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APPLICATI� FOR CONSTRUC7�N PERMIT� <br /> CITY OF EVEHETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> Cl DEMOLRION G COMBIN�TION {?i1BUILDINfi ❑ MECHANICAL ❑ PLUMBING G SIGN <br /> PROJECTAD REOSS � � t�,(�����OS <br /> �`p M�R� 55 <br /> cn xn ""�"c <br /> V� <br /> � CIiY �� ��� <br /> i[N�Ni MI.M11ppf1E55 <br /> /.RCIIII L ORL�ESGNFP Y�6ADO�C55 <br /> LIiY lb ��rt <br /> `Tr Tp rp�K Si�fEl10EH5E• <br /> G[X[RILCONtRlClO� W�'��CSS <br /> YFCM11UCilCONiRAC1CP 11J.Il�DC�1C5$ <br /> CItY TIP h1�ME $tI.iELIGCNSf• <br /> 1'tUMBMGC�MR�CttM <br /> YeM1�OilNE55 Cltt b� M��E Si�iEIKCNSE• <br /> cpaau*�nccwwoue HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑-- <br /> ces< c woax uro sou+a[roor�cc nrvavco <br /> u»�+�cr niasa���.o rrH.w�r�o <br /> I HEREOV CERTIFY THAT I MAVE PEAD AND E%�MINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL All <br /> raoros[ous6 or ew�oirvc� PROVISIONS OF LAWS AND ORDINANCES GOVERNING 111�5 TVPE OF <br /> WpRF N'ILl BE COMPLIED WITH WHETMER SPEGPIED HEREIN OR <br /> acuceunnrprvaP�'�A�r�s�ovrt+oaowouen.cn*wowras� HOT THE GRANTING OF A PERMIT DOES NOT PRESVME TO GIVE <br /> AVTMORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> io� B'-�" °f OTMER STATE OR LOCAL LAW NEGUTATIN�CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TMAT I AM AUTMORIZEU 3Y 7NE <br /> OWNER OF TMIS PROPERTY TO PERFORM ME WORK FOR WM�CM <br /> APPLICATION IS MADE ANO I COMPLY WITN THE STATE <br /> CONTRAC�QRS liY/18.27 RCW AND 296200 WAC. <br /> vencuu*�o Jec � O// C� <br /> 3�" `3 "' � - 03 o�-eo <br /> carsmucirorvw�H�ErmEn.woncss.iacrHa+Erniueca % o�it. <br /> SpM�iUR <br /> CILY BUS�M[SS UCCN.L i10 <br /> PLUMBINQ MECH�NIC�L <br /> NO. TYPE OF FI%TURE OP ITEM FEE NO. TYPE OF EOIIIPMENT �E <br /> WATER CLOSET(TOILET) IVC—A'MNDLG UNITS <br /> FORCED AIR SYSTEMS <br /> BATMTUB <br /> LAVATORY(WASM 6ASIN� j HEAT PUMP <br /> i VNITMEATEFS <br /> SHOWER <br /> CLOTHES ORYERS <br /> KITCMEN.SINK 6 DISP qANGE HOOD <br /> DISMWASHER <br /> WATER MEATER <br /> LAUNDNVTRAY �yppDSTOVE <br /> CLOTNES WASHEP METAL FIREPIACE(WODD BURNING) <br /> URINAL FIREPLACE INSEflT(W�D BURNING) <br /> DRINKING FOUNTAIN GAS FIREPLRCE <br /> FIOOR DRAIN GAS RANGE <br /> �ACNFLOW PAEVENTEPS GAS PIPING <br /> SINK ISERVICE—OAR.LTC 1 EXHAUST fAN <br /> SUB TOTAL S _ <br /> SUBTOiAL 5 pERM1T S <br /> PERIdIT 5 <br /> � TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: ��E nEccw.ra <br /> ucMSEle�cH siOESEte4n � 1'1lNCRccKMJVBEu�/h �/ <br /> [PONt5E1B4LR � ✓ G� ' `/ O- 1/ <br /> �j C; ' ,C � ' <br /> usc mue 7 �m�nu <br /> v.uvtvr[ FEES �ALUIRION FEE <br /> �v i z�:. �, 9 .�s = A���a� IB <br /> �,E�o�.��u��.rb�� , �a�,�u„�� s���o�a��,� �,�,�a�,� <br /> � S <br /> OLLU>RiCv vJpSiDPLLS OLN:�NILO�D O�SEYWi MCCNGNILLI. <br /> GR IV flVES .NO <br /> /qp11qN�L FUN CMfCM <br /> fIPL54Ti�In�LRRC00 PEASON <br /> OiXER <br /> fY1E�L��M��LOG f1E�5OH $i/.IEBUM1DINGSUM:NI.RGE <br /> rmc�irr.ovsi riws.ovaoviox. CITVOFEVERETT weiawa+ns <br /> LOCALSALES <br /> �_/J �,.rE sJ I{!� pp TAX CODE IS 0105 T0711L <br />