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APPLICATI� FOR CONSTRUC7�N PERMIT��� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STAEET•EVERETT,WA 98201•257-8810 <br /> ❑ DEMOLITION ❑ COMSNIATION ❑ BUILpNO ❑ MECMAMCAL ❑ PLUTA011Ki � SION <br /> PROJECT ADDHESS _ --1 , �'I,. n �v6��' <br /> �� Nun.e'/ <br /> �R`iaN�. nU��l hr ��iY =p � <br /> ,E�,,,. � =s ��.. n �P �. , <br /> Mv`�,�t� r-n rc►�+,4�( a� , <br /> .ac�n�c*a+asn +i1 s cnm ) / rv (y r�w(LAGJp �I�` <br /> OEMRIl�iN1G� 4�0.��v ' �`�`i•— _� �E / �"'��l�•LIJ�CCNSf� <br /> �n r�c �l�Z �l'h /� �� 9,.40�1 -- <br /> 4CW�NC�LLON'a61pR Y�R�CME55 PIY to N42 Si11[lCENSE• <br /> �Dcn 7s�� <br /> pWMB�HGCOM�RI.CIOR 4�4�OJP65 CI1Y ZP 514[lKLNSE� <br /> conm�.ci vncc orxaa+ �. O O� p[i HEATING SYSTEM: ❑OAS ❑ELECTRIC ❑ <br /> �EscPie[xKMR/!$C{I���/ r1G�avf� CJMt�tfPta50X/.MDP�qNENO <br /> �_��� \ <br /> I NEREBV CERTIFY THAT I HAVE RE�D AND E%�MINED TXIS <br /> . APPUCATION AN�NNOW THE S�IAE TO BE TRUE AND CORREC�.ALL <br /> r4aros[o E eF�xw'ti� PqOVI510NS OF LAWS AND ORDINANCES 60VERNING iHIS TVPE OF <br /> WORK WILL BE COMPLIED 1YITM NMETHER SPECIFIED MEREIN OR <br /> iEaµa nwi;v��n*r,>�owHnuavou.n•cnfwocro¢s� NOT. 1HE GRANTiNO OF A PERMIt OOES NOT PRESUME TO GIVE <br /> ior �h� a AU7HORITY TU VIOLATE OR CANCEL TNE PROVISION OF ANY <br /> OTHEP STATE OR LO(:AL LAW REGUUTIN�CANSTRUCT!JN OR THE <br /> PERFORM�NCE OF CONSTRUCTION.TM�T I AM AUTMORIZED BY TIE <br /> � OWNER Of THIS PPOPERTV TO PERFORM TNE WORK FOR WHICH <br /> � APPLICATION IS MADE �ND �A COMPLV WITH THE STATE <br /> ren:nruiurnnra�n CONTR�CTORSUWIB2)RCW IN0296200WAC. <br /> CONS�PULfIONIOANIENOCN.MD�1F55.IClEP1U1[MMBER � ��/ ��� `�/ <br /> FF O�iE <br /> GilY BUSWESS l�C[NSE 1q <br /> PLUMBINa MECN�NIL�L <br /> NO. TYPEOFFIXTUREONITEN FEE NO. TYPEOFEWIPYENT FEE <br /> WATER CLOSET�TOILET) NC—AMNDLa UNITS <br /> BATHTUB FORCED AIR SVSTEMS <br /> LAVATORV IWASH BASIN) MEAT WMP <br /> SHOWER UNIT NEATERS <br /> KITCHEN SINK 8 DISP CIOTHES DRVERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTIIES WASHER i WOOD STOVE <br /> URINAL ' METALFIREPUCE�WOODBUPNIN6) <br /> DRINKINC FOUNTRIN FIREPLACE INSERT�WOOD BUPNINfi) <br /> FLOOR�FAIN GAS FIREPLACE <br /> BACNFLOW PREVENTERS GAS RANGE <br /> SINK�SEPVICE—�AR.ETG� ! GASPIPING <br /> EXHAl1ST FAN <br /> i <br /> �— <br /> i <br /> SUB TOTAL 5 $UB TOTAL S _ <br /> PEPlAIT 5 PERMIT S <br /> TOTALFEc 5 TOTALFEE E <br /> FOR OFFICE USE ONLY: <br /> IPDNtS[tOALN PE�uSPB�ta SbE5E1B�tR MNCMECMNU40[P 'EE /� / AE 0PiN0 <br /> � O � <br /> useza�e I �or�eu v�ur�*sn[ FEES V10.U11TION FEE <br /> �res ❑rw W�iona � Z„7 <br /> HEr.H.iai�.rar+ r�orsrmvcucw svco�eioc.� <br /> ttuue�xc <br /> rccueu1cv uoas*.aEs occun�ntiow B�uueN* �µ��y <br /> cAaur <br /> nres ❑'.o <br /> fm[svmvnunemD n[�sa+ �.Wnq�+kh�teFCR <br /> OLHfR <br /> ll�t[�UPMPLOO �E�SON <br /> 51�iE W lMG SURLN/�PG[ <br /> rvrEorca+s. rur+s�wyovroer CITYOFEVERE7'f we��cwa+�s <br /> T�— / � LOCALSALES <br /> p,�� 6 TA%CODEISJ105 TOTAL <br />