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APPLICATIO�OR CONSTRUCTI� PERMIT <br /> CITY OF E��ERETT•BUILDING DIVISION � <br /> 3200 CEDAFi STREF!•EVERE77,WA 98201 •(425)257•0810 <br /> ❑ DEMOLITION ❑ COMBINATION �B�U�QING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> [�I lic^ <br /> PpOJECTADDRE:'�S:o? " A+� p <br /> �pl(P( �{,SG �� uu�.00n[ss� �Vcirv� I"" �1m �O c2U� v�oti[Ri'a�.�-,S 73$— <br /> �rni� <br /> �cw�r w�n�noncss nrv nv vi�orr <br /> Fm�rc% � iqh Tn� . SI`/ S�c.ft f�t�C ,$[�i{t lO� l�7� �f�'�70 <br /> •ric�«r�cronn[sicvicn ue1.n�Fss cnr �m n�o•.r E("��=� �55 f} <br /> E�M�.a I � „r . s11_,S�i;}�� �/r—LG'S h7otiusui//�/,�/, 9d?7v <br /> G(NE��I LOYf�4�On M i �Utt F55 Ciiv l�f �u04t S4q UCMSV� <br /> l�12 <br /> uLCr��'uUtC.Ovin�[lun umeMwE55 G*�' Ii�• nn(k:r SluiucEvSE. <br /> �� <br /> PIu401NGCONIR��fy,tp���/. N��I�INFE55 Cliv li� Ce9�F S1�IFIICEMS[• <br /> a / OW <br /> cw�tmc�n��ccorwonn � HEATINGSYSTEM: UGAS �ELECTRIC ❑ <br /> uescn aF woae�wn Sow�r�ooucc wvoivm can�cr rr nzor�v�n n��a�Nr�u�o � � L <br /> �irunSp _YY�r�r.. n�/•-tjL� —l�i(LriSH7..CG T� (K pa� i�.. <br /> —� u' � -��o. 3 01�59 7/l/ <br /> !� I HERE�V CERTIFY TMAT I HAVE READ AN� E%AMINED THIS <br /> ��SC81}'�'� ��� APPLICATION ANO NNOW THE SAME TO UE TRUE AND CORRECT ALL <br /> �vqrosro as�or pvnmvr PqOVI510NS OF�AWS AND OROINANCES GOVEPNING TMIS-�YPE OF <br /> WORK W�IL BE COMPLIED WITH WHETHEF SPEGIFIED HERE�N OR <br /> lEcuo[5cn�rua+wrirorEnrvlsrow*,BEmwonen¢N*xro[om[si NOT. TNE GRANTING OF A PERMti DOES NOT PRESUME TO GIVE <br /> m� eioca or AUTMORITV TO VIOLATE OR UNCEL THE PROVISION OF ANY <br /> ,��/� // OTMER STATE OR LOCAL lAW REGUUTING CONSTRUCTION OR TME <br /> o?Uo'Z O I.C�mra n( A�C EUMt��LI.VI `f U PERFOPMANCE OF GONSTRULTION TNAT I AM AUTHORRED BY THE <br /> OWNER OF THIS Pfi0PER7Y TO PERFORM TME YlORN FOR WMICH <br /> �/379 ycQ� �ZZ- a�7 APPUCATION IS MA�E AND I ^OMPLV WITM THE STATE <br /> re�u w i o u�mnt n CONTRACi0P5 LAW�B 2]RG W AND 296 200 W4�. <br /> „e -A/ . / ��// <br /> CONSiI11Kt1(NIIO�IIIfNMP.�p[M1C5$ �Cl[AIONfNU4flF11 x /JOl�+� �� S'�7_�) <br /> _ e�evnmir. u.n <br /> c�rv euvr��cs i�ct�isc No <br /> PLUMBIN(: GECH�NICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSEi(T04ET) P/C—NIINDLG UNITS <br /> BATNTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER NIT NEATERS <br /> N1ICHEN SINN 6 DISP CLOiHES URYERS <br /> OISHWASNER RA`!GE HOOD <br /> LAUNORY TRAV WATER NEATER <br /> CLOTMES WASMER �VOOD STOVE <br /> URiNAL METAL FIREPLACE(WOOD BURNING) <br /> DRINNING FOUNTA W FIREPLACE INSERT�WOOD BURNING) <br /> FLOOR DPAIN GAS FIREPLACE <br /> OACMfLOW PREVENTEFS 3ASRANGE <br /> SINN(SERVICE—BAR.ETCJ GAS PIPING <br /> EXHAUS?FAN �_ <br /> SUB iOTAL E SUB TOTAL E <br /> PERMIT S PERMIT f <br /> TOTAL FEE E TOTAI FEE f <br /> FOR OFFICE USE ONLY: ��� <br /> �nnursnn.r. nr�ns��n.cx s�asc�e.c� rv.xa�¢.�ovnrn �rf 3� nrrn�n�o <br /> � �2 <br /> •2. � 2 S <br /> uatoa im.a[� v.c�v�sn[ FEES V�WATION FEE <br /> �� � _ �—/ <br /> v.[s n�mo�vc �6� /aS ry <br /> �� <br /> ueicaa nwonuv wo a nwuuxe cq�or a�oe�ri .— <br /> 2 p • u4nc (o F. nnax�.�r. _"_ '_ _"— _ .___"__ -- <br /> O <br /> oecurnn::. v�^�.em. ator�r�imm e�sErf�� vt��unu.i — — _—_ _ <br /> my1�oun ' <br /> N-3 � ❑�FS ❑ry� � <br /> ♦Dp11nN�1 f1�NC��ffM <br /> fINE<Mll'!Yl[NPE�]'O �F�tiCN __ �/O <br /> U���fR <br /> Iu:EnlfNeal4D � nf�cp� <br /> ama���io:,�e�n�.u.nr.e -- - �D <br /> ivntnrro���� nuus�nra���no• CITYOFEVERF.TT ���n��r.�»��•� <br /> �'� LOCAL SALES —-- —' --���/'"S <br /> u,�E 2�f �j Q TA%CODE IS J105 TOTA� <br />