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APPLICATI� FOR �ONSTRUC7�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98207 •257-BBIff � <br /> DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBWO ❑ SION <br /> Pi/ts/ �ss <br />'� ��h'%�9✓� S� EYeR�r�'I� /,u f1- <br /> �OWNER MNLIWI�E55 CrtY 1� A�E <br /> Nl �do�>eRS J1f'S5' S� S��/3aL.L_ v�e Cvs) �2 /e/�G�a/l <br /> iE T ^ MMLMDHE55 CIiY ZP PIICME <br /> APLHRECTORpE51GN�P MNL1pOPE55 ���� �� �E <br /> �1�..�, D�SDN PomST P,o BcX 936 SuMn�cR iv11 9�39d eso-n�o- T-/�O;JI{ <br /> cencnucorvrw�cron uui�mr+ess cirr �ao6�73.Y-6�// vurtucuae� <br /> MELNANP'<LLONLPACiOP IA<it��RE55 CIfY IIP RqHE Si�TELILENSE• <br /> YWMpINGCONIRPLIOR NAI��ppPE$$ CIiY E�P iNCVE $i�1ELICEN$E� <br /> corrtnnc*anceorwoaK HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> OESC BEWd1N�ND50UAFEL00TAG[11fYQVED CONL�LiPER$CNNIDPHONEIA. <br /> �`�`/�O�i�' M <br /> I HERE9V CERTIFV THAT I HAVE READ AND EXPMINED THIS <br /> APPLICATION AND K�:OW THE SAME TO BE TRUE AND CARRECT.ALL <br /> veovr,seo use oF amw�+c pROVISIONS OF LAWS AND OROINANCES GOVERNINQ THIS TVPE OF <br /> d` SF� C qQf0.y 'r"" WpRN WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ieceioes;.aivrwr�orPnooer �sNowx e�cxrx+enecNrnoca��es� NOL THE GRANTING OF A PERM:T DOES NOT PRESUME TO GIVF. <br /> ior e�xK o�__ AUTHOPITY TO VIOLATE OR CANCEL TME PROVISION OP ANV <br /> OTHER`fATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEPFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFlIZED BY TlIE <br /> OWNER OF TMIS PROPEHTY TO PEFFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITM THE STATE <br /> ceace�i�r i D.MuneEe CONTRACTORS LAW 1027 RCW ANO 296200 WAC. <br /> �1ELl��-���_na � �is � �f' Y-a�oa <br /> C�iF11CiICNLONILEND£R.MOfESS.TELEPNONENUlAOER X <br /> Sqx1iUPE DeIE <br /> CIiYB04uE55UCEN5E1q <br /> PLUMBING MECIIANICAL <br /> NO. TYPE OF FI%TUXE Ofl ITEN FEE NO. TYPE OF EOIIIPMENT FEE <br /> WATER CLOSET ROiLET) P/C—A'HNDLG UNITS <br /> BATMTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN� HEAT PUMP <br /> SHOWER UNIT MEATERS <br /> KITCHEN SirlK 8�ISP CLOTHES DRVERS <br /> DIEHWASMER RANGE 4WD <br /> LAUNDRYT9AY WATERHEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL � METAL FIREPLACE(WOOD BURNING) <br /> ORINNING FOUkTAIN FIREPLACE INSERT(WOOD BURNING) <br /> FLpOR ORAIN �AS FIREPLACE � <br /> BACKFLOW PREVENTERS GAS RANGE <br /> SINK�SERVICE—BAR.CTC.� GAS PIPING <br /> E%HAUSTFAN <br /> —��_ __— <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TJTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> iPONL5Ei0ACN P[�flSEiB�CI( Si0E5EIDRLR CNECNNIIY �P FEE AECEIGiN� <br /> � �QU <br /> usemr�E io*necn I WUNiSiIE FEES VALUATWN PEE <br /> ores n na emimnc �— <br /> NE�GNtLIMILAipN NOO�OViCLLI1IG SIZEO�OLpGTI <br /> U8�t5 PLUTAB�NG <br /> OLLUo�11CY IAClSiO4E5 OLCUPI11ilOAO 9�SENENI MELN�NR;�I <br /> GROU✓ <br /> ❑YES ❑NO <br /> �rt1E5VIlMnI[qRE00 PEA501: �D�I1pN0.PUNCM1ECN <br /> piNER <br /> fIREPtAPA1PE0D PCPSJN <br /> SiA1F BURDING SURCNM6E <br /> rvreottor�st auuvrvaovenar CITYOFEVERETT vue��cwa�ns <br /> LOCALSALES <br /> o�rE TAX CODE IS 3105 TOTAL <br />