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APPLICATI0#1 FOR CONSTRUCTON PERMIT <br /> ITY OF :VERETT]BUILDING DIVISION <br /> 3200 CEDAR STREET]EVERETT,WA 98201 •257-8010 44WIT <br /> 11 DEMOLITION 1 I COMBINATION bil. BIIILDiNO ❑ MECHANICAL I PLUMBING II SIGN <br /> PROJECT ADngFCS _ A; <br /> EVf7fETT 9fZa1' �IrliS o 2 <br /> ASA <br /> CITY IP N rrr_ <br /> wCWI[CT pI C(EfN[q Y.4 Mpr]] CITY IP [.Illyl[ <br /> IPi8/6"weS /9/t WA treru sr £rAmrtr <br /> p[I(INL C011INY:I011/ YN\gpU11E]] ��+��L �1 np[ �f ft11F\C�\fN�Jf• y <br /> Zre�lrr] �f'J.'S7�'�It/1/ <br /> W 4[CMIIUCl0�1 <br /> CITY <br /> - n _ _ S11tE lCENSf• <br /> R.."`QCO4rwTm I.gOMl S Cln !P ACI( [IglF lrfNf[I <br /> CONI�" tIPrE OF IYOls. <br /> ddCJ. `t-` _ HEATING SYSTEM: AGAS ❑ELECTRIC Cl <br /> C[\�!ligfyyro�t�vISW41[[WI](E II�'.Yln CON1K SW Mp VIC[(p <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> gRpV]fO ufE m4pq APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> S�F � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> 1E64 OE]CWtfIN OF P110PfgT 151pWN![\QY OTT.I7KH TYq COPS) WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE <br /> for S JF th"IL x 1CLD 1 C AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIONer!6 MADE AND COLI?LY WITH THE STATE <br /> rwrFl tq]In WwwR [ANTMDT SLAW IB 27 RCW MD 298.2001VAC. <br /> K � //// � �y//� <br /> CONSINIICIION LOAN MILER. ftbIT.7ELEM� I DER / ��i <br /> C <br /> atE <br /> G1�.59lrLNSf Iq C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM —_ FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) / _ p NC—NNNDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ O HEAT PUMP <br /> � — SHOWER O UNIT HEATERS <br /> _L KITCHEN SINK 6 DISP / CLOTHES DRYERS <br /> / DISHWASHER RANGF HOOD <br /> / LAUNDRY TRAY ITWATER HEATER <br /> / CLOTHES WASHER C7 WOOD STOVE <br /> O URINAL ME TALFIREPLACERVOOD BURNING <br /> p DRINKING FOUNTNN O FIREPLACE INSERT IW000 BURNING <br /> FLOOR DRAIN 1 GAS FIREPLACE <br /> BACKFLOW PREVENTERS GAS RNIGE <br /> O SINK(SERVICE—BAR.ETC.) OAS PIPING <br /> EXHAUST FAN JIN <br /> BUB TOTAL f SUBTOTAL f <br /> PERMIT f PERMIT f <br /> TOTALFEE f TOTAL FEE $1 1 <br /> FOR OFFICE USE ONLY: <br /> rRONI KTSgCK7 REAIISE1SKX/ EAN YISKq DIECtIIAIL11[A F[L gFCFP1 NO <br /> ZO ZD - O/ a-7176 <br /> ux lONE I LOr NIG oKAxtfyr FEES I VALUATION FEE <br /> E n Nu O <br /> •.I UNr LMTAI M eta DALUM] 4IEa m06'II <br /> I�ANCr IOUEWMf OCLYPNI7lOW M&LI[N7 / LIECII\11L4 <br /> 3 J• Z "111 K/J <br /> rml wREao RV]Ox gEMKM4 nKI aluK <br /> WWII <br /> r[NARY REDO PLASON <br /> STATE SNOSIO SUICH <br /> rrvE or wNST nANsu]Nar[Ys CITY OF EVERETT nwlr <br /> LOCAL BALES <br /> wrt Z TAX CODE IS 0105 TOTAL <br />