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APPLICATI�1 FOR CONSTRUC'�N PERMIT� <br /> CITY OF EVERETT•BUILDIl�G DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257-8810 <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDINO O MECHANICAI ❑ PLUMBINO ❑ SIGN <br /> PqOJECT�1DDR�E33 L 2�,� - �i� " Sy J.W, �vc� �✓A 9�10,j <br /> C <br /> �uc�no�sa urr a � Ccl�+�9zs-4u-�9�t <br /> SA E <br /> .�. .���5 �. � ^� <br /> SA•n e• <br /> MLXIiECTON0E8�6NFR �IAWME68 �" ZP P�� <br /> ,$A�'+� c <br /> 6ENEWLLCONfMGipi MAM1��diE39 GlY ZP RIONE BT1TElFFN6E� <br /> MECIUNIC�LCONIPACipi W0.�OOXE55 Lltt IF PIqHE ST�TEl10EN5E� <br /> PWMBNOCOMMLTOR WIMM�E55 � SV P�qME STAiEl1CFN5E� <br /> cowrw�crva�ceaworix. HEATINGSYSTEM: �GAS ❑ELECTRIC ❑ <br /> 9Z2 - <br /> cescniee wwm�vo sau�e raotnae wrvaveo ncr>Enawua <br /> „ ? .t z� 925-Isa 1 zS <br /> Aoo [�vann.9 Towc�. I �'x rl <br /> � _ I HEREBV CERTIFV THAT I HAVE PEAD RND EXAMINED THIS <br /> 7 HPPLICATION AND KNOW TNE SAME TO BE TRUE AND CARRECT.ALL <br /> PPOPOSED USE OF BIIilDiM6 PROVISIONS OF LAW9 AND ORDIWWCE$60VERNINO THI9 TVPE OF <br /> �0�2��i WORK WILL BE COMPLIED WfTFi�MNEfMER SPECIFIED XEREIN OR <br /> LEpµp(SCppTqrypFp110PEptt�SHOMIBELOWd��TTIGMTYOLOP�E51 NOT.7HE �MNTINa OF A PERMR OOES N�T PRESUME TO GIVE <br /> ior ��K � AUTHORITV TO VIOLATE OR CANCEL THE PflOVISION OF ANY <br /> OTHER SUTE OR LOCAL LAW REOULATMa CANSTRUCiION OH THE <br /> PERFORMRNCE OF CONaTRUCTION.TH�T 1 AM AUTHORIZED BV TME <br /> OWNER OF 7HI5 PROFEHTY TO PERFORM THE WORK FOR NMICH <br /> APPLICATION 19 M110E AND I COMPLY WITH 7HE STATE <br /> COMMCTORS W 1827 R� W AND 296200 WAC. <br /> PMLEL TAt I D.MIMBEP (�O <br /> �/YiS — v�"" bt2' . / <br /> GONSTNIICfICNLONILENDE0./�AESS.IEIERqNENU�lER X — <br /> Sp1YNPE �� <br /> CIIYlUSNE65 LICENSE N0. <br /> PLUM&NO MECII�NIC�L <br /> NO. TYPE OF FI%TUHE OH fTEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILEn P/C—MHNDLO UNR9 <br /> BATHTUB FORCE�AIR SYSTEMS <br /> LAVATORV�4ASH BASIN) HEAT WMP <br /> SHOWER I UNITHEAiERS � <br /> KITCHEN SINK 8 DISP CLOTHES DRYERS i <br /> DISHWASHER RAN6E HOOD � <br /> UUNDRY TRAY <br /> � WA7ERMEATEH � <br /> CLOTHESWASHER i WOODSTOVE ; <br /> URINAL METAL FIREPUCE(WOOD BURNING) i <br /> ORINKINO FOUNTAIN � FIREPLACE INSERT�VOOD BURNING) � <br /> FLOOR DRAIN OAS FIREPUCE <br /> BACKFIOW PREVENTERS � ���E � <br /> SINK(SERVICE—BAR.ETC.) ! G!S PIPINQ � <br /> ' E%HAUSTFAN � <br /> i <br /> i <br /> i <br /> SUBTOTAL S � SUB70TAL S � <br /> PERMR S i PERMR S i <br /> TOTALFEE S TOTALFEE S � <br /> FOfl OFFICE USE ONLY: <br /> FPOMSEI9ACK / PEMSEiBALK / SIpESEIBIiCK/ VUMCMJiQI(�'�BEA �y � 2� ��E��� <br /> {( A��AY <br /> K! (l L�+O <br /> USEZONE ^/ �orraen v�cu+*S�tE FEES VALWITION FEE <br /> ��s �� �� svu <br /> Heionturnir�raN � raaroweuna s�orxnari. <br /> UNItS � RUYBW6 <br /> OLLUPNILV N?R51piE5 OCLUPANLIOAD ��� / y[(�`�('X <br /> 4 P OVES PNO <br /> � ADDIfpNKRANp1EClf <br /> FWESPRiNKLENPEO'O PEASON <br /> OTIIEP <br /> iWE�IAPNpE00 PE�SON <br /> STAIE Po:IIIMNII S�NLMNqE <br /> rrnc or cor+sr wws.wvaweo a CITY OF EVEflETT ���5 <br /> LOCALSALES <br /> o�� TAX CODE IS 3705 TOTIIL <br />