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APPLICATIORFOR CONSTRUCTI�1 PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STAEET•EVERETT,WA 98201 •(425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN6 ❑ MECHANICRL ❑ PLUMBINO O SIOH <br /> PROJECT ADDRESS:So% EL GF/RQ.LtF �Vo� <br /> LVN,✓.d �a/LY P 7,a.1'/3.�/ L�i�C pernt 9�A8�L `�'Z z�G 4678 <br /> OwMFA yuleWnE55 Qf� D� vrqxf <br /> 1F1UN1 4M W01K55 G�Y )Ip M1qNE <br /> A�Pcr�i:r�s ,v , /�?sir-is�z�'v.r�-- _�.��,y�c� Rro7z v�- s�ss-v�,b.. <br /> nnC�M�fttpl�pESiGVCn M�n WM+Ess c��r /ir r�i(wf <br /> Mtr,�,zEwstt� CcuS�rtuctiaU�Yu+v3'�Iva�;,�(y,��<.eN, A�&zr�(vzs33F•zc39 Hrt����.�o�2i� <br /> crNcn.ica��n.cirn uui�aincss cn. �m �irr,c s���[iKrMu. <br /> MFCN111�C1LCON1MCIpf1 4�il�MN1E55 IlM1 )T pll^NI i��IFIKEN$F• <br /> P111YlNpCONIRY:IpI 4�IlLfMT1C55 CIfY PP M1lp.[ SUIFIKfNSf• <br /> CON�1UCf rvM10E M NqiM <br /> MEATINO SYSTEM: j7,f GAS O ELECTRIC ❑ <br /> �ESCM1Bi 3r���wpncroor�c�HX `I, cwi.c�rcnswunna�rro kA-yyo.y�/ W <br /> dl�n�„ Y_h <br /> �,✓ ShS- 8S-5�900 <br /> I HEREBY CERTIFY THRT I HAVE READ AND E%�MINEO iM15 <br /> riroros�pu<e a am�pan APPUCATION M!U NNOW THE SAME TO BE TRUE�NU CORRECT RlL <br /> r q , PROVISIONS OF UWS AND OROINANCES GOVERNING THIS TYPE OF <br /> � �' WORN WILL BE COMPLIED WITH NRIETHER SPECIFIED HEHEIN OR <br /> t[uuo[sc iwornqn[n, is�qxNeaow �nrtnnwca+[51 qp7. 7HE G�7AN11NG OF A PEPMIT DOES NOi PRESUME TO GIVE <br /> tot��acK or L� />`U ^-' AUTMORITV TO VIOUTE OP CANCEL THE PROVISION OF �NY <br /> OTNFq STATE OR LOCAI.l�W RE6UUTINO CONSTRUCTION OR TIIE <br /> PERFORMANCE OF CONSTflUCTION.THAT I AM AUiHORRED BV THE <br /> OWhLR OF THIS PROPERTY TO PERFORM THE WORN FOR WNICH <br /> 11PPlICA�ION IS MA�E AND I COMPLV WITH THE STATE <br /> IMntEI� i D raNBFn CUNT CTORS UW iB 27 RCW AND 296P00 WAC. <br /> 30 - �00 -00 3 - 00 c/� <br /> LWSI ILIIONIMNIEMIEII.N)fM1E55.1E1[AIOMEMUMIIER �� �� 3�IJ�" <br /> SKVM UE 0��[ <br /> pIY W yNES!IIC[N$(YG <br /> PWM91N6 MECNANICIIL <br /> NO. TYPE OF Fl1RIlRE OR ITEM FEE NO. TYPE OF EOUIPMFIIT FEE <br /> WATEH CLOSET�TOILET) / NC—N/INDLG UNIiS <br /> B�7NTU0 PoRCED AIR SYSTEMS <br /> � IAVATORY(WASX BASIN) HEAi PUMP <br /> 1 SMOWER UNIT NEATERS <br /> NITCMEN SINK 6 DISP CLOTHES ORYERS <br /> DISHW�SHER RANGE NOOD <br /> LAUNDRY TRAV WATER HEATER <br /> �ji CLOTNESW�SNER WOODSTOVE <br /> URINiLL METAL FIREPLACE(WOO�BURNING� <br /> DRINI(IN�FOI/NTA1N FIREPLACE INSEfiT(WOO�BURNING) <br /> FLOOR DRAIN �� GAS FIREPIACE <br /> BACNFLOW PREVENTERS GASRANGE <br /> SINK(SERVICE—BAF.ETC.) GAS PIPING <br /> EXHAUSTFAN <br /> SUO TOTAL S SUB TOTAL S <br /> PEiMIT f PERMIT S <br /> tOT�IFEE S TOT�LFEE f <br /> FOR OFFICE USE ONLV: /OU . Jlr <br /> fIKY11VTP�C11 tVMSf/���CM LC($CIB�CII 1'I�NCIIIC/R�NVVRl11 f(/(] / � �/ IIfCi1�INQ <br /> �� '� �^/ /� l`��ti /�1J.v <br /> user�rvr � �m��rte vetu.�aic FEES V�LWITION FEE <br /> — ❑rEs ❑ru �—� <br /> NEIOIIIIM^IION / 1N0'VUWElUN6 S�.Edl;W�11 �u1pM: •�'Y,7rt iGo.,.�r !�`+ <br /> -8 2lA1 �No S Mi�.m,.� — -- � D ov <br /> a:C�m�Nc�(xo('Is�t�nls tx:cur�MlwD B/.. LrtM� utn�v�f�� �t✓ <br /> ���U � �VFt OrM �SL� <br /> fIPE AlE11PE0� 111'�[(MI ��INn�I M1�NOrtf.[ 7 O� ;/n� <br /> � � ___ _ iC <br /> ourtn <br /> rnrte mn m.snv <br /> ,il/.11 fl1MUM1:51111C11�INi[ i � <br /> � <br /> urrn�cous� ruNs�rrnovmor CITYOFEVERETT nmucxpr+s � <br /> LOCAlSALES -- — — `—,����� <br /> --IJ a.�c.3 2b�9 d TAX CODE IS 0105 i0i11L / <br />