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APPLICAT�OR FOR CONSTRUCT�N PERMIT <br /> CIN OF EVERETT•BUIIDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION �6C BUILDING ❑ MECHANICAL ❑ PLUMBINQ O SION <br /> PROJECT ADDRESS:_�II� H�x � � <br /> � f{LTGhI CYIP.Y a r�� y9��r aE c-✓�zr�r 98ao3 yas-as�.-s7v�( <br /> OMNfn �— uu�AppuE55 Clrc iir PWNE <br /> IENA�II 4�11�fI0��F5$ fJIY !IP V�1CMF <br /> •nC1UifCiMIXSiC:if�� u��I�fIf1NE55 U�v li- ��� <br /> GLNFIP ill��ClOq M��I�D(IDE55 Ci1Y l�� PiNM�F S��IIIICENSF� <br /> MFLu�ONIn�C1pP 4ul1INN�f55 Orv h�` Cllp:f 5lIIFUCENSE� <br /> puwqn.t�.cO��iner,�pn vut�[%WE55 Lm I�v ��G SiMFIiCENSF• <br /> couin.ci w.cr or wnnK /�v. �+ MEATING SVSTEM: ❑GAS ❑ELECTRIC � <br /> prR��oF w'nne�MU qU��R i00t�cE MVOLVFo cOq4C�vin50N�M1 replF uo <br /> N�r� �.n�:ac-� (,�cTncH FA 95z, s�,{T <br /> J I HEREdY CERTIFV TNAT I HAVE READ AND E%AMINED THIS <br /> PPPLICATION AND NNOW TNE SAME TO BE TRUE AND CORRECT ALL <br /> nnorosw ust or nannux: PROVISIONS OF UWS AND OADINANCES GOVERNING THIS LYPE OF <br /> V/ORK WILL BE COMPLIED WITH WMETHER SPECIFIED HEREIN OR <br /> iwuoczcmm�p�c.�r�roc[mr�swwHe[iavronert�cHrwocon[s qpT, TME GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> io� p�a� or AUTHOP.ITY 10 VIOLATE OR CANCEL THE PROVISION OF �NY <br /> OTHcR STA1E OR IOCAL LAW REGUUTINO CONSTRUCTION OR TNE <br /> PERFORMANCE OF CONSTRUCTION.THqT I�M�UTHORRED BY TME <br /> OWNE9 OF TNIS PROPERTY TO PERFORM THE WORK FOR WMICH <br /> APPLICATION IS MAOE AND I COMPIY WITH THE STA7E <br /> CONTR TORS LAW 18 27 FCW AND 296200 WAC. <br /> P CRJi�D IUHkR <br /> �� .` %r��- hol- cl3- co06 �j�, � <br /> C(Y�SIOI�GtIt»IIO�NIfNfIF0.41M1(55 �REPeDNEMV4REP x � 7h��-'�v � -�3 �� � <br /> S:GN�i �AI[ ' <br /> GfYBU4NE55llG[NS O <br /> PLUMBING MECM�NICIIL <br /> NO. TYPE OF Fl%TURE OR ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> WATEH CLOSET�TOILET) NC—NHNDLG UNRS <br /> BATHTUB FORCEO AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SMOWER UNIT HEAfERS _ <br /> KITCHEN SINK 6�ISP CLOTNES URVERS <br /> DISHWASHEH RANGE HOOD <br /> LAUNDRY TRAV WATEfl HEATER <br /> CLOTNES WASNER WOOD STOVE <br /> VqINAL METAL PIREPLACE�'JOOD BUHNING) <br /> DRINNING FOUNTPIN FIREPLACE INSEFT�WOOD BURNINCa) <br /> FLOOF URAIN GAS FIRF.PLACE _ <br /> OACKFLOW FREVENTERS GASRANGE _ <br /> SINN�SERVICE—BAP.ETQ) GAS PIPING <br /> -- �— EXHAUSTFAN <br /> SUBTOTAL S SUBTOTAL f ' <br /> �T <br /> PERMIT E PERMIT f _ <br /> TOTALFEE E TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> inar�ivrn.r, �' nru�snn•n. sm[sr�n•c+ n�Nu2c��:uunrn rrr/ �,� nfcrmrr�o <br /> ^ �' /U" �"' fo�l�(s /�.; � <br /> n•:��n�.r.�--- _ iu�u�i� v�t��u�� _ FEES _ VAIUATION_ _ FEE <br /> — o.rs ❑r,� _J�,� <br /> 5 <br /> k - � R„���,��� z 2 U !50 <br /> pUf.Wl'�nu'Jt/ nUbDwfILVrt{ SRLOrPlW9r �— <br /> � <br /> r ��•.��� ` S / 1'1114P�Nfr ' <br /> / J • <br /> i1i_ .__ .._.__ _ __.. 1 <br /> t�tli.l �• ��� �����'i�l<I�II R�[F4fN1 �/fl'111n1f.n1 <br /> f\i i M`` � lN.. � � <br /> (.�I�rI�lii` .. .___ _. _ . . <br /> y I___ I .. ' ❑�ES �0 <br /> •DpIIpN4.P��q ORCw <br /> �'. i.nllirf.frll� ��fnGry. —.� _ <br /> OIUF� <br /> Ii:�1�aI.vl.duDlU _. _ I�In�OV�_� � <br /> tl�ll fl�1�111ir1f 51111C�I�IIC.0 �_'�� <br /> orvcrrn•:��—'"-'— binw�rrnovrnm CITYOFEVERETT runnswnnev <br /> LOCALSALES ------ -�_�.------y-- <br /> _�_� _ i,q�E �e �q./q� TA%CODE 153105 70T�L _ <br />