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APPLICATI�1 FOR CONSTRUC7�N PERMIT� <br /> CITY OF EVERETT•BUILUING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257•BB70 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN6 ❑ MECHANICAL i7 PLUMBING ❑ SIGN <br /> PROJECT ADDRESS <br /> 5 �N m � 5� �1/EY'e17` Gt1�4 48201 <br /> ox++cn +�.u.owsss ci.. :v aai+c <br /> THo�,ns A �� zs2N m itq�E Sf ��,c-.vcff Wk 9 8 7v� <br /> rcrv+xr uu��ocacss citr xv r�a:e <br /> 0 .�v+�J <br /> �PCNIICCLp1�UF5GMR M�iI�DWE55 ��N �� p�� <br /> �W n Ur <br /> GENER�ICONiRAGTqI M�0.10ME55 U1Y ZF PM11L SiI1ELCENSE• <br /> ll[LNI.NK4GONiR.1CLOR 1AL4�DIX�C55 GTY ZiG P ^KNC SiQEL'CCNSC• <br /> vWMO�MM1fAMnKfOP Y9l�OJP65 CILY ZIV %bME SUtE\KLNSE� <br /> cor+*a+crraceawann �O� HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> �scaiecwon+u�nsw�wcroor•cEnrvavco • co�n�circuspr��rvov�cra <br /> U� H✓horf n n Q i'� <br /> c � 6 5 <br /> 1 MEREBV CERIIFY iHAT I RAVE READ AND E%AMINED TMIS <br /> APPLICATION AND NNOW TME SAME TO BE TRUE AND COriRECT.ALL <br /> rnorouo ose or Bwmmc PPOVISIONS OP LAWS AND ORDINANCES GOVERNING THIS TVPE OP <br /> C WORK WILL�E COMPLIED WITH WHETNER SPEQFIED HEPEIN OP <br /> �m � [5 a�a�prorraottan6rawseaowouen•cn*�+'otaarts NOi THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �orZ1'� Z8 e�ocn�a 'e �• AUTMORITV TO VIOLATE OR CANCEL THE PP.OVISION OF ANY <br /> � ^ OTHER STATE OR LOCAL LAW REGULATING GONSTRUCTION OR THE <br /> .� y (��/ O� PERFORtAANCE OF CONSTRUCTION.THAT I AM AUTHORIZED OY THE <br /> OWNER OF TNIS PROPERTY TO PERFORM iME WORK FOR WHICH <br /> Sh0 0�+���+ C�OUYI�'y APPLICATION IS MADE AND I COMPLV WITM THE STATE <br /> rnncur�+m eaMotn <br /> CONiRACTORS LAW 1927 RC1Y ANJ 296200 WAC. <br /> 1 ' S7 H- �Z7-oo f <br /> ca+ai�uciroH io+v iexcea.eooncss.*Ean�wrrt nuuece _ <br /> e wE <br /> Liiv BUSiNC55 LICENSE NO <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER LLOSET(TOILET� 0.'C—AHNDLG'..AITS <br /> BATHTU� FORCED AIR SYS7EM5 <br /> LAVPTORV�WASH DASIN) HEAT PUMP <br /> SHOWER UNIT MEATERS <br /> KITCMEN SINK 6 DISP CLOTHLS ORYERS <br /> DISMWASNER RANGE MOOD <br /> LAUNDRV TRAV ��ATER MEATFR ' <br /> GLOTNES WASHER WOOD STOVE <br /> —�— <br /> UFINAL METAL FIREPLACE�WOOD BUFNING) <br /> ORINKING FOUNTAM FIREPLAGE INSERT�WOOD DURNING) <br /> FLOOR ORAIN GAS FIREPLACE <br /> �ACKFLOW PREVENTERS GAS HANGE ~ <br /> SINK�SEPVICE—BAR.ETC.� GAS PIPING <br /> —�— <br /> E%HAUSTFAN <br /> SU3TOTAL 5 SUDTOTAL 5 <br /> PEIiMIT S PERMIT 5 <br /> TJ"'ALPEE 5 TOTAIFEE 5 <br /> FOR OFFICE USE ONLY: <br /> rno��ts[ro�en nuns[ie4^.� sio[5[iB�eK rt�e+ �ceKn�rno[n �[E ,j n[CEmtrq <br /> � _ 7 Q % - Z D - <br /> usczo��� �meau v�uH*Srt[ / FEES VALUp110N FEE <br /> orEs �� eunonr, O-L <br /> �RiGN1l14i�1bN / NOOfDWCItIW. SIZEO[BiIXiTI <br /> urviis �uua:ra <br /> occuru¢r r�oo�s*oPxs occ�n.H.io.0 �s[ucnr �EC��H�w <br /> c��pu� <br /> � ��E� � <br /> rinEsrnmtiwawo ne�son <br /> enonarvuruxctiecR <br /> OLMCR <br /> {IP[/.LARMPEOD RE�SON <br /> S1�tE Bo���iNG SUPCN�PGE � <br /> tvreorcoHsr rur�ssaenoveoor CITYOFEVEREIT �veinwwus � <br /> � � LOCAlSALES <br /> �„� TAX CODE IS 3105 TaTAI <br />