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APPLICATIORFOR CONSTRUCTI� PERMIT <br /> CIN OF EVERETT�BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVEREIT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION I� COMBINATION [�PBUILDING '� MECHANICAL �j PLUMBING O SIGN <br /> PROJECT ADDRESS:_��°� - S�.Iu. W.�WMt)e+W iCD�?yeycET3� /- <br /> �.�. l�i,vc..w(�f+cY�( l:►c AAeS` S4�`,Qus c.e) � ki rws 992,25' MtS� -�A3-9ee:�- <br /> rnwFn uM� f.ss cm n � vwME <br /> 1[N�NI 4Y141'y1f55 LIIY )IV P�qNF <br /> �!(n,�6 .�s....� 2Snzz_�eIE1s_r_ Se..,es L%�,.,j- ��,e 8'c-9 -2vr4 <br /> •ncp�*rcronn[s�cu{.n uu�elMr�css �nr hT— Mrtwv <br /> .I�_•p_F]N,fy (avcM .n..� .Q� .o �s�✓e <br /> cruOulcONiMcrpn uu�Lp�MESs Cilr r�r PiqYE Sl�ituQNSF� <br /> Mi04MC�1(pY1B1C10� 4��lLfA)RFSS ry.lV AP p11pNf it�1FUCENSE� . <br /> 1`I114BI1�GCU11�f111:�qi F1�Il1IXNlE55 [IlV I�� 1'NOHF SI�IFIICEN5F1 , <br /> �L i1�C1 VfMC(O!W011F I <br /> d�d�c� HEATING SVSTEM: �GAS ❑EIECiRIC ❑ <br /> U[SCNIBfV/OFX�NUSOU�IIFR%I4OEWy�lVEO CbIIIClMf150NnNfIP1�pNFNp <br /> _,Nw /9tt.S' !Yr ' .�. �_�,KE-" �GS� �4J -f✓oJ <br /> I a:sr�. �a�ra <br /> I HEHEBY LERTIFY THAT I HAVE READ ANO E%AMINED TMIS <br /> rnorptpouse or nunoiva aPPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> S ¢- R PPOVISIONS OF LAWS AND ORUINANCES GOVERNING THIS iYPE OF <br /> _ WORK WI�� BE COMPLIED WITN WHETHER SPECIFIED HEREIN OR <br /> tftu n[srninuouw rrror¢nrvisqwneaowOn�rtncn�wotOM[s pp7, iHE GRANTMG OF A PEPMIT DOES NOT PRESUME TO GNE <br /> �o� -3 nioce or AUTHORITY TO VIOLATE OH CANCF.L THE PROVIS�ON OF ANY <br /> OTIIER STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORN FOR WHICH <br /> APPLICATION IS MAOE AND I COMPLY WITH TME STATE <br /> rnncc.�+a i�miuntn CONTRFCTORS UW 1B 27 HCW AND 296200 WAC. <br /> L���,/ ��/� n,r� nn�l <br /> L(M1�.�f11X;1�MIl1�NIfNOff1M[MIC55.1[1FA10NEMU4REN . ��(J y� <br /> _�.��C �.UA.✓C�AL �.�/Y(l� vc�.iunc n•rz <br /> �-�1VA^WQdA $�-.r 3 tnrwv�cssiccuscxo <br /> PLUMBING ' MECN�NICRL <br /> NO. TYPE OP FI%TURE OR I7E1A FEE NO. NVE OF ECUIPMENT FEE <br /> Z WATERCLOSET�TOILET) NC-MINDLGUNRS <br /> Z, BRTHTUB FORCEDAIRSVSTEMS <br /> �j LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT NEATERS <br /> NI�CNEN SINK d OISP / CIOTNES DRYERS <br /> / DiSHWASHER PANGEHOOD <br /> LAUN�HV TRAY WATER HEATER <br /> 1 CLOTHES WASHER WOODSTOVE <br /> VHINAI METAL FIREPLICE QNOOD BURNING� <br /> ORIIJKING FOUNTAIN FIREPLACE INSEHT(WOO�BURNINu) <br /> FLOOR[IRAIN GAS FIRENLACE <br /> OACKFLOW PPEVENTERS CaASRANGE <br /> SINK(SERVICE-OAR.ETC.) GASPIPING <br /> O � EXHAUST FAN <br /> $UB TOTAL E SUB TOTAL f <br />� PERMIT f PERMIT S <br /> TOTA�FEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> �nrnrtvinarn m�nSr�P¢K siMS[IB�Cx r1u�Ui¢e�N rn :fr nffPrrqO <br /> � � s s��ay� 30 <br /> uvi �ovr �murt. vicewv� FEES VRLO�TION FEE <br /> �--� sy5� .�s o� - —,.—,— <br /> nixmmr. _ Q/_ c(�p . . ;OJ <br /> —__ ___--' ' . <br /> u[ic�novnq�� tiaaUwnutiG s¢(t��w���ocni ..__ _ J.���.YL � <br /> uhn.. _f�`J Z S� PIV4Pwfl �(� DO <br /> . . . _._... __{ <br /> Irtll!��'.:'♦ '.�".�"..����� IN�f'IiC�N11U�D fl�if4iN1 <br /> �,����. M�„�.���.� �v i o� <br /> �.3L�-1 _f_ ❑,�5 rx� — --- -- <br /> ro.-i w�,:�....ui,i+inn ' 'nnca� - �owunmu n�Ncurc. <br /> � ' _'___ —' __ _-_ <br /> 1 � awrn <br /> -�7-S :.- ,�i:i�:a-_ . m.�m - - _.� — <br /> .. stu�mau��.ucsonouna[ � ;SJJ <br /> nrenr7r•--"—' nn�c�rrcovrnm CITYOFEVERETT rnr�..rwrn�+< ' <br /> LOCAL SALES �?�f`�"� <br /> �-_I�( __ n��E �f L QB TAX CODE IS 7105 TOTRL S '�v <br />