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� � <br /> � APPLICATION FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT•BUIIDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201•257•8810 <br /> DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECXANICAL C] PLUMBING ❑ SICN <br /> flOJECT A�DRESS <br /> I(n 1�1 ��'Lc3AD�,t]/�-N `�'a/L.�CT'l' `/l1A <br />�VNAS T/Wn� � �•ow�c s � ut. z. �w.t <br /> W �t'�RTi�vicest}II7 <br /> ��n ttruire�nr.� tvrafrr II,�A'q�_tl�-,-44G -�=,r�0 <br />++� �ppL�cnN� M.n�ooacss n*r <br /> E. GR/�N� PlVecOPCJ�'�cNr' b¢�P TKA Wl��dcu PIEV�tSPR-w�ENT' 4ROJP <br />�.�� •sc sr__ � �,rca�.k�e�s�nwa Aa�i •Zp('LSO-740U <br />.Mi1fCi04Ct5iG4lP Mu�♦ n[S$ Gir jq h�pY[ <br />,oE ,ur, �ui5 uz�ha«. uEwlOi Pfue.� WA q�nd 42�-e2��5o <br /> IEP��CCM1iF1L�..F M�iI�WHESS LL C�lY jiV MpNF STAIEL�CENiF• <br /> PAHAl11 /1NTQACnf�lS Q�1� '.�1��N/ER���ATTLE Ww.q�115 2�-7Z9-8cW4 (.��p.l�.y����Pµ <br />:n�wUICOHIe�RCF M�iLe00uE55 C�T !✓ RqNE 1�tElFEeSE• <br /> N/A <br /> 4Bi\ C^vNRqiO4 M�iI�OJN[55 OlY Se I '�1{ fLiElCENSf• <br /> ilF��i iP'Ci 0�NOAK <br /> .?yj� HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> �S.EE��OAR"J`50 W AF iO�GGE ihVpV W COMi�CT I[R10N�rv0��.Nf NO <br /> ��� � � <br /> G <br /> 3 I MEREBV CERTIFV THAT I HAVE READ ANO E%AMINEO TNIS <br /> ' APPLICATION ANO NNOW THE SAMIE TO BE 7AUE AND CORPECT.ALL <br /> oosEo usc��ew�0 nc PROVISIONS OF UWS AND ORDINANCE9 OOVERNING TM6 TYPE OF <br /> WORK WIIL BE COMPUED WITH WNETHER SPEQFIED MEFEIN OR <br /> �� -n,a,�u1o1n1o�va�vEsrvis.onr�ettowou+r..cnmrocoo�Es� NOT. iME GHANTING OF A PERMIT DOES NOT PPESUME 70 GIVE <br />', �y�y�aioCK��or AUTMORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHEF STATE OR LOCAL UW fiEGUUTIN6 CONSTRUCTION OR TNE <br /> g�Y�-����.sr�� � PEFFORMANCE OF LONSTflULT10N.TNAT I AM AUTMORIIED 6Y TNE I <br /> OWNER OF TMIS PROPERTY TO PEFFORM TNE WORK FOR WMICH � <br /> - APPIICATION IS kRDE AND I COMPLV WITH TME STAiE <br /> . � �.�o nuue[e CONTRACTORS LAW 18.27 RCW AND Y96.200 WAC. <br /> S1PpP�0Y���YIfA�EP.I.DOPESS,iEIEVnOM1ENU4BfN x <br /> fKiH/.iYRE O�1E <br />' GiY BUS�M[56lCEMiF NO <br />'IMBING MECN�NICAI <br />,O. I TYPE OF FI%TURE OH ITEM FEE NO. TYPE Of EOUI%AENT FEE <br /> 1vAfERClOSET(TOILET� � NC—A'MNDLGUNITS <br /> 8�1TMTl:B ' PORLEOAIRSYSTEMS <br /> , LAVATORV pVASM BASIN� HEAT PUMP <br /> Sn?�`+ER UNiT MEATERS <br /> KITCMEN SiNN 6 OISP CLOTMES O4VER5 <br /> OISMYlASHER RRNGE M000 <br /> �A�M1�FYTRAV WqTEPMEATER <br /> CLOTMES WASNEF WOODSTOVE <br /> . URin,�l META�FIRE7LACE�WOODBUFNING� <br /> DRiNHIKGFOUNIAIN �� FIREPIACLINSERT�WO00BURNING� <br /> ROOR DRAIN GAS FIREPLACE <br /> B/+CKFLOW PPEVENTERS GA$HANCE <br /> SINK�SERVICE—BAR.ETC.) GAS PIPING <br /> i E%MAUSTFAN <br /> SUBTOTAI S ' SUBTOTAI 5 <br /> PERMIT S PEflMIT S <br /> � TOTAIFEE S � � TOTALFEE S <br /> R OFFICE USE ONLY: <br /> QSE�OKK PE�FSE�B�CK S�OESFTl4R e�/,ry�nFCKM1YwOEM ^ iEE PKEiViNp <br /> :on[ iora4cs v�uni6�rE FEES VALUATION FEE <br /> ❑vE5 0�+0 p���p�� i <br /> n1ln�.LnpM1 v00�UWEWNG SQE��Bl069i <br /> UM1i15 O�UMBJ%J � <br /> F�FCv np:�b�^.F�FS OCNo�NiIOW 0�Sf4EN! u(CM�NKAL � <br /> C�E6 O�J <br /> SPeiMiE4AE00 PE�50n WORi0Y4�l�Nf.wfC� ' <br /> I <br /> O1M(N i <br /> 1lIRA1pECJ XE�SON <br /> Sf�i�BULLDMGSUPCn�4Gf � <br /> .�ca�v vi�Hs�oaaovcoer CITYOFEVERETT ouatqwOAas . <br />