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APPLICATI� FOR CONSTRUC�N PERMIT <br /> CITY OF EVEREff•BUILDING DIVIS�ON � <br /> 3200 CEDAR STAEET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ �EMOLRION ❑ COMBINATION ❑ BUILDINfi ❑ MECHANICAL �PLUMBING ❑ SIQN <br /> PROJECT ADDRESS: ,���j{�' IT Sw <br /> -rupy s�� <br /> pWNFn uut�pUlEsS GIiV I�r vrqNE <br /> 1[N�NI 441�bO�F55 f,IIY IIV VnONF <br /> ♦�NRlCt01�f)f$IC�IF11 MUIM�fIF55 LIIY li1' 1`N(W{ <br /> ffN[I1/.lCOY111Af1f)fl ���III�Ol��ESS �IIY }il' 1'�l!)YE t1At[IICENSF• <br /> MFb��biGLL�4DUC�UR 4tit/.MN�E55 f.�tY hP P�BJNf [I1iFUCENSE� " <br /> CDMMV+� IT� PLVMDINV ��y��.�1 _ UMMuM1 bSOb <br /> P111401�ACOIIIP�f.Iq1 M��ILIXNF55 [�ix U� " ��F SGifll[FNSf� <br /> co.rtn.cr�ma u�wnne <br /> 3 L Oc) ' HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> OFSGA�BF W'JRN�MfISW��E fOOt�GE NVOIVEO CONI�C�VfRSpN/.HI�I'N(H1{NO <br /> I HEREOY CERTIFY iNnT I HnuE REAO AND EX�MINEO THIS <br /> i�rrro;rc u;t or nvrtuiva APPUCAiION PND NNOW THE SRME TO BE TRVE�ND CORRECT qLL <br /> ' FROVISIONS OF LAWS AND ORDINqNCES GOVEFNING 1HI51YPE OF <br /> WORK WII L BE COMPLIEO WITM WHETHER SPECIFIEO HEREIN OR <br /> icc��nescnmuor�orr�ror¢nrvisw�wr�es�owan�nr.cMnvoconts� NOT. THE GRANTING OF A PERMIT WES NUT PRESVME TO GNE <br /> mr eioca or AUTHORITV TO VIOLA7E OR CANCEL THE PROVISiON OF �NY <br /> OTHER STATE OR IOCAL LAW REGUUTING CONSTRUCTION OR THE <br /> PEflFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> — OWNER OF THIS PERTY TO PERFORM THE WORK FOR WHICH <br /> APFLICATION I MA E AND I COMPLV WITH THE ST�TE <br /> r.ncn u i mwxtn CONT CTORS AW B. 7 RCW ANO 296200 WAC. <br /> G�,v os8 oct� -' ,(,(,{,�,/ 9/��98' <br /> COYSIBIKOpNtO�rvIfNfIFf1.AfNM255.iC1E1`MOMENUMRF� x <br /> '_!G �tURF UM <br /> CIiY BULNES$IiCENS[NO <br /> PLUMBING MECN�NICRL <br /> NO. TVPEOFFlXTUREORITEM FEE NO. TVPEOFEOUIPMFl1i FEE <br /> WATER CLOSET�TOILET) h/C—MINDLG UNRS <br /> BATMTUB FOPCEO aIH SYSTEMS <br /> LAVATORY�WASH BASIN) HEAT PUMP <br /> SHOWER UNIT NEATERS <br /> KITCHEN SINN 8 DISP CLOTHES ORYERS <br /> DISH WASHER RANGE HO00 <br /> Lr1UNORY TRAY WATER HEATEP <br /> CIOTHES WASNER WOODSTOVE <br /> URINAL METAL FIREPLAfE hN00P BUFNING� <br /> DRINNING FOUNTA W FIREPLACE INSER7�VJOOD BURNING) <br /> FLOOR DRqIN GAS FIPEPLACE <br /> BACNFLOW PREVENTERS GASRANGE <br /> SINK�SERVICE—BAR.ETC.) GAS PIPING <br /> E%HAUSTFAN <br /> SUBiOTAL 5 SUBTOT�I f <br /> PERMIT E a-J�DD PERMIT f <br /> TOTAI FEE 5 d� 'V(J TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> �nnuttnMrn nrN5rtp4r 90E5t1B6R r��qb�¢xnuunrn rff nFC:m�No <br /> �'0��� <br /> us�.iovr �o�•��u v�uH�sn6 FEES V�lUM10N FEE <br /> --*— <br /> ❑rEs ❑uo nwrn+: <br /> uf�r���i�o�pnUv poanwlll�Nc sl[o�'BIOLrt� '— <br /> )vil.\ ��114PWC <br /> f1pVl`•,•::♦ r��l�'��l1 CYf111'�H11U�0 B�SFMC�� Nil'.���M1�f11 � � � � <br /> ❑rF5 ONO <br /> lI1�L'il�il!•��LlIIP[!]U IIi1tiM /�OI�InN�I 1'1�N1:��fL� <br /> pll�ffl <br /> 11�[FIAIVNl�LO'D NF��nV -- <br /> [I�tt flV��OW G S�III[u�11E[ <br /> nr�rncova rinws�rrurntnov CRYOFEVERETT ninucwnu.c <br /> LOCALSALES -� — ---�— — - <br /> nvt TAX CODE IS 3105 TO7AL <br />