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APPLICATI� FOR CONSTRUC�N PERNtIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8870 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL Q� PLUMBING G SIGN <br /> PROJECT ADDRESS: ��U L_ Sn7- ���JJJ <br /> P_�n-�o� c� /� �/7 �J V[// <br /> ovnfn �7 wu��ow�rc��/�/ e'ivj — Iir ��ev[— <br /> t/��LAM/.' i/�7 9lJ K . <br /> IFN/.NI VYI�I%IRf[5 f.liv l�n v��p4F <br /> AfIC1Mt(�IO�f1E51f:1(I� u��I�Of1Pf55 f.�tv !�r f'��(trif <br /> L{NkA�lCON11�PC1(YI M��I�MN�F55 C�l� ]�� ��I�:Y( [I11I11[fN5{� <br /> MFCI�/.I�i[�I(nY111�fIUP 4��1�1�1WF55 fiM1 lif' f'�I[Iti( CI�If1�CCM1[�• <br /> �p17p_n.v�l.rw.h�,ub ��S__ST/*,vw�uu A925L 7.SL-13oa Co..,rv.u/LCO.�J_3op <br /> VIIIYBMlsCO111P✓:1(X1 4�'1�I111�F55 Cilr jlv IY�.TiF St1lFllfF�.ti• <br /> CDNf11�L11'111Lf U���X --'-- <br /> HEATING SYSTEM: C]GAS ❑ELECTRIC ❑ <br /> urscwnr w�a.�rn,oe•�a.00r�c[wwrim mnucr v�nsnti.nn rnrnr��u — <br /> ��� _ ______ <br /> I NEFE�V CERTIFV t11AT I /IpVE READ AND E%AMINEO TNIS <br /> qPPIICATION qNp NNOW THE$AME TO pE TRUE ANO COPqECT ALL <br /> i np�pa�ov;t er p•.umua PRUVISIONS OF LAW$FNU OP.pW4NGE$GOVERNING THIS TYPE OF <br /> WORN WIIL UE COMPLIED WITM WNEiHER SPEGIFlEO N[FEIN OR <br /> tmuofscnn.uonor�oor¢nnisravmP[mwcu�n+ortwocon[Si NOi. THE GR4NTING OF A PERA11i �DES NOT PRESUME TO GIVE <br /> io� Biocx or AUTHORi1Y 70 VIOLaTE OR CANCEL TME PROVISION OF ANY <br /> OTNER STATE OR LOGAL LAW REGULATING CONSiRUCTION OR TNE <br /> ❑ERFORMANCE OP CCNSTRUGTION T11AT I A61 qUTHORIZED U�TNE <br /> OWNER Of THIS P(i0 TY TO PERFORM THE WOFN FOR WNICN <br /> APPLICATION IS 1ADE 4ND I GOMPLY WRH TIIE SiqTE <br /> P�Acnuvio,nn�nvn COHiqP:TORSlA4'tP2]R YJANDi96200WAC <br /> iCONS1R11LII1M110�N1IufIFN/dXY�([SI(l[AIOMENU4pE11 _ _— <br /> I .'.(Iln 11! (1.11[ <br /> �11YBV4N(�Sl�ff11V'.O <br /> PLUMBING MECHANICAL - � <br />� NO, TYPE OF FI%TURE OP ITEM FEE N0. TVPF.OF GOUIPMEN7 FEE <br /> WATEP CLOSET�TOILET� P/C—AMNDLG UNI75 <br /> 9ATHTUO FORCED AIR SYSTEMS <br /> LAVATO�iV(WASH BASIN) HEAT PUlAP T— <br /> SMOWER UNIT NEATFRS <br /> KITCNEN SINK 6 DISP LLOTIIES�RVERS <br /> DISMWASHER RFNGE HOOD I <br /> LAUNDRV TPAV WATER HFATER I <br /> 3 CIOTHESVlASHER WOODSTOVc I <br /> 'J� URINA� METALFIREPLALE�WOODBUftNING) I <br /> � pRINNING�GJNTAW fIREPtACEINSERT(1YOODBURNIK3� I <br /> FLOOR DRAIN GAS FIREPLACE <br /> 9PCKFLOW PREVENTERS GASRFNGE i <br /> $INK(SERVICE—BAR.ETCJ GASPIPING �l1QO—�— 'i <br /> I ORI P O��/ C(,f'T'I-N FIC E%MAtIST FAN �_ I <br /> SUB TOTAL 5 SUli TOTAL 5 <br /> — �T <br /> PERMIT y PERMIT S <br /> TOTAIFEE 5 tOTALFEE 5 '�. <br /> FOR OFFICE USE ONLY: '� <br /> �nnuttitN[. nr4ncfID¢v S�o[Sclo4[ rleub�LCnNuvx�n r�� nfrF�rrno I <br /> usi�ta�r � io�un+ wuwsm fEES VRLUATI�N FEE <br /> ❑rF5 ❑vU fliutOiW. — _--- — — <br /> I�FIf.11�I�VIII.liO4 h00rOWIll1K. 51!lO�PIOL'�� �------ <br /> ni�5 <br /> ux.wr, <br /> occure..::r �.i,,.�„ w.cor.u��o.n e.srerv or�:�u�.�ui _'_.'_-- -_-.—__ ' _ '_'__ --- <br /> m�ow• <br /> ❑rt5 ONO <br /> IMOSP�in+IEPPCOD ��V�S(n �OpliMinlPUtiC�R[K <br /> (lu�fn <br /> ilnfAUHN�LOU ��G�V <br /> GI�11 flV'�11��.1'.S�If1Cli�(1�t <br /> �rrrnrco��cr rinvs�rrn����nnr GTYOFEVERETT rra��.,:wn��.� '-- ...'� - ----"' --- <br /> LOCpL SALES ------ --- �— -- <br /> �,.�E TAX CODE IS J705 TOTAL <br />