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APPLICATION FOR CONSTRUGTION PERIMI <br /> ���«,« <br /> ��eMq,�� � <br /> GI7V OF <br /> everett <br /> � BUILDING DEPARTMENT TO BE COMPLETED IN INK-PLEASE PRINT — <br /> � 5 zss-es,o <br /> � � DEMOUTION i I COMBINATION i i BUILDING _I MECHANICAL I I PLUMBING ! I SIGN <br /> � ''b � ��` u�,RnoonFss �} ♦� c��,r,i�r /����I.�Tir rrque <br /> ��� �'IOI.� W�����2nn n�is1bSOD �Y� ���4 �1L�Q6� F��LLVIL(.1,_'^�,�'y��'' �����—_ _ <br /> cirr n+� r�ror+e <br /> ��O enr.�atEctonoESicNen Muienoness cirr zm r��oue — — <br /> � <br /> y o[ucn�icaane(c�ron u�Knnoness cirv xir rua+e iKEHSE� <br /> � '.�. � ��IANC�I C(JN�f1�C10�� M�R�nD11E55 LITY ZIP �110NE IIGENSE� <br /> �� �y.y f.liv lIP "--- PIq11F LICGNSE� <br /> ['d{J f�I1M01NOCpJIMC��'� H�RADOf1E55 <br /> 4�� CC�� <br /> Z�y j� cuss a vronK <br /> `.' H y I 1 N�W I I ADDITION I.l ALTERAiION I I REPAIR �DEMOLITION I 1 W�%ODSTOVFJFHPL INSERT f l BUILDIN6 AELOCATION <br /> � corut�ctrensor+u+nr�qr�eno. <br /> ty y ieN�Nr�urnoveueN*oniNrcnronneu�iartv --- — <br /> nty y corrtn�crrn�ceorwon.: - <br /> Q r IICSCRIBE W011N�NO+OU��E fOOlAOE INVIXVED <br /> �Z� <br /> �1 — _---� <br /> � Ha y rnorosEouseoreuaortp I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED iH15 <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALI. <br /> imn�o[scnmi�orrnorcmvis�ovmne�owon�tuenramc�irs� PROVISIONSOFLAWSAhD0f7�INANCESGOVEf1NIN6THISTVPEOF <br /> WORK WILI DE COMPI.ETED WITH WHETHER SPECIFIEG HEREIN OR <br /> io� pib.K or _ NOT. 1HE GRANTING OF A PERMIT DOES NOT PRESUTAE TO OIVE <br /> � ��� AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LbCAI.LAW REGULATIN�CONSTRUCTION OR TNE <br /> PEIiFORM4NCE 0-CONSTRUCTION.THAT I AM AUTHORIZEO EV THE <br /> OWNER OF 1HIS PROPERTV TO PERFORM THE WORH FOR WHICH <br /> APPUCATION iF MA�E AND I COMPLV WITH THE STATE <br /> CONTMC70R5 LAW 18.27 RCW AND 296200 WAC. <br /> siaruroneacannecwnon.wnronizeoeccNr J�TE <br /> --- - ^ � � ,.��ip <br /> rnaecteooness / , , vrucnriscirrousn�essu Iq�NOBU �1E55NME <br /> .. a L �� <br /> �� � PLUMBINO M H NICAL <br /> �� NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE F EOUIPMENT FEE <br /> 1 ' - WATEP CLOSET(iOILET) _ i—_= NC-NHNDLG UNIiS-H P ; __ <br /> � BATHTUB FORCED AIR SVSiEMS-B.T.U. M E.A. ' <br /> ---� UNIT H[ATERS-B.T.U. M �_ <br /> �� IAVATORV�WASH BASIN) —_ <br /> SHOWER CLOTHESDRYERS <br /> HITCIIEN SINK 6 DISP VENTIL�710N FAN _ <br /> DISHWASHER RANGE HO00 <br /> �' � LAUNDAY TRAV _ �_ _ �'✓�tER HEATER � <br /> i _. �_ _ WOOD STOV 1— <br /> CLOTHES WASHER � <br /> � ME fAL F!iIEPLACE d CHIMNEV <br /> U�INAL - <br /> �� DRINHIN�fOUNTAIN f— FlfiEPLACEIN5ER1 �_ <br /> � FI OOR�RAIN HEA1 PUMP <br /> , �1=' BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINN(SERVICE-BAR,ETC.) � , <br /> -r- — � <br /> — i <br /> i '�I�1 '— ' — —�-- <br /> SUBTOTAL f <br /> SUBTOTAI 5 �_ _ pERM1T S —T <br /> �� PERMIT f <br /> ' TOiAL F[E S TOiAL FEE S �_ <br /> � lf10NiSEiO�CN (1E�II6F.IBACN &�FSFfpAf.M PUNC11fLkNUMflF11 fEE i1ECEIPINO <br /> us¢zarz �ot�ne� wc�Ni sne FEES VALUATION FE�_ <br /> I I VES I I NO � <br /> nun.rnr�c� . <br /> nr�acous�uiow�nie �rnacoxs�umu MmnM. *+�+r�,��wn����. - -- - <br /> o,�. ---- -rwMnuui-----� - -- - <br /> s�z�apioo rroorswn2s n.sruem MECIIANC�L <br /> I I YES I I NO � <br /> (KCUPANCYIOAD il0E5PI1NKtER5f1WD ��FIO�IiLIMIIN1011 ����En ' <br /> i <br /> 1 I YES I I NO S1AlE0UILDINO5Uf1C11ARGE <br /> nF.sa�ron srnn�Kiens <br /> — - i—_ <br /> �s�n�e eNenav suna�nnce <br /> errirMior��ttCnr viuis�rrnoveoer CITYOFEVERETT runucwonKs � <br /> � LOCALSALES � <br /> TAX CO�EIS 3105 totA� ' <br />