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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVEREff•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINA110N ❑ BUILDING ❑ MECHANICAL ❑ PLUMBINA ❑ SION <br /> PqJJECTAODRESS� rJ.� a2 A�V. Wi <br /> � _<-'Rvac� 73 oTwiMi,c FVT 98�e13 <br /> ovmen wui�wnfss an m vro+[ <br /> I[N�N� 4�11�bq1E55 G�Y )IP ONOMF <br /> ��C�Mi�L10PpE5�GN[I� M�iI�U�uE55 CIIY )�P I'NONF <br /> f.MCMlCO4fPI.C10t1 4ut�00nE55 C�IY !iP Mq4[ SlAtfuCENSf• <br /> MLOi��+�Utf.ON�wC10P MuI�DIX+F55 Citt )il` F�bNf SIrtFI�CFNSF� <br /> L9 �11 NE� , 5�1 9 `a� AUr W� F_vT g'�Se� 3�3-U 7�9 <br /> 1�1114PPIGLO�I�N1f,1M Y11111)pfl[SS CIfY !IV CIqNf SlA1flICFN'.'e• <br /> Cp1II1�C�f 111C[Of W(N�N <br /> NEATING SYSTEM: ❑GAS ❑ELECTRIC O <br /> OFSC`F�RM•N�SOU��(�OOIAGfWVOIVE�� ��^ '1�� CCN11Cf%XSON/.Mpi'IUNfNO <br /> r US Ie' r <br /> I HEREBV CERTIFY 7MAT I HAVE READ �N� E%�MINED TMIS <br /> ��ansvuav or nunoiuc� APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORN WILL BE COMPLIED WITH WHETNER SPECIFIED HEREIN OP <br /> tfc�iof5cnmuprvorrrwrEnrv�sewWrvBEiawOu�rtnc�rvromnRi ppT. THE GRRNTING OF A PERMIT OOES NOT PRESUME TO QIVE <br /> �m eiacK ar AUTHORITY TO VIOLpTE OR C�NCEL TME PROVIS�ON OP ANV <br /> OTHEP STATE OR LOCAL LAW REGUUTIN�CANSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTION.TMAT I AM AUTHORIZED BY TME <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> rencn w i u rnruptn CONTRACTORS LAW 18 2]RCW AND 496200 WAC <br /> cros�n�rcn��o���rutMnu�rnEss.rafr«anEMwxEn . (�/�✓�+ -1 <br /> �m� wrt <br /> CIfYB119NFS5liCFNSC NO <br /> PLUMBINC MECNIINICIIL <br /> N-- O. � TYPE OF FIXTURE Oii ITEM FEE NO. TVPE OF EWIPMEHf FEE <br /> WATER CLOSET(TOILFT) A/C-M7NDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> NITCHEN SINK 8 OISP CIOTHES ORYERS <br /> �ISHWASHER RANGE HOOD <br /> LAJN�FY TRAY WATER HEATER <br /> CLOTHES WASHEF WOGD STOVE -T <br /> URINAL METAL FIREPLAJE(WOOD 3URNING� <br /> DRINRING FOUNTAIN FIREPLACE INSERT�WOOD BURNING� <br /> F�OOR DFAIN GAS FIREPLACE <br /> BACNFLOW PREVENTERS GASRANGE <br /> SINR�SERVICE-BAR.ETQ) GAS PIPING -�- <br /> E%HAUST FAN <br /> SUB TOTAL E S�tl'OTAL f <br /> PERMIT S PERMiT 5 <br /> TOTALFEE S TOTALFEE S 3 <br /> FOR OFFICE USE ONLY: <br /> inrvrtann.r, nnnsnp.c� s�ocsr�e¢n n�ea�rtemuuxrn rrr - nrcnr�r.o <br /> ua iow -'--- " �ounu v�uvtsrz FEES V�LU�TION FEE <br /> - _"�_ <br /> ❑rEs ❑no n�ninnif. <br /> ��fiCd�IVWuuD\ �OMOwllll� SRf0�R1aR1 ' <br /> ��•�1� �1114fli4� <br /> .. . .._._ _ _ �� <br /> I.I.�il� ���.111 �f11n�11110�D fl�SCVLAI M�Il��ti(• <br /> r n <br /> .� . � � <br /> ❑�[5 ❑NO . _ . _ ._. ._�__._ <br /> iT.i-�i.u�6r.cnu_—_ nr�stw �uwnnwin�wa�r... <br /> ov�m -_".- ___" -- -_ <br /> k�l�l PITl.'A1�lI)f] r11��7V - <br /> clll OVdI:iNl:Si111Uu0(1[ <br /> nr�niro����-- rinas�nrnpvronr CRYOFEVEREiT rnxncwon.c -"-- ""'- -'� --- <br /> LOCALSALES -� - --- - <br /> _ __ 1„��E TAX COOE IS 3105 TOTAL _ <br />