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APPLICAT�N FOR CONSTRUC�ON PEItMIT� <br /> CITV OF EVERETT•BUILDING DIVIS <br /> 3200 CEDAR STREET•EVERETT,WA 98201•25&BB10 <br /> ❑ UEMIOLITION ❑ COMBINATION � BUILGMIO fd MECHANICAL � PLUMBNq ❑ BWN <br /> PROJECTADDAE88: `�'CU3 Fok�rT Dit. <br /> NIARk E�..rs `1t1�J Fortrir i�a 582�3 2f9-J-5uN <br /> aw�rn rua�ow�ss an im rrpr,E <br /> l�yni <br /> TE�f YN1�001ESS CJIY 1P p11�VE <br /> �NHRLId10F51fi11FR W4�p011F55 GIY IiP P�p� �— <br /> JW��x 7;�.��Ja.i <br /> aEwEnucon�n.cton wui�mnEss tirr nr n� �r•�Ei��� <br /> .fn.:t�+ /IuNTry✓4 <br /> YFCYIIMCN[pRR�CtOfl WiRApqiE55 fA�Y TiP %qHE S��tELiCFHSF� <br /> MnKv�ou.c Pta,y9r,�6 <br /> q�WMGC0111(1ACtp1 Y�iIMqIE55 tlM1 pP %I(WE SMIElCFNSE• <br /> LMiMLt PpLE Oi WpM1t <br /> �3.3 3] � HEATINQ SYSTEM: G36AS ❑ELECTpIC ❑ <br /> o[uneE wa��w sawr�roorr.oe wvaarto co.rt�ct vtnsw�w nrurt w <br /> � � �i ! .t it Ir. /� / i t i y !' Mnn� ci crt 2S5 S yv b <br /> ✓ <br /> C.,,<Sl� � . 706o r .�F�f �f./ .r � f wk11 3 n G78-YYo6 <br /> ri, S� J 2 y,p f�..�i; • �j MEREBY CENTIFY TH�T I MAVE qEAD ANO E%AMINED THIfi <br /> P110PoYD USE Oi MMbMO �����J �APPLIC�TION ANO NNOW THE SA.���70 BE TRUE AND CORRECT ALL <br /> h'�n� O .k�""�-� U P���SIONS OF L'.WS AND OqD:NANCES W VERNN6 TW S TYPE OF <br /> iEc�uascwvraxamoeEnnia�e owon�n�cxnwcv i •' �RK WILL BE COAIPLIED WITH WHETHER SPEGFIED HEREW OR <br /> NOT. THE ORANi1N(i OF A PEfiMIT OOEB NOT PqE&MAE TO GVE <br /> ior zS µmt v�� ���oaa F�re�, t P./. AUTHORITV TU VIOUTE OR CANCEL THE PIqVI610N OF ANY <br /> OTNER STATE OR LOGU.LAW REODUTINO CONgTRUCTION OR THE <br /> /<</r.l'��+ T� c>i-ere f"t� n 'v;r� A . PERFORMMlCE OF CANSTflUCTION.TH�T I AM��7110NIZEO BY T11E <br /> OWNER OF TMIS PROPERlV TO PERfORM 7HE Wpy(Fpq Wµ��l <br /> APPLICATION IS MADE ANO 1 COMP�Y WITM fME BTQE <br /> wxELiw`ID Mius[p CONTMCTOR$L�W 1827 RCW MJD 286.2p0 WAC, <br /> vv�r-��� -uzs-- �.., ''2�_ G/ /C7 <br /> CpKfN1lGiNnlON1lEMEP.�Op11E55.iFlEpIdENJ4lEN % �,�. / 5� / <br /> SI(iN/.i) E W�E'� <br /> / <br /> Gry&ISINESS IICENSC Iq <br /> VLUIIlINO MECMA/NC�L <br /> NO. TVP[OF F.�INK OII ITEM FEE NO. TYP!OF[pUNy[Nt �(E <br /> �i WATER CLOSET�TOILEn / �_�y�{Np�p�� <br /> �- BATHTUB 1 FOflCEDAIHSYSTEMS - <br /> ��, LAVATORV(WASH BASIN) %/ HEAT PUMP ' <br /> � SF10WEp � <br /> I IINIT HEATERS <br /> I KITCHEN SINK 6 DISP 1 CLOTHES ORVEflS - <br /> I DISHW�SHER �� RANGE HOOD . <br /> i UUNDRYTRAY - ' I WQERHEATER _ � <br /> I CLOTHESWASHER WOODSTOVE <br /> - UFINAL MEfAL FIREPLACf ryJOOD BURNING) <br /> - DRINKINGFOUNT�IK FIPEPV.CEINSEflT�WOODBURNING) <br /> ROORURMN j GASFIREPIACE <br /> - BACKFLOWPREVENTERS � GASRANGE <br /> -- SINK�SERVICE-BAR.ETC.) GAS PIPING <br /> EXHAUSTFAN /// <br /> SUB TOTAL f SUB TOTAL f <br /> _ PERMIT f i PERMIi f <br /> iOTAL FEE f � TOTQ FEE f <br /> FOR OFFICE USE ONLY: 77 �G <br /> fRfM1iSEIPACM REM$f�GLN $ICESFiB�LR/ 1'IANCIKf.MMM111ffl fFF �O f4V��p <br /> n . / 71� � jl�l � e�._ 72� � <br /> uSErowE I �ouaEe vN:�H�ytE PEES VI1lUAilON FEE <br /> �� nrFs ❑HG - —1-- <br /> — a�^�^��: ss sss i/92! — <br /> r�F�ruI1�MR�11�N� NO pf UW[LLiNG SRE or Btu:rtl <br /> Z(w IlNllt PIIIWIMi � <br /> '1.1 �lO $.F, _���_ <br /> pCCVPANCY MIIMSIIW[S O(:Cllf'1NI144) flAXMfN} ^O <br /> (�IIq1V M11:II�Mf.11 <br /> a 3 2_ ��.« ��, ------ --- �� <br /> ninsnnnai[ax[an nusa� '—' ' �n.�ewun�Hnnc. /JG '/O <br /> — _�_ <br /> pp�f II <br /> 1111[4MM0[O'0 RF�SM <br /> SI�I[Blllll)Ixli]IItt:11Mlf[ - •/� <br /> nr[nrcw�sr rinr�s��rnrnmer CITYOFEVERETT �neiv:xrx�.r. <br /> _� LOCAL SALES ------ ---- --�-:— <br /> _ une 7�22,5 _ TA%CODE IS J105 TOT�L_ � �;(�� <br />