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APpLICATION FOR CONSTRUCT�ON PERM11' <br /> ������e« <br /> < <... . e <br /> CITV OF <br /> everett <br /> BUILDING DEPARTMENT <br /> ��� 259-8810 TO BE COMPLETED IN INK-PLEASE PRINT <br /> ta� DEMOLITION COMBINATION y BUILDING MECHANICAL 1�PLUMBING SIGN <br /> � owr�¢n ueu�oonrss cnr nr rvavc <br /> a �1Ck��-�Uk1t1S 7cr�L �'ni>SD�J �D ��/�:'r� ��.� �>S-.Z4.S i - <br /> � LCHANT MNlA00RE55 GI1Y Z�P PNONE <br /> SArv�C <br /> y�� eRG��rt[CiplbESiGNFR MRRAppR[55 Ciiv ZiP P�qNE <br /> y{��od l���tna�,7 oaS�.r 74y ik�_ �t5c� EA`T Carnqnr� 1.>. �iF.:�.�)1 f•„1.9 • �17.((.�,_ <br /> �N'tl cEr+En.�cc»�in•ctoa u�i.�oonEss ciir z�r rHonE i�ccwur <br /> �' � F�u�►r�v ��J tJ . • t E,?.o\ "`2 �lv I.S �,p<�G 1.1:2 ����- <br /> x �3 MonkL- Ccr`a i:�tl �_.� L'si <br /> MECN�NIGQLONtR�CiOR M.1hA0ORE55 CIiY I�P PNONE IICENSF� <br /> �d <br /> O � �IN�B�NGC(WLR�CIOR 1A4�L�DONE55 r,�iv � :�� PMONE IICENSE� <br /> �[ag 'w�r.M�-� PL �,�_����_ 11�a��i5v�l IN`jn��u G�53 -G.'?�( ; /���?Afnp I `SI FG_ <br /> a � Cl SSOFW011N <br /> y NEW 1C ADDITION ALTERATION RE^'IR DEMOLITION WOODSIOVE�FRPL INSERT BUILDING RELOCATION <br /> t� <br /> H 1ENAN1IMPROVFMENIORINTE11qRREYODFIONIY � �ONi1CiPENSONANOPHONENO <br /> gy ca+rn�cTrAwcorwonK: :� :JZ�C y�i��.`_C ,� � ������� �� <br /> � y �ESCPiBE WORN 11N�50U�RE f00T�GE INVOIVED „ <br /> �� �elo«�eAr� �l�__n�a,,,�,. 5^ ' `4' <br /> rnovoseouseovemi iHc c '� � _I, ,,Q I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> O� �'r_ �c=:�--�--j�T1 `�� �A j,(�/,�/� ��'�µP L APPLIC�TION AND NNJW TH£ SAME TO BE TRUE 4ND f,ORRECT.ALL <br /> iEaioescamrwNovraovEeiv�srowmee woa�irecNFou cories Pi70VIS10NSOFLAW3ANDORDINANCESGOVEFiNINGTHISNPEOF <br /> WORK WILL BE COMPLETED WITN WHETH[R SPECIFIED HEREIN OR <br /> �ot y�i B�oCKCYP� ��OCLv �S�OC'.�'� i ��-I 1�.�-�� NOT. THE GRANTM�i OF A PERMIT DOES NO7 PFESUME TO GIV( <br /> AUTHORI7V TO VIOLAiE OR CANCEL THE PROVISIONS OF ANV <br /> '`L� �-J OTH[R STATE OR LOCAL lA1Y qEGULATIYG CONSTRUCTION OR THE <br /> PERFORMANCE OP CONSTRUCTION. THAT I AM AUTHOHIZED BV 7HF <br /> OWNER OF THIS FROPERTV TO PERFORM iHE WOFK FOR WHICN <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAV.�18.27 RCW AND 29E 200 WPC. <br /> �.A � i i? ,'-.��{ 'SR -Ui)O' C l "1 • C .� b "� sir.rumnt ur c�osr+�nu,r,ro�on nurHoaveo e,eNr oerev%.G�. .1 U <br /> �'X�",`'`'t-+ I")'le-U�L�2� <br /> C� o o � Ga,���,���: �:, > --- ;� . _n_ ��v����-�o__— <br /> �PROJECT�pDRE55 �' <br /> nPPI1G�HIS Cliv IIIISiNf SS licP�ti!NO ANO PIIS'NF55 NnIIE <br /> � � �� PLUMBIN� MECHANICAL <br /> ���� NO WATER CLOSET�TJILEpF OR ITEM FEE NO. n C-�A'HNDLG NF 5�.'{Pp ENT FEE <br /> i —�+-�/1!_ __.-_ _— <br /> 1 BATHTUB -- FORCED AIR SVSTEMS-B.T.U. M E.A. . <br /> LAVATORV(WASH BASIN) �— UNIT HEATERS-BS.k1�A4�---- . <br /> j ��� � SHOWER '� CLOTHESDRYERS <br /> �' KITCHEN SINH 8 DISP VEN7ILATION FAN <br /> ,I DISHWASHER RANl;E HOOD <br /> � LAUNDFVTRAV WATEHHEATER _ <br /> i ._�' CLOTHES YIASHER -- WOOO STOVE <br /> `� UflINAL METAL FIREPIACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> - T <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREI'ENTERS GAS PIPING <br /> �� ROOF DRAINS-RAINLEADEFS EXHAUST FAN <br /> SINN�SERVICE-BAR,EIC.) _ __ _ <br /> I �� -- — � - -- - <br /> �� - — <br /> SUA TOTAL E _1 Sl1B TOTAL E ' <br /> ��� PERMIT_ E ___ _ __ ____. ______PcRM1T _S '� <br /> TOTAL FEE S ~ 70TAL FEE $ I ;Q� <br /> fNONiSEiBACN ( IIE�NSElO�CN � 90ESf111RCM � Pi�flf�l!(IMNUM01� �I! %S �FLlIPINO <br /> - +�"1 '�? $se Q.e �'S+ �� c� . - J �) 1 J ! �� r.�+-- <br /> us[r I io��n�e vecerrt snr FEES VALUATION F E <br /> � �x„�,�. ti �_ _ ��,���>��� ,YSs— —�y�yGG <br /> vEs <br /> trvioiroNsiuiowesit trrto�[o�rsiecro�i ' � � ��3 <br /> __.v._AI—_ � �• . rwrAnwc- - ---- ----- --_���0. <br /> sizr or n�u, No o:sroniEs n�siMEr+r � U����p��i�p� � 5�6 n <br /> �� 7' /I' / VES NO _ —__..._ ____ _... -.. ._� <br /> eccurnNcv�oeo rn+esrnH.irrasmon ��eiartiiMireuc»r O1nER <br /> _ —._ _". "' __ <br /> VES Y NO — y ; � <br /> q _ . __ Sint[PWtDINGSUPCHARGI �C <br /> mesor�ronsrawrci[ns -._._ _ -- _._.. _ _ . . _ __ <br /> tiiAlE ENERGY SURCMAIIGf <br /> nrrncenonecc �+r ruHs�rrnomnnv CITY�fEVERETT puBUCwORKs � <br /> �� LOCALSALES <br /> TAX COOE IS 3105 rorai ��j p <br />