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APPLICATI�I FOR CONS4RUC7�N PERMIT� <br /> CITY OF EVEHETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8H10 <br /> ❑ LEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING u SIGN <br /> PROJECTADDRESS <br /> OW Mr.L�COPF$$ CIfV ZIV WqM1E <br /> �,�'crufiii ��m/�e� 3�a1 a/�-ftiPi C�c°�,cE w�! 9�0/ __ <br /> iEN11�Ii-I PAR�DDRE55 Clh 2iV �fMONE <br /> IPb�1IECiOB�ESA'iYC11 M�IUWPE55 Clfv ZN' V1qr,E <br /> GEN�R�LCnN1P/.CiC�1 MAIl��O(1C55 L�IY 1�� PHON[ $LAi[l'iE1RE• <br /> 1AC Ni PLLONif1 ^ fl \IAILAppPES.^� I �L'+ PN(.`N[ $L�iELY,�[IiSE• <br /> ��e �'�S� a0� 'r siur��-�nw� 9�.�n—Z��Z co�ETa-J3d� <br /> Pl11MdINGCO�lINP�iON AIPILPN�CS$ Cli � 21P P11p1�E $IAiELICENS�♦ <br /> caiw<c*rn�ccorxuna �`3� �/ HEATINGSYSTEM: ❑GAS ❑ELFCTRIC ❑__ _ <br /> oescniee wona exo sou�ae vrouuc rt�vavco mr+rncr�o�sox uio rrror¢rw <br /> I HEREBV CEflTIFV THAT I HAVE READ AND E%AMINED THIS <br /> APP�ICATION ANO NNOW THE SAME TC BE TRUE AND CORRECT ALI. <br /> Peorosso us¢oc ew�owc PROVISIDNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> V/ORK WI�I.9E COfdPLIED WITH WHETHEF FPEGFIED MEREIN OR <br /> iEcunescemnona�vaovEnnisrwwr�oE�awoe�n.cnrnocow[si NU? THE GFANTING OF P.PEPMIT DOES NOT PRESUME TO GIVE <br /> �or o�ocK o� _ AUTHORITY TO VIOLATE OP CANCEL TNE PROVISION OF ANY <br /> OTHCR STATE OF LOLAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANGE OF CONSTRUCTION.THAT I Aht AU iMORIZEO BY THE <br /> OWNER OF THIS PROPERTY TO PEFFORM TME WORK FOR WHICH <br /> APPLICATION IS MADE AND I CONPLY WITH THE STATE <br /> v�ac[�ux i o�wueen GONTRO OPS LAW 27 RCl4 AND 29fi200 WAC. <br /> I <br /> mNsrr+uc*wNio�vi[xoca,�coAess.iac��or:Exu�ne[n �„�P.CC(/JL�;�(�L_ `l'/�//p <br /> x <br /> _ sicrvu ne o�t <br /> cnv ousn�css ucsr�sc r�o <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF FI%TURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATEFCLOSET�TOILET) AC—AMNDLGUNITS <br /> BATMTUB FCRCED AIF SYSTEh15 <br /> LAVATORY(WASM BASIN) HEAT FUMP <br /> SHOWER UNIT HEATEPS <br /> KITCMEN SINK d DISP CIOiHES DRVERS <br /> DISHWASMER PANGE HOOD <br /> IAUNDRV TRAY WATEF HEATEP <br /> CLOTHES WASMER WOOD STOVE <br /> URINAL METALFIREPUCE(YlOOD Ol1RNING� <br /> DRINKING FOUNTAIi fINEPW6E INSERT�WUOD BURNMG� <br /> fLOOR DRAIN GAS FIPEPLALE <br /> BACKFLCWPREVENTERS 1 G45RANGE <br /> SINK(SERVICE—BAR.ETC.) GAS PIPING <br /> EXMAUSTPAN <br /> � <br /> SUBTOTAL 5 SUBTOTAL SI <br /> PERMIT S PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 �_ <br /> FOR OFFICE USE ONLY: � �oL-0A- <br /> iPONiSEl84K uE�aSEi9PLK SOESEi04K �UNMCCqvJUBER iEE AECfl�Trq. <br /> usezo<e �orece� v�curt5rtt FEES VALI1qTION FEE <br /> -vES ^NO Buh.^.'�M <br /> nEiO„iliMiRiiON NOO�OWELL�N� SiIE0F0tW'fl - � <br /> U'+i15 vip�.�B'�u0 <br /> a OVo,��YiM1�G�SfpFfS I OCCU✓ANLLO�p 9�SEREni MEC.n�rtUL <br /> � �vES Cti0 <br /> �IPES�a'�NKICRaf00 Pf�$JV ���ILION0.FVdCXEC[ <br /> 0*wEA <br /> {'iPEeleeuP_OC IPE�SON <br /> 5"��E BUiIbNG S�AC��P'uE <br /> irv6c�co�+sr aurvs�venp.mer CITYUFEVERETT >uate�ne.s <br /> LOCALSALES <br /> o+rE TAX CODE IS J705 70T�L <br />