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APPLICATI�I FOR CONSTRUC�N �ERMIT� <br /> CITV OF EVERETT•BUILUING DIVISIUN <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257•8810 �_��" <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL C] PLUMBING i'. SIGN <br /> PROJECTADDRESS�D� I `h�� p��_ �. ��Qe��-1- q�aoy � <br /> a <br /> wi�c u+a�ocncss ci*v iw wa�E <br /> r�1��(e�nnKer laR'a8' �ou�nle � ,�s�c��- _4s�?o� �o�-7� y-lao8' <br /> W1011E <br /> RLIIItECLOf1OE5GNi11 MAI�AO�C55 CIiV 21P %1WK � <br /> �Eu�aaie NeQi;w�Hi �o ��F��£�u�a�u�� F�Fe��� asaos ya�:�5 - 9�x <br /> ceniaiccr�.a.croa urii�ooness nrv nv rnoH� surei�cnae. <br /> YECNANiCRLLO11iR�LiOB IA�M1AppRC55 � ZIV PNONG SII.IELIL[16[• <br /> PLUTABI�1GC0111111Ci�R MI.ILMJPESS LIIV IIV 1'1�01.[ $lAi[llLffKE� <br /> LON1NILtPiiiLECFWCNv ,9Sy <br /> HEATING SYSTEM: GAS i i ELECTRIC �� <br /> o�swme oenfxosou.ncrooucenrvavco ror�u tne s rur�o r�erro <br /> om zt a or�Je S ' NC�� <br /> - 5- 9 �— <br /> I HEREDV CEflTIFY TMAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND NNOW TME SAIdE 70 DE TRUE AND CORRECT ALL <br /> raovescousecrommwc PROVISIONS OF LAWSANO ORDINANCES CaOVEFNING 7HIS TYPE OF <br /> WORK WILL BE COMPLIED N/ITH WHETMER SPECIFIED NEf1EIN OR <br /> i[usipcscainnor�orraovcarvis�wwxo[�owon�**�<Nnvacow[s� NOT THE GRANTING OF A PERMIT DOES NOT PRESUN.E TO GIVE <br /> ior oiwn or AUTHORITV TO VIO�ATE OR CANCEL iHF. PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGl/LATMG CONSTRUCTION OR TME <br /> PERFOR6IANGE OF CONSTRUCTION.THAT I AM AUTHOHIZED�V TME <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORN FOR V�MICH <br /> APPLICATIO �S MADE D I COhiPLY WITH THE STATE <br /> r.acEi ux i D r�u�.mEe CONTRA -AW 182 AND 296 OO WAC. <br /> COt5iPUC110NLO�NIENDER.���RESS.iClCPt10NENOMpEfl ✓ ✓ -_`� <br /> S�GN�tV�E ��fE <br /> CiIV BUSiNE55liCEYSE Iq <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FF.E NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET� NC—PIHNULG UNITS <br /> �ATHTUB FORCED AIP iYSTEMS <br /> LAVATORV(WASM BASIN� HEAT PUTAP <br /> SHOWER UNIT hiEATERS <br /> KITLHEN SINK&DISP CIOTHE3 DRYERS <br /> DISHVJASHER RANGE HOOD <br /> LAUNORYTRAY WATER MEATER <br /> CLOTHES WASHER M�OOD STOVE <br /> URINAL METAL FIREPLACE(Yl00�BURNING) <br /> ORINKING FOUNTAIN FIqEPLACE INSERT(WOOD Bl1FNING� <br /> FLOOR ORAIN GAS FIREPLACE <br /> OACKFLOW PREVENTERS GASRANGE <br /> SINK(SERVICE—DAq.E7C.1 GAS PIPING <br /> E%MAUSTFAN <br /> SII�TOTAL S SUBTOTAL S <br /> PERMIT 5 PERtAII' S <br /> TOTALFEE 5 TOIALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> IRONiSEiBACe PURSEtOaCN SiD[SEtB�CR PUNCI�ECMMIM'[N FEE PEC[IPiAV <br /> co 02-0 <br /> uticzoe[ io�nau vecu�tsne FEES VALUATION FEE <br /> r,res ni�o euno��a <br /> NEIGN1lIlAIiAlION NOpipl'iEIIING SIZEO�BIDGTI I <br /> I1t11I5 PLU4101NG <br /> WCVG�Ih'.Y�1AC�i10Gt5 OCCUP�NIlOAO DASEIAENI GFCIN11Cq �—� <br /> cnouo <br /> nres ❑r�o � <br /> fIGG5G1iI1NlERq[OU PE�SON �WIIpN�LplANC11ELR <br /> OMCn I <br /> RRE�Uuuq(po nEeSOY <br /> SiM[6URO�NG SUPCeLPGE i <br /> iVPEOlLONSi PUNSAPPNOVEDBY qTVOFEVERETT �UBI�CI'iq1X5 I <br /> LUCALSALES i <br /> �„�E TAX CO�E IS 3105 7o7AL <br />