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APPLICATIOR FOR CONSTRUCT� PERIII�IT <br /> CITY OF cVEREff•BUILDING DIVISION �C+�� <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION lX COMBINATION ppI BUf`L�DIIN6 ❑ MECH�NICAL ❑ FLUMBINO ❑ SION <br /> PROJECTADDRESS:���-'S�21 ��ki� I .l d �n� LCT Z ;L�qTfMca�S C-«Nw�eq <br /> '1,....1.�i.� �,.3,�.ut�c,-.h... L- 'i '_ 'c 7L-z� +.'�n. �'� .�..�lk...�t- c,., '%rLic -i:i ) - 3,S2c <br /> OWMFu 4ul E55 CiT' li� � FNME <br /> IEN1Y1 YNI�OM�fS$ GiY IIO 0110NF <br /> •f1C�nifCtOPM5�G0EP M�i1MM1E55 GIY ]�� P�KINF <br /> `1 <br /> `L_�1.�'., C�..�i..,1,..._ �,... C-3zz 7LtFet� 4s n,K-/...�- i8z,c it7�3>-as �l�F«:.zi4�Ct <br /> f.(�IC141 LONINLICQ M�it��0[INE55 p�1Y 8P P�MiMt 5�11[IICENY� <br /> MfOUb�q(p4i��L10P W�Uf%Mf.55 Clry )iP PIbNf tUffUCFNSE� <br /> P�IIMpINGCONIR�f,lp1 4�il�L(Nl55 ph IIV CNWIi 91tF110ENSE• <br /> corvrnect nmcE ur vmna <br /> HEATING SYSTEM; dGAS ❑ELECTRIC ❑ <br /> �ISLP�flFWORK�4fi5pU�PE����GEMVO:VFD L ��C�PfR$pN Nfl Mp�IFNO <br /> , I r\ I � SP ��� TLl'C S/G/. �LISI � L�ELI N � 37 3S z f, <br /> , <br /> r;.�.��� r; , , 3 -- <br /> I HEREBY CENTIFY THAT I MAVE READ �ND E%AMINED THIS <br /> mrorosvo usr nr pmmwc APP�ICATION PNO NNOW THE SAME TO BE TRUE ANO CORRECT�LL <br /> PROVISIONS OF LAWS AND OADINANLES GOVERNING THIS TYFE OF <br /> WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEFEIN OP <br /> :eeuotsnuruor+�sraov¢nnisrarmxnowcnen�c�iwocorEsi qp7. THE GRANTING OF A PEflMIT DOES NOi PRESUME TO GIVE <br /> �or e�acs ar AUTMORITV TO VIOLATE OR CANCEL THE PRQ�ISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OH THE <br /> �NJJ�T i{`T'� PERFORMANCE OF CONSTRUCTION.TMRT I�M AUTHORIZEO BV THE <br /> ;;� _ 9 :} - 3- D f��� � - OWNER OF THIS PROPERTY TO PERFORM TME WORN FOR WHICM <br /> ,�. .y;y _ ;q „ y�� _ ����� APPi1CATION IS MAOE AND 1 COMPIY WITH TNE STATE <br /> nepcu u+i o�.uux[n ! COryjRACTORS LAW 18 27 RC1Y�ND 29ti 200 WAC. <br /> I 1 1 <br /> COHS�OVLIIONINNIfN(KIIMRYiE55.1[l[MICMENU4PFP x 1\1..� `L•J"��ti <br /> r�/;.�nT�r,: c,q ,F .S�r4 -�7yZ vn�um¢� �a� <br /> O1V 6ULNESS IICFNSC NO <br /> PLUMBING MECNIINIC�L <br /> NO, TYPE OF Fl%TUHE OR REM FEE NO. TYPE OF EOUIPMFNT FEE <br /> � WATERLLOSET�TO�LET) A/C—NHN�L6UNR:'� <br /> BATMTUB FORCED AIR SVSTEMS ' <br /> � LAVATORY(WASN BASIN) HEAT PUMP --� <br /> SMOWER UNIT HE�TERS <br /> KITCHEN SINK 8�ISP ! CLOTHES ORYERS <br /> DISHWASHER � WNGEHOOD <br /> LAUNDRY TRAY / WATER HEATER <br /> / CLOTHES WASHER YlOOD STOVE <br /> URINRL METAL FIREPLACE(WOOD BURNING) <br /> DRINNING FOUNTAIN FIREPLACE INSEFT(WOOD BURNING) <br /> FLOOR DRAIN / GAS FIREPLACE <br /> OACNFLOW PqEVENTERS GtS RANGE <br /> SINK(SERVICE—UFR.ETQ) ,j GAS PIPING <br /> E%HAUST FlW <br /> d� <br /> SUBTOTAL f �'JBTOTAL f <br /> Ptnn:ii S PERMIT f <br /> ' TOTAI.FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> innqtuID+r6 nr�n[rtp�Ck 40(5[�B�Ctl r1�uO�EC+6:•min RF µ ^ nffFlMMo <br /> T.v ' ��' �" �r�G�o .:�� <br /> oE�;n.,r �✓/ io�.�+u v.cee�sur FEES VALU�710N FEEp y �7 <br /> ❑rEs ❑uo nwn�w. _ LCCr v> GJ 1/S <br /> ��fiF����wil�npu �.O(MUWfl11NG 54EO�BlW/11 —r— � <br /> iP:iL � <br /> � � PI��MPMG <br /> �� 55B 4/ S.f. --- -- --- - -----" <-- <br /> in..iv x•..�•�.'.^� IX�.I:Iin�NllU�l� fl�GiWN� Mfl'I��tiil'�1 <br /> tu � � <br /> � <br /> �.��u t 2 , <br /> ❑\[G ti7 - ' .. - <br /> �.�.-t'.�.�.:.n1l��i:IOU Ilf��(1N ��p11p4nI1�1�NC��(Cv <br /> UlliF� <br /> i u;:dCiui��u-- nr�spv 1�—�—�// <br /> c4p nWtfYqf.Snn[�un(:[ ""._ ___L�'�LY.) <br /> rvrvoito��e�--- r�nvs�r�npvrnm CRYOFEVERETT run�mwou.c 2�`_ <br /> LOCALSALES <br /> _�-1� ��.�t 29 TA%CODE150105 ror�� - -- --_— —-�� <br /> � <br />