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APPLICATIC'1 FOR CONSTRUC7 .JN PERMIT <br /> , CITY OF EVEFiETT•BUILDING DIVISION � <br /> 5� � �� / � � , ` ',(; 3200 CEDAR STHEET•EVERETT,WA 88201 •259-8810 <br /> ( <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILGIN ❑ MECHA CAl I' , ❑ PLUMBINO O 810N <br /> ��ROJECT ADDRESS: �? ,[c ' � C7� �I � �.0 NO W��lf�Cj {�1`�> <br /> • .Na1a�i3� �t J'Fi � cE�S �bJp owt� <br /> p�rtp MnILM011E59 CIiY !�� ^ � P��OME ��,� 7 <br /> n-�C-� i 7 - "1�11�1_4� _.Y_Y'i^?J�J'/� <br /> t¢w�nr M 11[qfK£5 fATr �iv � ����� r��a+e <br /> ���+'�"�` i• � ''_J�J� J <br /> � pppE "�� M �OOIIE54 CIIY 711' P110NF <br /> � /X1K(N ' �l!t: �II`-JD� __ � 7 G�i —7? _ <br /> rvuca+rnect MuIGWOE55 CItY /R' P�qHE SI�IElMENSE� <br /> 11E�IIMIIL�LCOI:TR�CTOR MI1RMd1E45 CAIY 111' PIIONE ST�fFL�CENSF.I <br /> 1'INRNOCqA9l1GTd1 MML�WilE34 GfY I�P ���ONE SIAfEIICENSE� <br /> ��t��� �"�M� HEA ING SYSTEM: ❑(iAS ❑ELECTRIC ❑ <br /> oc�.�waw�ra �ne roor�nvoweo C VEReON 11W ra 1 ?1 <br /> C ' � � <br /> ���� <br /> pf,� r� I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS <br /> r.� � KJ� APPLICA110N AND NNOW THE SAME TO BE TRUE AND COHRECT All <br /> Vna�oxo uec a wiw PROVI&ONS OF LAWS N!D ORDINANCES OOVERNIN6 THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED NEREIN OR � <br /> icaKaexwonwawror�mr�s�awnseiowa+�rt�cNTwocov�s� MpT. THE ORANTINO OF A PERMIT D�E6 NOT PRESUME TO OIVE <br /> ior aocu a AUTHORITV TO VIOLATE OR CANCEL THE PROVI610N OF ANY <br /> OTHER STATE OR LOCAL LAW REUUUTINO CONSTRUCTION OR THE <br /> PERPORMANCE Of CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ER OF TMIS PROPERTV TO PERFORM THE WORK FOR MMICH <br /> ICATION 13 MADE AND I COMPLY WITH TME 3TATE <br /> rw�i iuc i.0.Miw[n .TORS LA)N-1B47 RCW AND 48200 WAC. <br /> CONBiR11C110N lMN lENOEH.AOd1E58.TElER10NE NUMIIER x Q(i�u�� • • <br /> 510N �� E <br /> qTVMISINE58t E MO <br /> ���p MECMIINICA <br /> ND. T1TE OF Fl1fTURE dl REM FEE NO. IYPE Of EOIMPMENT FEE <br /> , WATEpCLOSET�iQILE� � NC—MNIDLOUNRS ' <br /> g��{{Ug ' FORCEDAIRSVSTEMS ' <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> g�qyyEq � UNITHEATERS ' <br /> KITCHEN 5!NK 6 DISP i CLOTHES DRVERS i <br /> DISHWASHER � f7AN0E HOOD � <br /> LAUNDRY TRAV � WATER HFATER i _ <br /> CIOTME3 WASHER � WOOD STOVE � <br /> URINAI � MRAL FIREPIACE(WOQD BURNINO) ' <br /> DRINKIN(3 FOUNTAIN , FIHEPLACE INSEfiT rvVOOD BURNIN6) �_ <br /> FLOOR ORAIN � OAS FIREPLACE ' <br /> BACKFLOW PREVENTERS � OASRANpE __� <br /> SMIK(BERVICE—BAR,ETC.) � (iA5 PIPINO � <br /> FJCHAUST FAN <br /> � <br /> � ' <br /> � ' <br /> i ' <br /> � ' <br /> SUB TO fAL f ' SUB TOTAL { � <br /> PERMIT S � _ PERMIT f � <br /> TOTAI FEE ! � TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> i110N75Ero�C1I iIEMSEIMILN S�UESFTBIICM �I�NCIffCIlNU48FR �EF �FCFMINO <br /> ,��a31 <br /> us¢ionc wt��� v�c�tir srtc FEES VALUATION FEE <br /> ❑YE6 O� BI➢IOMb ' a � rV <br /> IIEqNT LMf11TpN NO OF UM'ElUNO 512E Oi 1100/f l � <br /> IMIfF p�UM0�N0 � <br /> -�T <br /> OCCIIPMIL� N00151MF5 OCCUP�N1L0�0 S�SEMENT MECN�Htf.�l � _ <br /> 01101R <br /> OYES ❑NO � <br /> � <br /> FlREBMtlNNLERREO'D RE�SOM �OWII�N�IPIANC�RCK ` _ <br /> � <br /> onrtn ' <br /> FINEMMMREO'D RF�gOM <br /> SI�IE BUI�UINf 51111CIUfKtE — — !•�� <br /> f� <br /> irrEar,ows� rinNs�rrnov[nar CITYOFEVERE7T rua�ir.won�s ' <br /> IOCALSALE3 ---- ---- �J � v'� <br /> o�iE TAX CODE IS 9105 TOiAI <br />