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APPLICATIO�FOR CONSTiiUCTl�I PERMIT� <br /> CITV OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257•B8f0 <br /> ryf DEMOLITION ❑ COMBINATION ❑ BUILDINO ❑ MECHANICAL � PLUMBINO C7 BNSN <br /> PROJECTADDRESS <br /> wm:n u�a�oon[ss cnr rv no,E <br /> :�j�+t E.�virlr 3910 wrh'+ae AdF. Ev..r�f, W� 9f(�ol 41S-25J-E67% <br /> r[ruHr u�tr.ornese cm to no[ <br /> /.HL�M�EGT W pC61OMFN 4�4�Od4l6 CIT tP Fq1( <br /> �f�pp Ca�✓.vawr,�kl.iD,�••Bof3iy �wkel�l� uI1 9rz�S yzSv`/FtTrb�••����� <br /> _ AUF.vFlc+6UD� <br /> 4ELM�'1C4Cd11PIC�p1 WR�M)IIFS! CIIY !O RIC�E 511�FlILEM�f� <br /> 0.1NlxqLdtP4�ON Y�4�OM(S] CI1Y tf 01IJ14 {41FlCfME• <br /> CUNIPIL�IYIC[CE NVN � <br /> HEATINO SY8TEM: ❑OA8 Cl ELECTRIC ❑ <br /> MSCPIlE W(MM IJ9 6OV�Pf f0p110[MNCIVlO COM�ICi VFPSON�M V110�N W <br /> � c�Om J <br /> ?I� � SI� I HEPEBV CERTIFY THAT I HAVE READ AND EX�MINED THIS <br /> � �PPLICATION�NO NNOW TME 6AME TO BE TPUE AND CURRECT.ALl <br /> i+arouo ust or eutio�n PqpVISqN3 OF UWS�ND ORDINANCE9 OOVERN�NO THIS TYPE OF <br /> WORN WIIL BE COMPLIED WITN WHETNER SPEqFIED NEREIN OR <br /> icniuo[eenvrnr�arnorEnrvryHowr.eeiowon�rracnmocow[ei rpT. THE UPNITINO OF A PERMR WES NOT PRE9VME TO�IIVE <br /> wr__ppr,R pr AUT1qRITY TO VIOUTE OP CIINCEL THE PROVISION OF ANV <br /> OTNER ST�TE OR LOGAL LAW EODUlINO CANSTRUCTqN OP THF. <br /> PERFORMANCE OF CONSTR qfl.TN�T I�M AUTHORIZED BY TNE <br /> -- OWNER OF T115 PROPER PERFORM TH[WORN FOR KHICH <br /> �PPLIC ION IS MADE D I LOMYLY WITH TNE STATE <br /> nux:n v.•�u rws[n CONTP TOR$UW tE 7 ANO t0l2Q7 W�C. <br /> C(Ni•. , v�10411fMLFP. � .fflll�IpE MM[P x ' li�/y Q �LJ-0I <br /> 6�0 �IwE MR <br /> cnr eosrrtea iaus[ro <br /> � MECH�NIG�L <br /> TYVE OF FItTURE OII ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � I OSET(iOILET� NC—MINDLO VNITS <br /> �� fORCEO�IR 5Y6TEM9 i <br /> 'v�yyA3M&ISIW I HEAT PUMP <br /> i UNITIIE�TERS i <br /> '�NN 8 DISP i CLOTIIES DRYERS i <br /> �ff.l1 RIINQE NOOD � <br /> L�•uvtnrc IRAY WATER HEATER <br /> :,LOTMES W�SNER WOOD STOVE <br /> UNINAL I MET�IFIREPUCE(WO00 BURNIN(i) <br /> ORINNINO LOUNT�IN FIREMCE INSERT(W000 BURNI � <br /> FLOOR ORAIN OAS FIfiEPLACE � <br /> BACNFLOW PREVENiEPS OAS RANGE <br /> SINN(SERVICE—BAN,ETC.� G�S PIPINO <br /> E%NAUSTF�N <br /> I I <br /> i t— <br /> SUB iOTAL f i SUB TOTAL f <br /> PERMIT f ' PERMIT ! <br /> iOTALFEE f TOTIILFEE f <br />� FOq OFFICE USE ONLY: <br /> ��m»rtsc�e.c� ��nseie+c� swEtEn�e� rw,uccer�w�etn rt� �[cmro <br /> �� <br /> uscrart w+ui[+ v�cw�sirt FEEB V�LU�TqN FEE <br /> nns nxo an� <br /> rrtnH�ivrt��on worwrtuna su[vnroi� - <br /> UW�! RIMM9 <br /> �.,CCIm/X',v qP1ro�l3 OCCUMNIIWD MlFYfN� ��H�4 <br /> one nru — <br /> rnesm««i[nr�oo ae�xw �mnvuirwaacR <br /> onrtn <br /> lnfuuwROD n[�MN <br /> e.•rz suao.n nunnunae <br /> r.raac�sr rwieu�no�toer CITYOFEVERETf ,uxcwawa <br /> LOCIIL 611LE8 <br /> p.� TAk CODE IB�I03 iOTl1l <br />