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APPLICATI� FOR CONSTRUC7'�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAIi STREET•EVERETT,WA 90201 •257-8810 <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MECl1ANICAL PLUMBING G SIGN <br /> PROJECTADDRESS <br /> � L ! � W. 7t)3a3 / <br /> OWNEP YuI�LQP[SS CpY SV PIIb2 <br /> ,�v�� rcEM�Nr, s-�1�,c <br /> lcrvu+r � uu��pon�ss cirv zm rrqnc <br /> �nc�necroHucsc.Ncn uui�oo�css cnv .:m nqn[ <br /> OCNEPµCON1R�L1pP M��I�COPE55 CI1Y IW C4iJyM�o�,� Si��ElFCNSE• <br /> S,ni7H � �377lccT2 ./ /0917-1/jiJR sE F�.r�y�y�— �„� �,(�yoS ��7E�5/ .3 C /�S M / <br /> MECN�111CµCONI11µ;lOP AIAI�• 1E55 CItV jW %qllC �11Cl�CCNSC• <br /> RU40iNGCON1p�CiM Au4��On[SS LIIv 1��' Ihqll( S��IELKb6[. <br /> CONiMCi GRCE Ci NORK <br /> HEATING SYSTEM: ❑GAS fl ELECTRIC f- <br /> oesoanc won+um sowac�w+•e[nrvo��[o tormcr ncnsor�•uo n�ro.c xo <br /> � <br /> I HEREBY CERiIfV TMAT I HAVE READ AND E%AMINED Th115 <br /> APPLICATION AND NNOW THE SAME TO DE TRUE AND CORRECT.ALL <br /> raorescDuse or eunortz PROVISIONS OF LAWS AND ORDINANCES GOVERNING TMIS TYPE OF <br /> \YORK WILL�E GOldPLIED WITN WMETMER SPECIFIED MEPEIN OR <br /> lC�0.MLCNTtpNCPV110PCqlY�$,qriNpEIONIX��iI/.L�IIWOCOIYE51 NOT THE GRANTING OF A PEflM1T DOES NOT PRESUl.IE TO f.IVF. <br /> ior eLIXR _w AUTMORI7Y TO VIOLATE OR CANCEL THE PPOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCiION OR THE <br /> PERFOR!AFNCE OF CONSTRUCTION.TMAT 1 AIA AUTMORIZED�Y THE <br /> OWNER OF THIS PROPERTV TO PEPFORM THE WORK FOR WHICM <br /> APPLICATION IS h1ADE AND I COMPLY WITH TME STATE <br /> �u¢u*e�i��iaue[u CONTRACTORS LA)Y 1B 27 PCW AND 296300 WAC. <br /> 1 <br /> <en.�a:xrror��ouiicuocn.�ooness.iaer�arwrvuuoen x /��✓/� /?h4l�i �/ <br /> sr.G��u�� o�rt <br /> C1tv PUSi1�C55liLENS[1q <br /> PWMBING MECHANICQ <br /> NO. TYPE OF FI%TURE Ofl ITEM FEE NO, TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) A C—AHNDLG UNITS <br /> BATHTUB fORCED AIR SVSTEM1IS <br /> LAVATORV�WASH BASIN� MEAT PUldP <br /> SMOWER UNIT HEATERS <br /> NITCMEN SINK S DISP CLOTHES DRVEPS <br /> DISHWASNEH RANGE HOOD <br /> �Al1NDRY TRhY \YATER HEATER <br /> CLOTHES�vASMEfl WOOD SIDVE <br /> URINAL 61ETAL FIPEPLACE(WOOD OURNING� <br /> DRINKING FOUNTAIN FIREPLACE INSERT�WOOD BUPNING� <br /> FLOOR DNAIN GAS FIREPLACE <br /> DACKFLOW PREVENTERS GAS RANGE <br /> $INK�SERVICE—�AR.ETC.1 GA$PIPING <br /> E%MAUSiFAN <br /> SUDTOTAL S SUDTOTAL 5 <br /> PEFAIIT 5 PEPMIT $ <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> TON15[IB�Cn P[ARSRB�Cx 40ESF10�CN %ANO�RRNV4E [[E P6O�ilp <br /> � - C3/ <br /> u_e1o��c io*mu v�curtsrte FEES VpLUATION FEE <br /> ❑res rrw emmn.; <br /> ��caN�uu��.ro�i �waso�+tunw s4coroiocii <br /> UNItS <br /> �1U41B�NG <br /> CLCVCAIKY �i�CfStpRfS OCLU��Ntl0�I1 B�Sf'ICNf I <br /> GROVv �CC1I�M1IC4 <br /> :i�cs n r+o <br /> f�nESPniNetFPREOD PEI.SOtI MOIfpN4nUH6rtC1( —�i - <br /> OLMCn i <br /> iIREAUPMPEO� NGSLN <br /> Sl�i[&IrtOiM:SV�CN�PGE I <br /> �re�orcm�st Nuns•�rnouoev CITYOFEVERETT rue�c�vo�..s <br /> LOCALSALES <br /> �,;i TAX CODE IS 3105 TOUL <br />