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APPLICATI�1 FOR CONSTRUC7�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREeT•EVERETT.WA 98201 •257•8810 <br /> - DEMOLITION X COMBINATION ❑ BUILDING ❑ MECHANICAL �7 PLUMBING - SIGN <br /> PROJECTADDRESS <br /> S22 Y��W R�DfaE DR• EYEQ.ETT, WA 9620; <br /> p:.�.'u M�II�OD��C55 CIfY 2V AMK <br /> i��r_ y wxi-y 425) 259-2021 <br /> JNN'�M1— 5t7.Y16w iuDt,�E D0.. �YERETT 9E'+�3 � <br /> m..�n u�nr.mr+¢s on rn �c <br /> nr�rlfCiC�llf,Y.qtl� W�l�f%TE55 CiiY IM' RM/1[ <br /> Fppp �Assa.. �yo� t1NceW��F. Mu..uzce 96275 (425� 3�-b-3�175 __ <br /> niiicn.icc-ruc�a� ui�omcss / n a*v in rr.ra su�siccv-�. <br /> l � ./ �"�LI. , - �AJ _ <br /> ���r��.���,.e�coii.n+no unnr.00ncss ertr m n.ae ..u�[iee sc <br /> ii. .,.e:c<,•:�nclon MuuoM6s C�n rv n�mx s�itl�:A:vse. <br /> , .,,,,•"°"""`°.O`� HEATING SYSTEM: �GAS f;ELECTRIC i-'� <br /> ��� ii�� ro . — <br /> �:�,nrz c:oa.o�o srn�nnc roouc[nnano conua>tnvNurm mmra ra <br /> �..�JtESIDWT�w4 p�ca�ouCL 3.iso s{. PFED 2.�.�Tcp. (4�5) 348' 3975 _. <br /> _..�IJin/ =r'Ac " APDITo 20 ; -- <br /> nnpi -rioN "JG S� -. � ��[R[�Y GERTIFY THAT I MNVE HEAD AI'� E%AIdiNED THI'i <br /> iq/�RJ\GC APPLICATION AND KN01Y TN[SAM[�O�E TRUE AND COARECT Pll <br /> .. "�.�nvs[orooi�om� PROVISIONSOFIAWSANDORORIANCESGOV[RNINCTHISiYPEO� <br /> R��DRJI'CIA1. WORM \YILI.OL CGMPLIED\YITN WHETHER SPEQFlED MEREIN 0� <br /> ;�,n;.i,i_yn+irnor�w rnwtmr�s�uxreutrnoa�*�4ernoewrt5� NOT. THE GPANTING OF A PERMIT pOES NOT PRESUIdE ID GiVE <br /> i eiocn or AUTIIORITY TO VIOLATE OR CANGEL THE PRO\95i0N OF ALv <br /> OiNER STATE OR LOCAL LAW RGGUlAi1NG CONSiRUCiION OR TM[ <br /> PERFORMANCE OF GONSTRUCTION THAT I PIA PUTIIORIZ[D OV iH[ <br /> ---- OWNER OF TM!S PROPER7V TO PEFFORM THE 1YORK FOR\YHiCH <br /> '�j(�Z90L�DOIQDOd ' APP�ICRTION IS tdADE AND I COIdPLY 1VIiM TME STATF. <br /> ����-=n�K�u rmuncn GONTR�CTOPS�AVy'LN 21 R W AND Y96 200 WAC. / <br /> �5/ /Y 1 <br /> ��i ///ll. G 2��0 <br /> i o-,inua�a��io�viuinnr.wnasrutMar�[�uue[n .��lkIX6/� <br /> � ,�r�� o�rE <br /> j9 <br /> C�i\6USiNI 5F Ix:CNSE 1p <br /> PLUMOING MECNRNICRI . <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO, iYPE OF EOUIPMEHT FEE <br /> 7j WAiERGLOSEi�TOILET) A'C—A11N�LGUNITS ' _ <br /> ' pA7��T�� � fORCEDAIRSVSTEMS __ <br /> .t. LAVAiORY(WaSH BASIN� I MEAT POM? . <br /> y SHOWER UNITMEATEPS _ <br /> � KITCMENSINK6DISP GLOiMESORYERS . <br /> � DISNIVASNEF RANGEMOOD ' _. <br /> � LAUN�RVTRAY � WATERHEAT[R __ <br /> / CLOTHFS�VASN[R i W�DSTOVE . . <br /> � URiNAL � METAIFIREPIACE�W00DBURNIN�) __ <br /> I D�MhING FOUNiAIN FIPEPLAC[MSERi PYOOD OURNINGI <br /> 2 flOORUPAIN GRSFlPEPLACE '_ <br /> � I pACkfLOW PREVENTERS I GAS RANGE . <br /> 1 SINK�SLFVICE—�hR,ETC) GASPIfING <br /> �— E%MAUSTFAN . <br /> SUOTOTAL 5 � SUDTOTAL S <br /> P[PAt1T S � PEPAIIT S ' _ <br /> IOIALFEE 5 � TOTALFEE 5 ' _ <br /> FOR OFFICE USE ONLY: C�YP'O -- <br /> � ��.is�ro•r. nr.iuowc. s�cescie¢e runc�rc+�n.�vetn rn 4 �mcmrra <br /> � � �� � <br /> � -.,,�' wt�m� •:.c�vt c 7EE5 VALUATION FEE .— <br /> � [�9.�r r.vu �o eundru � /3� ;-- <br /> .� ..a1�drt�ip.1. MIS hvfltM: SiZEC���D011 RlMBi1q �OS ._ _ <br /> ( (IJ <br /> Zp� i_L� ] <br /> i iv5ldF4S IXCU�'�NIIO.N P�SN[ MW1�44CK Jll I��` <br /> �L 3.,,,, ' � ;,�,, - <br /> �ppRl(NHR�MPrtCII <br /> �._..�� ..un�,ioo nc.wti _. <br /> omta <br /> � ���,�nso c+sen � S-J <br /> sn�wwo.q sunc��u�oE , r ^ <br /> - �` "O"°�� qTV OF EVERETT nm�c wrn+s ry/i <br /> LOCALSALES <br /> � ���� I i,�� � TAX CODE IS 3105 TOiAI _ _____ <br />