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APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STAEET•EVERETT,WA 98201•(425)257-8810 <br /> ❑ �EMOLITION ❑ COMBINATION ❑ BUILDINQ �MECMANICAL ❑ PLUMBIN(7 ❑ 810N <br /> PROJECTADDRESS: ���^ �"^ �"� �'�� � <br /> q�m wui.owcss an rm rrvrt <br /> �Yhn�/)')ili�cn �ii��31�4'1����.n,i, s,�e���F �iXa.�i l�1.�s1-�3o��i'�� <br /> irru..� wu s nrv m n'o'h <br /> �a:urtc�onttyc�rtn u�n�otw[ss ci�r nr n�q�.f <br /> GfMtnntf.�M�n...:tOn uul�IX�lss c�tr Tr P�✓m c4tL�KrxR. <br /> YiC11�FIL4COY���C10� 4ul�GG�ES$ OiV l�� i'IKKY [�1�FLKEN�:f� /��( <br /> r"�,��„L /'�.._ .�,,.., �.;� �sa%Y,,d :io/ � 9�,�v �s�g/,f'� �'dno(�.i�.x`�'LJ <br /> ry114RN�.CW11N�f.iM VNlI.IX1NE55 Clh !�� I'�KIMF -�—$l�tFrE af• �f/� <br /> �� <br /> cowm.c�nn¢c M vmun <br /> MEATIN6 SYSTEM: Q GAS ❑ELECTAIC <br /> U[Sf1Npf WJ�x�NfIS�IU�R�O]��GF NVOIKD f.ONi�Gt rtNSM/.NC I'�V�F MJ <br /> l <br /> I NEREO� CERTIFY iH�T 1 NAVE AEAD �ND E%�MINEO TNIS <br /> APPUC�TION M!D NNOW TNE SRME TO BE TRUE�ND CORRECT ALL <br /> �vo ust or noimMn pROVI51ON5 OF LAWS�ND OPDiNANCES GOVERNING TNIS TVPE Oi <br /> WORI(Wi11.�E COMPLIED W�TH WHETHER SPECIFIED NEREIN OR <br /> �m�ta5r.mrnpnorrrrortnttis�ro�vnnowour.nr.c�rvrota+[s; NOt. TNE GR�NTING OF A PERMIT DOES NOt PRESVAIE TO OIVE <br /> �o� eioc+ or AUTHORITY TO VIOUTE OR CANCEL TME PROVIS�ON OF �NY <br /> OTMEP STAiE OR LOCN.UW RE(3V111TIMf CONSTRUCiION OR THE <br /> PERFORMANCE Of CONSTRUGTION.TMAT I�M�ViHORIZED BY TNE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORN FOR WHICH <br /> �PPLICATION IS M�DE AND 1 COMPIY WITN TNE STA7E <br /> CONiRRCTORS L�W iB 2]HLW AND 296200 WAC. <br /> 1�1RCfl 1��I U MMR111 / ^ (� <br /> CO451�IIL�IONIO�NIINt%11.I.[Ip�C$$.iLlI11�OMFMNIRFP x I 1 /\M l' YII �I.�.lG_ <br /> __ sruu-'{�imY—T-� onr <br /> v <br /> Ci�vlV V�ESS lS[MSC MO <br /> PLUMBINO NECN�NIC�L <br /> NO. TYPE OF Fl%TUI1E OR ITEM FEE N0. ThE OF EWIPMEMT FEE <br /> WATER CLOSET(TOILET) /VG-Mma4 UNIf3 <br /> BRTHTUB fORCED AIR SYSTEMS <br /> lr1VATOFY(WASN BASIN� HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCMEN SINK 6 DISP CLOTIIES DRYERS <br /> DISHWASHFR RANGE H000 <br /> UUNDRV TRAY WATER HEATfF <br /> GLOTHES WASNER J�'OOD STOVE <br /> URIN4L METAL FIREPLACE�WOOD BURNINGI <br /> ORiNKING FOUNTPM FiREo�pCE INSERI pY00D BURNiNG� <br /> FI.00R DRAIN GAS FIREPIACE <br /> OACRFLOW PREVENTERS GAS RANGE <br /> SINN�SEFViCE-BAR.ETCJ GAS PIPING <br /> — E%NAUSTFAN <br /> SUDTOTAL f SUBTOTAL f <br /> PERAIIT f _ PERMIT f I ' <br /> TO1plFEE f TOTAIFEE f <br /> FOR OFFICE USE ONLY: <br /> n�wv*wc� m'.nsnn�c. sio[Srm�ce nr.xnrtcauowrn r�r nrtnr�w <br /> uzt�orr im un� v�uwt A�t FEES _ _VALU11710N _ FEET_ <br /> ❑tts ❑m� nwnrr. <br /> ��i inia o�nenu ao a�vmwa: ��tc o�n�mm "--- 1— <br /> nuannc <br /> _-'_ "_ _ . '__i-_ <br /> n..,n��. �r:cur.u�ro.n a�sufwi vr�a�.�ru '_ — "_ <br /> on.,�� ❑.rs O nn _ _ _— _- ._ <br /> �oo-nn.un nwartc+ <br /> ���—,siinnmu nre�w - - <br /> aunn <br /> -i w+mm�m�t--"' nr�•nv <br /> Sinll RunUivC gMCWpf.[ <br /> �ro�n�van�-- rinvs�rrnmrnn• CRYOFEVERETT n�nncm�n.a -.-.. --'-- -_ <br /> LOCALS�LES -' - -- <br /> �„�i TAX CODE IS 0105 TOT�L _ <br />