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APPLICATI� FOR COIVSTRUCTrN PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257�2�10 <br /> � DEMOLITION COMBINATION ❑ BU�LDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PRO.IECT ADDRESS � / <br /> �[T �7 F/7`�� <br /> ��R M111/.pf.PE55 -- CIIY IV plryl( <br /> Slcp�,�. 20��� �g�yf /Iw C-��.rH �i�'zv / 5'zstsz �6� z <br /> �V�MI MARACLPESS qiY IP iMONE <br /> /�FCNRECiOROL5IGM1LP Y/.LL�DORE55 ��{V jp p���E <br /> GE�K0.4COilip.�CiCR uqLnDDPC55 CIiY ZIV R1q�C SU�EIlCCHSE• <br /> �� ke n��kkii U�if w �i� l��- F�r„�(1 gP�3 uzs- �yy�y �df�zE,�tai��a <br /> /z C w.0 on «ooyc�s cm xm <br /> N�d6 SGiElKENSE� <br /> /�/ft/°,1 ,��. �ii...lr� <br /> RVMB�NGCON}qKiOq M4LAOOPFS. OIY EIV %qNE S1��EllCENSE� <br /> GIXIIMCt VH[ECi WqIN — <br /> I�f�� O HEATING SYSTEM: J�GqS ❑ELECTRIC ❑ <br /> oESGaaEwcw�i.r+osOu�n[roouc[i aveo cor�r�crrcasw„woar�wrtiro <br /> �'7I�,t. /� . 5 , o ✓C�f �i ��w6/�C� � _ Jn�C r"ll-��C{t'.�� y7sj(Jy�r/Of? <br /> l/: >rPi i %r {�r� � �J ! .n '�i 1`� <br /> ��/ h � �I /n n/Ch� �f(k /, . I NERE�Y CERTIFY THF7 I HAVE READ AND E%AIdM[D TMIS <br /> cnoi�os[ou;c�{ew�nnp APPLICATION AM1D H110N THE SAME TO OE T(7UE AND GORRECT ALL <br /> �'.SII/Crt��� I PRCVISIONSOFLAWSANOORDINANCESGOVERNINGTHISTVPEOF <br /> «o•�oe5caivrwHovnnov[arv�swwHe6iowonen�cerwoeor¢s� WORN WILL DE COAfPLIED WITH WMETHER SPECIPIED HEREIN OP <br /> NOT. '.1E GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �cr eiax M AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> GTh1ER STAT[GR LOCAL LAW RcGULATING CONSTqUCTION OR THE <br /> PERFORlAANCE OP CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF THIS PROPERiY TO PERFOp1A THE NORK FOR WHICI: <br /> APPLICATIGN IS MADE AND I COfdPLY WITH TNE STATE <br /> Pence�*u i o rayem CONTRACTOpS LAW 1827 RCW AND 296200 WAC. <br /> � �'..�> �l�% O:'j DD �p�/ / �/ /� / <br /> CONSiliUCIIbILOANLENO[H,/.00RESS,TELEVHONEINY9E11 �, ��lL. ���Gly /// �"J/ J/ G� <br /> U <br /> &GI Ip41E Oq[ <br /> Oiv8U4xE55UCEx5Elq. <br /> PLUMBING MECHAHICAL -- <br /> NO. TVPE OF FIXTIIqE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC-0.MN�lG UNITS <br /> BATMTUO ' I FOqCEDAIRSVSTEMS <br /> LAVATOflV(WASH BASIN� H[AT FUtdP <br /> � SHOYlEA UNITHEATERS <br /> KITCMEN SINK 8 DISP CIOTHFS ORYERS <br /> DISITYlFSHEfl RANGE HOOD <br /> LAUNORY TRAY 14A1 E!i HEATER <br /> CLOTMES WASNER WOOOSTOVE <br /> URINPL i IAETALFIREP�CE�WOOD90RNWG) i <br /> ORINNING FOUNTAW FlREPiACE INSERT(WO00 BURNING) <br /> FLOOfl DRAIN GAS FIREPLAGE <br /> BACKFLOVlPREVENTERS GASRANGE � <br /> SINK(SERVICE—OAR,ETCJ GAS PIPING <br /> Z EXMAUSTFFN <br /> i <br /> _ ; <br /> _ SUDTOTAL E � SUBTOTAI S <br /> PEPMIT $ : FERNIT 5 <br /> TOTALFEE S ! _ TOTAIF'cE 5 <br /> FOR OFFICE USE ONLY: <br /> ff10�1i5El0eCN pEARSEiBICR SipE5E10�LK pLNl��IECKMIYBE%` / FEE� J/ NECEVfAp <br /> � 1 � <br /> usezcne �ot.nu we�ersrt¢ FEES VALUATION FEE <br /> ❑rEs nHo eui�nr+c S �U <br /> nEwnuuiurqx voarowewra s¢sovoioarti <br /> u�ns AI l� rwueiHc <br /> ttr^yrNGY MRSiLf45 QCIIV�NLIpM MS�EM YCLNANIC�L <br /> 1(." ❑YES ❑NO <br /> pin[5pp:qxLERPEO� PUWII M�pR10HLLPUNOIECF <br /> OiNEP I <br /> fIRE�UIIMPEOD PEASON <br /> SieiE BUROiM SUIKM�PGE <br /> rraeorcovsr �u„�aanweoor CITYOFEVERETT vwi�c�waxs <br /> I f LOCALSALES <br /> �!—'�� _ _ cn+e��z) vO TAX CODE IS 3105 TOTAL <br />