT OOES NOT PflESU`AE 70 GIVE <br /> AtiTHORITV TO VIOLATE aR CANCEL THE PROVISION OF ANV <br /> �or oiatK � OTFIER STATE OR LOCAL L.AW REf.UTATING CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OAPPLICATOIONMI SP MADE AND PERCOMPLVMEWITOH KT ER STATE <br /> CONTRACTOPS lAW 1827 RCW AND 296200 WAC. <br /> r c�*�xio.r+uuecn O�Z�,O(15 ` f �/ � C — <br /> 1 z Z$ 2� 0 93 0- i� — <br /> or�sinucrio�+�o�N�cr+ocn. on[ss. c�E�^or+cr.uuacA ._l— onrc <br /> N�iUPE <br /> LITY BOS�NE45lICENSE.ti0. <br /> PL11M91NG MECMANIGAL <br /> FEE NO. TYPE OF EOUIPMENT FEE <br /> Np, TYPE OF FI%TUHE Ofl ITEM �y�_q,�HNDLG UNITS <br /> WATER CLOSET(TOILET) FORCED AIR SVS`.EMS <br /> BATHTUB HEAT PUrAP <br /> LAVATOFY(WASH BASIN) UNIT HEATERS <br /> SHO'NER CLOTNES ORYERS <br /> KITCHEN SINK&DISP RANGE HOOD <br /> DISMWP.SHEP WATER MEATER <br /> LAUNDRYiflAY �yppDSTOVE � <br /> CLOTHES WASHER METAL FIREPLACE(WC�OD BURNING) <br /> �RiNA� FIREPLACE INSERT(W JOD PURNING) <br /> DRINKING POUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS PANG: <br /> BACNFLOW PREVGNTF.RS GAS PIPING <br /> SINN(SERVICE—BAR.ETC.) EXMAUST FAh <br /> SUBTOTAL S <br /> – SU�TOTAI S pEfiM1T S <br /> PERh11T 5 TOTALFcE S <br /> TOTALFEE 5 '— <br /> FOR OFFICE USE ONLY: necc�orw <br /> p�,WC��CCMNUMO[R iEE <br /> fPONiS[iBaC1t AL�RSElOACM SOESEiBI&N _ <br /> usErou[ �or�nc� wtu�rs�re <br /> FEES VALUATION FEE <br /> ❑res n�o ammmc <br /> ��c�a�.urnrt.raN �+oorowcuna sizcoreioc*i vwue�r�c � <br /> uvns <br /> M'.CI�I+AfILY MOf%SiJ5h5 a�U��NIlO�� B15EMENi NECNI.NIC4 <br /> GHOVP (]\C$ ❑MO <br /> ,�IIION.LL PLIN f.11ECR <br /> fINCSfP01�LC�NEOO A���� <br /> OTICF <br /> v6:L.lGF4PE00 PEASON / <br /> SI�IE BUI�DING SURCHMGE <br /> I <br /> nvco�r.or+sr runseevaoveoor CITYOFEVERETT vun��:woaKs <br /> LOCALSALES ;QTA� <br /> w�i <br /> TAN^,ODE IS J705 <br />