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�t�m c��5 Yu��on �. �;�c r�. a�36 <br /> APPLICATIAI FOR CONSTRUC�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257-BB70 <br /> ❑ DEMOLITION ❑ COMBINA170N �WILDNiG ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> VRQIECT ADDRESS Z � <br /> e. <br /> �i�`�,�;,a��L`�"itis��-,.-„ Baa� 7�th PL NE p ollar�.cu�lle 9 Ssa7o 36o-6S�-�4 8 <br /> ,.�. ,��.�ss ��.. �-� <br /> uuexnc.ancesr..En r.uwwoAess cm z�v wro� <br /> c..we ei. n4 �p� <br /> pENEMICCNiMCTCM MMIACOf1E55 CIfY 21V PMG1E Si�TELICEN6E♦ <br /> y[�ryµl(,`µCpljlMC}M MPILAOME55 CILV ZiF PM1NE $TAiELICENSE♦ <br /> RWBW6CCMMCiCfl EWL�OME55 CITY 3iG CXONE SiRELICEHSE♦ <br /> CONi`�ipP10EOFM'OPN MEATINCaSYSTEM: �GAS ❑EIECTRIC ❑ <br /> [5�q10E ppK/�Np50UME�TI.GEi VED CONTRCiGER50 nND MNEHO. <br /> �1� 5( kTarr�•�e i e � �,_, �ea'�� 3b0 - 435-440y <br /> ��7 �- <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND GORRECT.ALL <br /> vAovosEo us[ar ew� PROVISIONS OF LAWS r1N0 ORDINANCES GOVERNING THIS TVPE OF <br /> p ty WORK WILL 0E COMPLIED WITH WHETHER SPECIFIED MEREIN OR <br /> �¢�,upescnnrrou m�vEAn�sxowNeE�ow �rr wM'o�i rypT. TNE GMNTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �pi as*a� �a.�_or { . AUTHORITY TO VIOLATE OF CANCEL THE PHOVISION OF ANY <br /> 1, OTHER STATE OP LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> Q S YRUY�d 1 h VU�' (� PERFORMANCE OF CONSTRUCTION.THAT I PM AUTHORRED BY THE <br /> OWNEP OF TNIS PHOPERTV TO PERFORM THE WORK FOR WNICH <br /> C LLf/1(1.'� '.�Oa.,SOC� APP��CATWN IS MADE FNO I COMPLV WITH THE STATE <br /> p�ELT!�+op^��q CAN�RPCTORSIAW 182] CW PND296200 WAG. <br /> �$tT S f1Yil�Cet+ ���� (p��IOI <br /> L0�15tPULTKK�LO.W LEHOEP.P�E55.LELEP�KYIE NUMBEP � <br /> SIGNI.NFE O 3 S 40S DAiE� <br /> nrv eusi�ss ucense ra. <br /> PIUYlNlG NECNANIC�L <br /> Hp, TYPE OF FIRTURE OR ITEN FEE NO. TYYE OF EOUIPMENT FEE <br /> WFTER CLOSET�TOILET) A/C—.JHNDIG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT NEATERS <br /> NITCHEN SINK 8 DISP � CLOTHE$DRYERS <br /> DISHW�SHER � RANGEHOOD <br /> IAUNDRV TPAY WATER HEATER <br /> CIOTNES WASHER WOOD STOVE <br /> ,,,.Np� METQ FIREPLACE(WOOD BURNING� I <br /> ORINKING FOUNTMN FIREPLACE INSERT(WOO�BURNINO) <br /> FLOOR DRAIN GAS FIREPLAGE ' <br /> BACKFLOW PREVENTERS GA$RAN(iE . <br /> SINK(SERVICE—BAR.ETC.) GFS PIP�N6 <br /> E%MAUSTFFN <br /> SUBTOTAL E _ SUBTOTAL S <br /> PERMIT S PEPMR S <br /> TOTAIFEE S TOT�LFEE E <br /> �FOR OFFICE USE ONLV: O� a� <br /> lFOMSETB/�CR / AEAPSEiBACM � $ICESfiOI.FI(/ RM� NECM��P Q/� FEE PECEIVtIq. <br /> f Iv <br /> usero� n � �or.we� v�cuns�*e FEES VALU�iWN �_ <br /> �j OVF4 ❑rv0 BUMOinC <br /> MEIGMLIMIini N � NOrcLf�WEL4HG SI�IE^C9FB:Cd11. �y �11MB1� ' <br /> �.�i/ Y S F <br /> CLCUVPMCY MCFSNPE$ CLU.�V1MLOiD fl�.SEMENT MELNA111L�L <br /> Z OYES � <br /> MpRKKULPVNGMECN <br /> RRE SFBirvNIER PEOD FEA9.^' � <br /> o+Mca <br /> FWE�Uf1MRE0'D flE�50N I <br /> Si�iF NRpN3411NLMMIf3E <br /> rvPEarccra? vur+saw�oev CffYOFEVERETT we��cww�s <br /> LOCALSALES tOT�I <br /> — oars / - TA%CODE IS J105 <br />