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APPLICATI�1 FOR CONSTRUC�N PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257•8810 <br /> ❑ DEMOLRION ❑ COMBINATION ❑ BUILDING ❑ MECHANIC�L ❑ PWMBINO ❑ SIfiN <br /> PROJECT ADDRESg <br /> 1(`IJ�� Ri�r ker fiveaxte �Ev:x�� � WA ��201 <br /> owNcn uu��ooncss ciiv iw ararrt <br /> '� c�Yl �.'VC( �� Pi�rVrr ���rhvir �.veT('�"{' ��) � 4o1.rJ c�.]c7��.� <br /> 1CN�NI M�4�DIX1L55 CIfY Zf Nq16 <br /> ♦��MIi[LipiCCSGMR M�II�C�V�C55 CIiY IN PqxE <br /> GLNCNµCON}NCiCP -�_ M�rt�CLP[55 CIiY �in AIJbE SUiEL�CCNSE� <br /> .� n�vri� '.����1tx] <br /> Mccn�rvqucorvID�ci09 u�R�Don[5s crtr jp Wip1E 5*��EIiClNs[• <br /> RUYartqCWiP�LiOR Mnr���p[55 cilv lip n�qME Si�RlCEHSF� <br /> CONt1U�i I�PCC Cf WOpF <br /> HEATING SVSTEM: ❑GAS ❑ELECTRIC ❑ <br /> �ocscniec woFK wo sou.nE rooir.cE ivvavco cox�r.c�vcnsw+um nror<ra <br /> � <br /> I HERE�Y CERTIFY THAT I HAVE REAC AND E%AMINED TNIS <br /> warouo we or mm�nc APPUCATION ANO NNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> S PROVISIONS OF IAWS AND ORDINANCES�OVERNIN6 THIS TYPE OF <br /> WORN WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iccuocscewr avuor[nrvisrawxenowon•n.cnttmco�icsi NOT. TME GRANTINO OF A PEBMIT DOES NOT PqESUME W ONE <br /> �ot pi¢R or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> GTHEN STATE Ofi LOCAL LAW PEGUUiIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TMAT I�M AUTHORIZED BV THE <br /> OWNEP.OF THIS PROPERTV TO PERFORM TNE WORK FOR NMICN <br /> APPUCATION IS MROE AND 1 COMPLV WITN THE STATE <br /> Y eut[�w io quuaca CONTRA TOPS LAW 1B 2]RCW AND 296.Y00 WAC. <br /> 7' �I�'�,, ^��] �( <br /> tars�nucr�oniaHicr,ocn.�oa+[ss.�Euwar+cr.uunrn Afc �t r � . \�X� �^—d 1'VJI <br /> C�tY OUSIW 55 L1C[NY NO <br /> PLUMMNO MECH�NIC�L <br /> NO. TYPE OF Fl%TURE OR ITEM FEE NO. TYGE OF EOUIPIIENT FEE <br /> WRTER CLOSET(TOILET� NC—ATINDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> IAVATORY�W.15M BASIN� NEAT PUMP <br /> $HOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISP CLOTMES DRYERS <br /> DISNWASH[R RRNGE HOOD <br /> UUNDRV TRRY WqTER HEATER <br /> CLOTHES WASHEP WppU STOVE <br /> URINAI � METALFIFEPUCE�WOODBIIRNING� <br /> ORINKING POUNTAIN FIREPUCE INSERT(WOOD BURNING) <br /> FLOOR ORAIN GAS FIREPUCE <br /> BACNFLOW PREVENTERS GAS PANGE <br /> SINK(SERVICE—�AR.ETC.1 GnS PIPING <br /> EXHAUSTF�N <br /> SUDTOTAL 5 SUBTOTAL S <br /> PERMIT S PERMIT E <br /> I TOTA�FEE 5 TOTAL FEE S <br /> FOR OFFICE USE ONLY: (Y�O�Oa„-�3 <br /> lPOniSCiPI4� R(�PSCiB.�CM SIDCSCiO�CN �LAHCIIECY.NIIMBEP �EE PECCIVl1q <br /> usslaus �m•nu v�csu.srt[ FEES V�LUATION FEE <br /> nrcs nrro ew�wra <br /> �caH-uunnov rroar�iurvc sir[amonl� <br /> orvrt5 RN/B�NO <br /> OCCUVNKY �qU51fA45 OLWn�NilO�� BISC4EN! <br /> GPOVV MEpUNC4 <br /> ovcs n ro <br /> rwEsvmra�canrao nE�w� �oona.�ur�tiucMcc� <br /> O1M[R <br /> fin[µ/,n4pfOD R[I.SOM <br /> Sl/.iE&14p1q SORCn1PGC <br /> mreacousr ruvs�rrwvEoer GTYOFEVERETT we�cwon.s <br /> LOCALSALES � <br /> p,,�� 7A%CODE IS 0103 7o7�L <br />