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APPLICATIO�FOR CONSTRUCTI(�l PERMIT� <br /> CIN OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 9B2J1•257-BB70 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL J$PLUMBING ❑ SIGN <br /> PROJECT ADDRESS 2�O 3 ' PPcC—1 FC �FUlS <br /> OwrvEP M�I�OME55 CIIT IP R�pb <br /> ``�i►,9 5 NL�4525-IZ7i"Q1.NEGtt � 1 3� 6�1 —813 <br /> ARCXI TpIDE51LNEP 41M1�LOilE55 GIT' IV PNCNE <br /> u�l6Z <br /> GEKMKCOXiMCiOR u1µ�W11E55 CIIY 2m RIYlE 6MtElILCNSE� <br /> M[UVNICKCONiP/Liq1 4�4�WPE55 CItY SO Aq14 S1I.iEl�CCNSE• <br /> flVUBiMG'pniP�,CtOq w4MpaE55 C�T' Is�� R9NE S1I.iEl�CENSE� <br /> UJ1�.u��MS ekt. ttl�Ml� C �3a3�28 u+� <br /> corim�Gr rr,we a wonn <br /> HFATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> MSCNiBE WOPK NA SW ME GOOi�GE IHVRKO il,Ci PCRSON NN RqNE Iq <br /> �aAVG C'�GlSC1IJ� \1'� <br /> � �`) 30-5641 <br /> . 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> APPUCATION AND NNOW THE SAME i0 BE TRUE AND CORRECT.ALL <br /> r�nos[ousea a mruo pqOV1510NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE Oi <br /> WORN WILL BE COMPLIEO WITH WHETNER SPECIFIEO HEREIN OR <br /> ieeuocscnr*a�+avriroennis�awr�ac�owoa�n.cMiwowncs� ryOT. TNE GRANTING OF A PERMIi ppES NOT PRESUME TO GIVE <br /> tor emcK or AUTHORITV TO VIOLATE OF .^.�NCEL THE PROVISION OF ANV <br /> OTHER STAiE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEPFOPMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED�Y TME <br /> OWNER OF THIS PROPERTV TO PEFFOPM THE WORN FOfl WHICM <br /> APPLICATION IS MADE ANO I LOMPLY WITH THE STATE <br /> 1'ARCRi�%IL M1M�ER � �W� CW D28620D AC. <br /> WNSIPVCLpNIOANI[110EP.�Cq1E55,1RFPMJIIENJNBER I�%� /0/JJ w <br /> x�run[ I o�*e <br /> CIiY BUSw[55 UCENSE�q <br /> PLUMBING MECHIIHICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER ClOSET(TOILET) NC—h'HNDLG UNIiS <br /> BATHTU� i FORCED Alq SYSTEMS <br /> LAVATORY(WASN bASIN) HEAT PUMP ! <br /> SHOWER I UNITHEATERS <br /> NITLHEN SINH 6 DISP CLOTHES DRYERS <br /> DGMWASHER ! HAHGEMO00 <br /> LAUNDRVTRAY I WATERHEATER <br /> CLOTH[5 N'ASHER WOOD STOVE <br /> URINAL � META�FIREPUCE(WOODBURNING) <br /> DRINKING FOUNTAM FlREPI.ACE INSERT(WOOD BURNING) i <br /> FLODR ORAIN � GAS iIREPLACE <br /> BAGKFLOW PREVENTERS GAS RANGE � <br /> SINN(SERVICE—BAR,ETC.� ! GASPIPINO I <br /> � E%H�USTFAN <br /> SUOTOTAL 5 i°U SUBTOTAL f ! <br /> �'ERMIT E � PERMIT S � <br /> Ui <br /> TOTALFEE E O� TOTAI.FEh 5 <br /> FOH OFFICE NSE ONLY: <br /> IRONi5Ei1fAC1( f1EM5CIBACK SiUESCiB�CK IYNILN^CC^AIANBEII iEE AECENItq <br /> W <br /> usczouc w*eeu V¢�ni6i*E FEES V�W�TION FEE <br /> ❑vE5 ❑1q &IlDmO <br /> �i[�.��i��uil�ipN �+OO�RM���rq S�ZEO�&UMi. <br /> urvi15 ��B�� <br /> oC�neHLv �qO�PpRS OCCUP�NiIOW B�SE4ENi MEGUH�Lµ <br /> ❑YES ❑Iq <br /> tIBE51'1LNMLEPFEOO RE�SON ���1��41'UNLNECN <br /> OiNfN <br /> !in[eLMMqEOD RE�SON I <br /> Si�iE&10.pM 6NC�IAIIOE <br /> rrriorconsr nu's�ranweoer CITYOFEVERETT weiGwaas <br /> LOCIIL SALES <br /> o.rE TA%CODE IS 7105 T0711L <br />