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APPLICATI�1 FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILOING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257-8810 <br /> ❑ �EMOLITION ❑ COMBINATION ZY�UIlDIN6 ❑ MECNANICAL @�PCUMBINO ❑ SIGN <br /> PROJECT ADDRE S <br /> �;tia4 ���. v a�olc s�re�- ���e u„R ��aor�3aa�n <br /> ONMN M�0. E Q Y I PIYJ�E <br /> m ��� Ga �5 r� k. s�-. �r�ec+� ,?- �i- as a.�a-�va� <br /> 1FN�NI M�Il�00RE55 CItY ZP Rq1E <br /> ♦uC1�I1ECtOn�ESGNGl1 M�RI.OM�E55 GiV I�P R�ONE <br /> 6ENCRI.Lf,ON�LICP �R�DIX1E55 CIiY S�' %Ip1E St�fELICENSE• <br /> �o'�� � C7l�l'1�I� _ <br /> YCCIUNIC�ILONLP�Ciq1 M�M1�OORLSS GiY ZG Rq11E SUtCIXENSL• <br /> PLUMBiNGCCN1R�LiOP YqIAOIXiE55 GIIY ZW PIIG.L StAtElKLt4E• <br /> CONIR�Ci PPCE Of Np14 <br /> — HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> oEs wona rrosou.nc om.c[mva•.� cww.rcnsorvu,or�arvcra <br /> 05�- a�,cf —' a e i2 e lGc�. <br /> �'1ieP.�tcin�� Q�I uan�� - in -Ia <br /> /1nn_�.� I MEPEBY CERi1FY THAT 1 HAVE READ AND E%AMINED THIS <br /> "'Y N' APPLICATION ANO NNOW iHE SAME TO BE TRUE AND CORRECL ALL <br /> raoros[oGs4'w nmioivo �y � PqOVI510N5 OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> J��OTI�L� 11��(.l� lliUS� WORK WILL BE COMPLIED WITM WHETHER SPECIFIEO HEREIN Ofl <br /> �ccuocsc��Prrorvarrro>cAiv��sH'om�1eciow�rr.nr.cniwocor�csA NOT. T11E GRANTING OF�PERMIT DOES NOT PRESUME TO GIV[ <br /> �o.a7£� a�«.�/�a �'� e Gn CO• AUTMORIM TO VIOLATE Ofl CANCEL TNE PROVISION OF ANY <br /> � OTHER SiATE OR LOCAL UW REGUUTING CONSTRUCTION OR THE <br /> / /f 01"� �I�l�� P . C � PERFORMGNCE OF CONSTRUCTION.TMAT I PM AUTMOR12ED BY TME <br /> OWNER OF THIS PROPERTV TO PERFOPM TME WORN FOR!/HICN <br /> sn(J�� APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br /> n.nce�uv io rmueie CONTRACTORS L�A�WI 1827 RCW AN,O L296100 WAC. <br /> 515 - 7'�'(J37- L�' I ,.�r�2GA Tic�. l.'�K-� 9///� <br /> CONStPUCipN IO�N LC11pEP.AppRE55.1[LCCNOIIE MIYBFN <br /> •NnE D�iE <br /> CIIY BIIS�NF55 LILFHSE 1q <br /> PLIIMBING MECHANIC�L <br /> NO. TYPE OF FI%TURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET� NC—AHNDLG UNITS <br /> BPTMTUO FORCED AIR SYSTEMS <br /> V.VATORV(l'JRSH BASIN) HEAT PUMP <br /> SHOWER i UNITHEATERS <br /> HITCHEN SINN 8 DISP CLOTMES DRYERS <br /> DISMWASHER RANGE 1100� <br /> LAUNDRViRAY ; WATER HEATER <br /> CLOTMES WnSMER WOOD STOVE <br /> URINAL j METALFIREPUCE�WOODBUPNING� <br /> DPINKING FOUNTAIN FIREPLACE INSERT(WOOD BUFNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACNFLOW PREVENTERS ! GAS RANGE <br /> SINK(SERVICE—BFP,ETC.) ! GAS PIPING <br /> E%MAUSTFAN <br /> i <br /> i <br /> SUBiOTAL S � SUBTOIAL 5 <br /> PERh11' S PERMIT 5 <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: C0004—OD <br /> lPONiSEiB�CM1 PE�NSEID�CN 61ttSEi946 MNCbECM1MIMBCP i[E P[LPCiNJ <br /> usczar�e imenu vr.ux*srce FEES VAlUAT10N FEE <br /> ❑res r.no vunon+o <br /> r�c�cr�ruuiuiior1 rworrnvuura s�:caeioo'ri <br /> uHrts �A , iwueiw <br /> IX'CUV�W.Y MlC�4JA'FS CCCM�IIILOAO O�SFVENi NFCN�NqM I <br /> UP <br /> �^ N A ❑YES HJ <br /> iIRE51'PWKI[pREO� PE�SON /'JD�tIOMKPUNCNELN <br /> NU o.�ca <br /> fMiE0.�RMP[JO PEAS(N� � <br /> /�� St�IE W0.DmO5VaCMMGE <br /> rmcofcor�sr rurvs r vEoer CITYOFEVERETT rue�cwwecs <br /> � N LOCAL SIILES <br /> � _ �_ oo TAX CODE IS J105 TO7AL <br />