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APPLICA�ON FOR CONSTRU�ION PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257-BB70 <br /> ❑ DEMOLITION COMBINATION ❑ BUILDINO ❑ HECHANICAL ❑ PLUMBINO ❑ SIG <br /> PROJECT ADDRESS <br /> /C+32 /hA9aE � r,i�-,�i�,-� <br /> OW1EM W1I�00PE69 ClIY ZP RIJIE <br /> 'FR�=o +Q�.wn `�xr.an-- /e3� ,naa.�Y EJeec�- 1`�sdd1 <br /> ,��. Y,,.�ss �. � � <br /> ARCNIiECTd10E51(tNEH Yul/�D�RESS CrtY IP qqxE <br /> 6E WLCOHIMCIpi n _WLMq1EB$ CTfY Sp PHONE BT�tElCEN9E• <br /> �T�/J1cia�iYV��lff"7��-'rbzti�-A1�l7-7�IN1Ll]R�J �lc�v~-�YT�i�I'EfJ�A t ' 01�C}U�� <br /> �4ECH �C�LC i AppqE55 �9+ IP p�p11E ST�iFIICEN3E��`— <br /> I�S �.' �i�.�..�Y/..QoL [.o • 7•,�a7 <br /> �rwueiwcartwcron wc�orn¢ss cm zn �¢. <br /> (3 /�,..� ��aam <br /> CONiMCT PPCE OF Ntlut <br /> HEATING SYSTEM: ❑GAS �ELECTRIC ❑ <br /> OESCqIBE WpIN INp 60UME FOOT�GE YM1'QVEO COHfI�LI Pff150H ND RpME�1p. <br /> � e, ira G a <br /> . I HEPEBY CERTIFV THAT I H E READ e�ND E%AMINEO THI: <br /> MPUCATION AND KNOW THE SAME TO BE TRUE M1D CARRECL ALL <br /> rnnoseouseareurto� �,� �y O/O pqOVISIONS OF LAWS ANO ORDINANCES 60VERNIN�iXIS T'PE OF <br /> C WOpK WILL BE COMPLIED WITH WMETMER SPECIFIEU HEREIN OR <br /> lEO�IOESCPotqNpiPlqPEqlY�LqNTIpElbMp1UTI{MMVCO45� NpT. TlIE OILWTINO OF A PERMIT DOES N07 PPESUME TO GIVEi, <br /> io�r�� �/ ewce oi AU7HORITV TO VIOLATE OR C�NCEL THE PROVISION OF ANY' <br /> LO'�- I S S�lL o . /�J t�a� —�� P RFORMANLE OF CONS RUCTION.THAT I AM AUTiHORIZEO BY THE <br /> OWNEq OF THIS P Q�EHTY TO PERFORM THE WORK FOR NMICM <br /> ��� APPLICATI�,�I //AOE AND I COMPLV WITH THE STATE <br /> r.wc[� ,uio,wueen CANTtU S/ /7B. flCWAND298.200WAC. <br /> 7 � ( -� <br /> CIX1bTINLiIONIWllEN0E0.�00RE641F1EW1011EMbrp x <br /> wrz <br /> cmeuw�ssi �w. <br /> PLUMBINO MECHANICAL <br /> NO. iYPE OF fl%TURE Op ITEM FEE N0. TYPE OF EOIIIPMENT FEE <br /> WATER CLOSET(TOILET) NC—MINOLO UNITS <br /> BATHTUB ! FORCED.�IR SYSTEMS � <br /> LAVATORY M'ASH BASW� MEAT PUMP <br /> SNOWER � UNITHEATERS I <br /> KITCHEN SINK d DISP CIOTHES DflYERS <br /> DISHWASHER PANOE HOOD � <br /> UUNDRV TRAY i WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL MET�L FIFEPUCE(WOOD BURNING) � <br /> DRINKINGF(1UNTAIN i FIREPUCEINSERT�WOODBURNING) i <br /> FLOOR DRAIN OAS FIREPLACE <br /> BACNFLOW PREVENTERS GAS MNGE <br /> SINK(SERVIGE—BAR,ETC.) GAS PIPINQ <br /> I E%HRUST FAN � <br /> i <br /> SUBTOTAL S I SUBTOTAL S <br /> PERMIT f i PERMIT f ! <br /> TOTALFEE f TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> FPONTSETB�CR � PEMSfllACN � SqFSETlACR �� PIANfjEGRMMlFD_O iE��• S_O RECEiTNO. <br /> �'� n n ii <br /> LN C. <br /> usEiomep lpTu+En vwwi re � FEES VALUATION FEE <br /> f-'� or�s o rro �� g � <br /> I�EqNTLI41T�i0� / �raowtuna su¢oranarti — <br /> �5�(0' S . rtuuewo �0 <br /> GCCUOYK.Y MpS�ORES OCCUPMRIOM B�SEYEIII �/ YFCIWKAL <br /> 1 OiEY 6'NO <br /> FPESPPNtIEflREOD REASON �R�4R/J1CNFd <br /> OMEq <br /> FwEAWiMHEOD q(�5p� <br /> 6I�1F B1M1fMtl bU1GWbE <br /> *vrcarcarsr n.ws�wnov¢oer CITYOFEVEqEiT MICNOlit9 <br /> LOCAL8ALE3 <br /> � wrE � p TA%CODE187105 TOT�L �/(p (�J <br />