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APPLICATI�1 FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIfiN <br /> PROJECTADDRESS <br /> ovm[n u�n�ooncss orv rv cwNE <br /> 4 b IC 5 e $ �I I <br /> 1[x41 M�R♦ E55 CITY IV NqNE <br /> �PC111iCCiOPpESN'iNE� MI.II�DM�ES$ C�1Y ZV RqK <br /> G[NCRµCA IF�C�OR M41t� `A[55 ��n' lr' Rb� � ���<<�EHSE• <br /> Paci�ic, C �nc,n_ ck.w�itJ� e,t'zit 98�7,01 sq'� pa(iGGC6RR7A! <br /> aEtu�H¢��CONiR4ton u�eW ss PIv SN NN1H[ sutElC[rv[. <br /> ttU1.IBitqCONtR�Ciq1 RER�O�FE55 Llb ZV R�ON[ SP1ClK[NSE• <br /> CCNIR�CL PI1CC OF Wp1K <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> aumec woF+uio sou�nt roouce nrvo�vm CONL�CI VEPSON.VN PIqN[NJ <br /> �� <br /> 1 MERE�V CERTIFY THAT I HAVE READ AND E%AMINEO TMIS <br /> APPLICATION AND NNOW THE SAME TO BE TPUE AND CORRECT ALL <br /> rnwoseo usE or xmionu PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> VA WORK WILL OE COMPLIED WITM WHETHER SPECIFIED HEREIN OR <br /> �[w�o�wawiq orvnovenrv�5rawnouowon�rucHtwoccvrts� NOT. TNE GHANTING OF A PERMIT DOES NOT PpESUME TO GIVE <br /> iar �aK a AUTHORITV TO VIOLAiE OR CANCEI TNE PROVISION OF ANV <br /> OTM[R STATE OR LOCAL UW REGUUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TMAT I AM AUTHORIZED BY TME <br /> OWNER OF THIS PROPERTY i0 PERfORM THE WORK FOR KMILM <br /> APPLICATION IS MADE AND I COMPLY WITH TME STATE <br /> ru¢[ ux io rvuunr.n LONTRACTORS LAW 1827 PCW AND 296200 WAC. <br /> dzo oov � �� �� <br /> CCNSiPUG1qN IO�N IEND[11,AO�IIESi.16CMqN[NUMO[11 <br /> N� DAiE <br /> CItY BUSINCSS l4ENSE 1q <br /> PLUMBINO dECN�NIC�L <br /> NO. TVPE OF FI%TURE OP ITEM FEE NO. TYPE OF EOUIPMEHT FEE <br /> WATER CLOSET(TOILET) aC—A'MNDLG UNITS <br /> BATHTUB ! FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATER$ <br /> NITCNEN SINK 8 OISP CLOTMES ORYERS <br /> DISHWASHER RANGE NOOD <br /> LAUNDRVTRAV WATERNEATER <br /> CLOTMES WASMER WOOU STOVE � <br /> URINAL METAL FlREPLALE�WOOD BURNING) <br /> DRINHING FOUNTAIN FIREPLACE INSERT(1YOOD BURNING� <br /> FLOOP DRAIN GAS FIREPLAGS <br /> BACNFLOY!PPEVENTERS GAS RANGE <br /> SINK�SERVICE—DAR.ETC.) GAS PIPING <br /> �1�. f �.. n. l�f E%HAUSTFAN <br /> i <br /> SUBTOTAL 5 SUBTOTAL 5 <br /> PERh11T 5 i PERMIT 5 <br /> TOTAIFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> fPOM5Ei0�� �GRSOOCK YDESEiB�C[� NCCKYpVuOEN _ R[� a/ a[C[iviNJ <br /> S O lN <br /> us[za�e iormEe v�cu�rsrtE / FEES VRIU�TION FEE <br /> �2 `I�1NO� nres y�w ounwr.c � <br /> nucmuurt��aN e�oorowuum s¢cneioeu <br /> � / UN115 ' �,y � � RUNBiM (� <br /> ✓ <br /> P`.LIICANLV NGGi$iCPC$ OCCVP�NLl0�0 O�SEYCNi �/ MECNANiC4 I <br /> �ur 1 ❑YCS f/F10 <br /> fINE5�f11i1xlfI1PE0� PE�$CW �CDIiqNl�ll'l/�NC11[CN <br /> onrtn <br /> rin�.uauu[ao n[�ww <br /> Si�iE B�rtC1A SUMNMGE <br /> �rnrorca+sr viei+s•nrnweoev CITYOFEVEflEI'f wai�ewa+.s <br /> ')]� LOCAL SI1LE5 � <br /> J[., m*c !.� 00 TA%CODEIS7f05 TOTAL 7r <br />