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��► <br /> ,APPLICA71� �OR COl�C�Tf�IlCT�N PERPt11T�� <br /> CITY OF EVERETT•BUILDING DIVISiCN � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8870 <br /> Eh70LIT�ON �fG COMBINATION ❑ BUILDING I7 MECH0.NICAL ❑ PLUMBING G SIGN <br /> PROJECT ADDRESS� <br /> �o:.Y�( ' /-�o f+� � R �a 6�e_ �«9FZ/Yi (4zs) 7�a -Z07.'.0 <br /> cnuui.�-�� u�:uooacss crtv :m riwus <br /> 'n �s,-- 4�ir �r�zcmam�_�`1��// �u.� ;Fn�2 CAzS 17s�!-z o7 z <br /> 1[,��N! YAILAOOAL+S CILY 21p PNONE <br /> ♦L�a1LCiJf1DEEqVER M�ILA�ORE55 CiT' tiv VHP4[ <br /> I�I�:Lti<LC�IRNAC�OP MAILADCPE55 C�LV Z�4 VMONE $iAtELKCNSE� <br /> u6n+tliWLLOHtR�GiOP IA�hAD�R65 CiIY ZiP PHOFl[ StAiEL6ENSE� <br /> I'l�l'.bINGCON1PAGiDR MAIL�OJFE55 CItY IiP PIIONE SiAtEIIC[NiE• <br /> couraecrPewcoFwonK HEATINGSYSTEM: �GAS ❑ELECTRIC ❑ <br /> ecsc��oe woen um savme rooace iv.aveo cc�rt�cr ven;oM+wo r��nue iro. <br /> ��3% S�A� A.2nl�� �_r $'E✓% dni� . R!'• / __ <br /> � I HEREBY CERTIFY THAT I IiFVE READ ANO E%A1,11NED THIS <br /> " APPLICATIO'1 AND KNOW TNE SAb'E TO�E TRUE AND COPPECi.ALl <br /> raorosm us6 cr eui�oma PROVISIONS OF LAl1'S AND OR�INANCES GOVERNING THIS TVPE OF <br /> V/ORK WILL BE GOMPUED WITH N'HETMER SPECIFIEO MLRER; OR <br /> �cc>�oescaivnox<'vaortanunanr+e[�orvone*ixnrv�acaaies� hpT. TME GRANTING OF A PERMIT �OES NOT PRESl11dE TO GIVE <br /> �or 3 -z - o�aK�L_—ev� � A�Tr10R1TV TO VIOLATE OR CANCEL THE PROVISION OF A�rv <br /> OTHEF STATE OR LOCPL LAW REGULATING WNSTRUGTION OR TME <br /> ,l/ � 7a� PERFORMANCE OF GONSTRUCTION.TMAT I Ah1 AUTHORIZED BV THE <br /> L-�� p OWNEfl OF TMIS PROPERTY TO PERFORId THE WORK FOR WMICH <br /> —�^� ''i�'� � qPPLICATION IS IdA�E AND I WIdPLY WITM TME STATE <br /> r��7 '��� - �z-����� CONTRAC SLAWb.'•1RC}yAND291200WAC. <br /> v.acu*nx i o.�wuoen / <br /> Tn�iv e�rL � <br /> m�urr.ucnonw.ruexern.eoor.a:.rzicrHor�sxuvoca X 6 2 - /�-CX/ <br /> si ��c o..F <br /> :rtr ous�ncss uccr�s_rio. <br /> PLUMBING MECHANICAL <br /> N0. _��YPE G�FIXTUNE Of71TEM FEE NG. TYPE OF EOUIPIEENT FEE _ <br /> VJATEF ClOScT�TOILET) A'C--AMNOLG UN.�TS <br /> J B�THTUB FORCEUAIFSYSTE0.15 _ <br /> LAVATG6r�WASHBASIN� HEATPUIdP ___ <br /> S10WE❑ C'i1T HEATERS <br /> KITCMEN NH 8 OISP C�ATHES�RYERS <br /> DISMIYASMEF � �.�NGEHO00 <br /> LAUNpRV TRNY NlATER HEPTLii <br /> CLOTHES WASMER WnUD STOVe <br /> UPINFL �dl TAL FIREPLACE pV00D�UPN'NGI <br /> � ORINdWGrOUNTi.��� FIFEPLACERSERT�WOODBVFNING� <br /> FLOORDRAM i � �^_, GASFIREPLAGE _ <br /> CACKFLOW PREVENTER GAS RANGE <br /> SI4K(SERVIGE—BAR,FTC.) GAS PIPING <br /> — E%HAUSTFAN <br /> SUBTOTAL S SUBTWAL 5 <br /> PERMIT 5 PEFMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> iRO11iSET0<CN PGRSEID�LN S��FSE*OAIX WA�A4GNECMfA'MBEB iCE �� HCC[IPiNJ. <br /> �;' :,n � � oe.�a- G.: „ <br /> uiEze!:r� �or.nu �/ v�aertsue FEES ___�p��AT10N FEE <br /> �:_Z `l5(ipY �Es nrio o�iicr+c OS 689 � <br /> ncmiu��ai: u�nsrnhcurt+c I��o��nZQ �, . vwuewc . <br /> T <br /> CtiCatV�GY LOC[4GFE5 WNPINIIOPp OAEA�[Ni � y[�ryANiC/.L _ I <br /> �'_�y �• 2 _�.Es No --� <br /> RP[SPi:✓NLlQ�LOO �EPSGN IL91ipN4PVNCNEIX <br /> � <br /> O➢Ilfl � <br /> fiREAV.P4NE00 P[�SOtI <br /> $tA1E OIlIl01NG$Uf.CNAPGE <br /> �wccrr,oest. — v«rrs�Pvnweoav CITYOFEVERETT �uo�cwor+es � <br /> LOCALSALES <br /> �_�� r,rt• 122,/�p LTAX CODE IS]105 TOTAL _ <br />