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APPLICATI� FOR CONSTRUC�'1N PERMIT <br /> CfTY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDM STREET•EVEREIT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLRION ❑ COIAMIATION CJ SUILDNIO � MECM�NIC�L ❑ ►LUMSMKi ❑ f10N <br /> YR0.IECT ADORESS� <br /> rli4RREL W/L�OY aT5// A29PL� 57: E✓E E7T �ZO/ (yaS) S�- �// <br /> NF11--- Yul�Wirts] Om Im prdt <br /> IIM�N� VN MOT.S$ d'� )i M�pYt <br /> �tlLMifLIMMLG4FP 4NIM(ME55 �itY /�r 1`w(v� � <br /> fi�N1�14CCNIf11C�P1�� �Y_YI��fM�IS$ C�I� )if I4x:Yf i��lI1K(My• <br /> �1S--�r_.'S� n 7� �G C.�'Z ,� <br /> MICNIMCNG IR�CiW 4�4M)d1f$$ C.Ih )i. hqNf t��IfIKfNSE• <br /> Iry�rThGCW�p ��OP v�rt�AR55 C�iv l�� �`�q4f St��F1ICFhYr <br /> aa/o9�1� <br /> ����.��„«��W�.,�, — <br /> C'O �,IE� Hf T G- NEATING SYSTEM: fQGAS ❑EtECTRIC ❑ <br /> OFSCpM WJM��Mti SOV�w[ipptb(NVpKO COMI�CI q w$(n�M�M'JM Np <br /> E Aiv • 2s 7so- ay <br /> s F R I HEREBV CEHTIFY TH�T I N�VE REI1D �ND Ek�MINED TMIS <br /> �PPIIC�TqN 11N0 RNOW THE S�ME TO BE TRUE�ND CORRECT/LL� <br /> vna�osso uv w nimnvc ppOV151pN5 OF L�WS AND ORDINANCE$COVERNIN(3 iH15 TYPE OF <br /> V/ORK WII l BE COMPLIE� WITH NMETHER SPEGFIED MEHEIN OR <br /> lEcuo[scmmiwarwyfprvislawr1Bivnon�n�cM*nvcd'rtA NpT. THE GR�NTOIf.pF� 7ERMIT OOES NOT PRESUAE TO OIVE <br /> io� aa.__p �UiHORITY TO VIOLATE OR C�NCEL TNE P110VISION OF �NY <br /> OTNER STAiE ON LOCAL L�W REOULATIHO!'�pNSTRl1CTqN OR TNE <br /> PERFORM�NCE OF GONSTRUCTION TNAT I M1 AUTqRqEO BV T11E <br /> OWNER OF TNIS PROPEATY TO PERFORM T/1E WORK FOR WMICN <br /> �PPLIC�TION IS M�OE AND I COMVLY WITN 7ME STIITE <br /> WntFim ra e CO^NTR�CT�ORSlAW182]RCWAND296200WAC <br /> �Q� � �020 �� � <br /> COMtlq1[iqN1WMIfMfIFN YMnt55�EIfAqNFM14Y1Fn S'����j�� <br /> U�If �L� <br /> CIIY W41FSS IK.FNt!MO <br /> PLUMSIN6 MfCM11NICAL <br /> NO. TYPE OF fl1ITU11E OR REM FEE NO. TT►E OF EpIMMENT FEE <br /> WATER CLOSET(TOILET) NC—M7Npl0 UNRS <br /> BATHTUP FORCEO�IR SVSTEMS <br /> UVATOPY(WASM BASIN) NE�T PUMP � <br /> SHOYN'ER UNIT HEATERS <br /> KITCHE��SIhY A OISP CLOTMES DRVERS <br /> DISHW�SHER RANGE HOOD <br /> L�UNDRY TRAY WATEq HEATER <br /> CLOTNES W�SHER WOOD STOVE <br /> URIN�L METAL FIREPLAGE�R'OOD BURNING) <br /> DRINKINGFOVNT�IN - FIREPLACEWSEFT�YYOODBURNING� <br /> FLOOR DH�W GAS FIHEPLACE <br /> BACNFLOW PREVENTERS GAS pANGE <br /> SINK(SERVICE—BAR,ETC� GAS PIPING —r_ <br /> _ E%HAUSTFAN _+_ <br /> SUB TOTAL f SUB TOT�L f <br /> PERMIi f PERMIT f <br /> TOTAIFEE f TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> �nfw�vtn�rt nr�PSnp¢R 40(SCIIIK� rt�ubilCrvUw a rft �rrrmirp <br /> usr�ovr ipt�n�r, v�um a¢ �� FEES V�lU11TION FEE <br /> Orts ❑rx) ��— <br /> PI�tMN'� <br /> I�fIG1111�V11�110" YOly[IWf111NG [IIfO��ICG�I ' '. <br /> II4i�[ �IYP'.4ri I <br /> OCl11M�'V n��i�91� lV".('lIn1M11U�11 B�[fVlnl r �� � ... � —i <br /> f.NQVI` VI I..�4N'�I <br /> 'J'�f5 OY� - � <br /> lin[SM11r�x1[�MC7p M�VI1N ��d�l(lh�l(\�YC�rlC� I <br /> OPHu <br /> 11�[/�UPNPfO�� �I�enV —"-� � � I <br /> s�m aunuac svnrvurK.t 'i <br /> �rrt rn ruvq ruac�rrnoKnnr ' — —_� ��� — - _""—' I <br /> CRY OF EVEHEiT runuc wn�.� <br /> LOGI1l5�LE5 -� — —�— ---— ' <br /> u.�t TAX CODE IS 0105 TOTAL <br />