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APPLICATIf� FOR CONSTRUCT�N PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISI01� <br /> 3200 CEDAR STFEET•EVERETT.WA 98201 •257-8810 <br /> - � DEMOLITION COMBINATION � . BUILDING � MECHANICAL '- PLUMBING ' . SIGN <br /> PROJECT ADDHESS t � <br /> �ro o, g2,o <br /> euc�oo�as o*r zm �ae <br /> �lac.�L? �ir�3����',��✓at`��i�o� y�s�'�/l/ <br /> �T Mnl1�'Jp�['_S CIiY SC nMTS <br /> Jl!,J�J a�G 2t�.L /; r�/.ror4 G,.�i ��.LO/ .���i.��$11�.�— <br /> _�.'lC1V[+L�(.✓�NEP NIIL�U[P!$. / LIIY $P Pllr�yh <br /> `�� i-,��rs�./�zo4�fKN <br /> R�WPE66 LrtY ll� RxNi F�2CM19E• <br /> /�..F.a, �n��- 7/� /J��r- �� �sr�+Y �ls�Zos�j.r����3�� <br /> cc � _�ioanFu.� u xea�u[55 citr rm cut su�[�r:uis[. <br /> / <br /> I�IIA�II��liC�Nllf�i�.� M�il�'JIX1C55 LIIV ZF I�M�Iq 'vfl.iLLIL[Il:if• <br /> \/ <br /> CONlR.KT GRIC[O�W lN�x <br /> ���(7' HEATING SYSTEM: fl GAS C�ELECTRIC "; <br />� cescn�r�;x+n�rtisu��.ncroo�.,cixvavco cmrt�crncnsa�.ra�vrro�rtr�o <br /> /ZiT� � <br /> O <br /> � <br /> 1 NEREBV CERTIFV THRT I HAVE READ ANO EXRMINED TNIS <br /> r�nor ,m ust c.emi�rvc APPLICATION AN�NNOw THE SAME TO BE TRUE AND CORaECT ALL <br /> PROVISIONS OF L,AWS AND OROINANCES GOVERNING THIS TYPE OF <br /> ¢,<iucscPm* �nvqpv�e*r�srrcrmiBF.�ov�onenecn WORK WILL OE COMPLIED WITM WHETME(i SPEpFlED HEFEIN OR <br /> ��Ee1 NOT TNE GRAMTINf> OF A PERMIT DOES NOT PRESUME TO GIVE <br /> w* e�ocx pr AUTHOPITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOGAL LAW PEGULATING CANSTPUCTION OR THE <br /> PEPFORIdANCE OF CONSTPUCTION.THAT I AM pUTNORIZEO 9V THE <br /> OWNER Of TMIS PROP[RTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS IAAD ANO I LOMPLV WITH THE STATE <br /> v�u�Ei*�xioxur.men CONTRACTO IJ� 17RCWAND296200WAC. <br /> �� <br /> LONSiRiKiiplLO�NLEM0ER11ppiEE9.TElEPHphNIMBCR X ^ �_ , <br /> ✓Y o.q <br /> L�iv Bv5 WCSS lICt16E Iq <br /> PLUM91N0 MECHANILAL <br /> NO. TYPE OF FIXiUHE ON ITEM FEE NO. TYPE OF EOUIVMENi FEE <br /> WnT[R CLOSET�TOILET� A'C—AMNDLO UNRS <br /> BATNiUB FORGEO AIR$VSTEMS <br /> LAVATORv�WASH BASIN) NEAT PV�dP <br /> SNOWEP l�N1T MEATEPS <br /> I KITCHENSINNBDISP ��OTHESDRVERS <br /> DISHWASHER RANGE NOOD <br /> LAUNDRVTRAY WATEF HEATEP <br /> GLOiHES WASNER WOOD STOVE � <br /> i <br /> URINAL METAL FlPEPLPCE�WOOD BURNING) <br /> DRINHIN6 FOUNiAM flREPLACE INSERT(WOOD�URNING) <br /> FLOOR ORARJ GA$FIREPLACE <br /> BACKFLOW PPEVENTERS GAS PANGE <br /> SINN lSERVICE—BAR,EiC� GAS 71PW� <br /> E%H�UST FAN <br /> i <br /> � <br /> SUB TOTAL f � SUB TO1RL 5 � <br /> PERMIT S PERMIT S <br /> TOTAL�EE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> fapll5frE4:x qEARSEtB�IX SCE5Eip1CN p�n�p�(CNNpqN fEC PCCFMl1q <br /> � U 0 -D53 <br /> uscmr�r ioturt� vec�qisi*c FEES V�LUIITION PEE <br /> n¢s nrro eumm�r, <br /> NEI6NiLMRAtq11 1qO[pM1{LLMG Si1E0i8LW11 <br /> U111i5 <br /> 1'I INBMO <br /> aOUP�M'v rq�lSt0u6 UCWPIJ1Il0�� 019EMEN1 <br /> MFCNAMC4 <br /> nns ;•r�a <br /> t�+[61'nr�r,�[HpfOD �E�SON WOrtpNILAAHCnFCk <br /> m�cn <br /> FME4AfIMPEOD q[�5p� <br /> 51�iE RUrtDIN6 611nCM�ROE <br /> *rrharcwsr vuHs�mnovEoar CITYOFEVERETT �ueia�.v;on., <br /> LOCALSALES <br /> o.�r TAX CODE IS J105 TOTAL <br />