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APPLICATION FOR CONSTRUCTIt,N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAq STREET•EVERETT,WA 98201 •259•BB10 <br /> DEMOLITION ❑ COMBMA N ❑ B ILDIN�p MECHANICl1l O PLUMBINU O SKiN <br /> OJ CT AO[�RESS: ' I O�i <br /> � d � - <br /> � � <br /> � � , .� <br /> �ui�mnEss un tn na.rt <br /> •rtcrwasar�n wu�omEss c+rv im r.p.� <br /> �� <br /> 11NCONf1U�C�tl1 YNMd1F55 f.�l♦ !n• M1qvF t1�IFlK[NY� <br /> II <br /> MCNCONiR�C�p1 Y4�Od4S5 f��V !il' 1YiVh SI��FlSFwSE� <br /> CpN�P1Glq1 YYI�WI[5T CI�Y 111' 1'IU��E S�A�ElKEMSE� <br /> ����R�^F "� HEATING SYSTEM: ❑0115 ❑ELEC7RIC ❑___ <br /> ._ �� OtJO .�— <br /> wvnx�Hosw��rtroo�rot vFo cw��c�nnswuanar.Ew <br /> 1T <br /> Tl �� 1 NEREBV CERTIFY �II�T 1 N�VL PEAD /1ND EXAMINEO THIS <br /> V APPLICATpN I1N�KNOW THE SAME TO BE 7RUE�M�COFRECT ALL <br /> xo�1c a PPOVISIONS OF UWS AND ORDINANCES OOVERMNG 71115 TYPE OF <br /> WORN WIIL BE COMPLIED WITN WHETHER SPECIFIEO IIEREIN OR <br /> p[srnvrwp� nn s�owue[iawon�n�cNrv�ocmcs� �1pT. T11E OA�NiINO OF A PERMIT OOES NOT PRESUME t0 CIVE <br /> a� a AUTI/pRITV TO VIOUTE OR CIINCEL THE PROVISION OF �NY <br /> OT11ER ST�TE ON LOCl1l UW REODUT�NO CONS7RVC710N OR THE <br /> � �(�` ��� PERFORM�NCE OF CONSiPUCTION.THAT I AM 11UTIKNIVEO BY TNE <br /> 7 -7 OWNE(i OF TMS PROI'ENTY TO PERFORM THE W��K FOR W111C11 <br /> /,���� _ •3/ 'L �Z/ � /' �� __ �PPUCIITION IS MAOE AND I COMPLV WITII 711E ST�TE <br /> ru o.r�Ntn CON�j�1CTOR5 W tE. �200 WAC. <br /> ' SGC- N � ( ,� � G <br /> �MIL�(MIOWLFMOER.M0�f5f.tFlERQ4MMRn X - <br /> • � �MF <br /> ' df'/bi5w1ES!IICFMS[MD <br /> MECN�NIC�I � <br /> TYPE OF Fl%TURE Op REM FEE NO. TYVE OF EOIMPMENT FEE <br /> WAlER ClOSET(TOILET) NC—MR1010 UMTS <br /> BATHTUB FOf10EU AIR SYSlEMS <br /> UV�TORY(WASH 01151N) NEAT PUMP <br /> S�qW�q UNITNE�TEPS � <br /> KITLNEN SINI(6 DISP CLOTHES DRYERS � <br /> qSHW�SFIEF MNGE FqOD <br /> UUNDRYTRAY WATERHEATER ' <br /> CIOTNES WASNER WOOD STOVE <br /> �p��� MEIAL FIREPLACE(WOOU 9URMNG) <br /> DNINIfIHOFOUNTIIIN fIREPIACEINSENT BURNIN6) <br /> ROOR URAIN ��5 FIREPUCE <br /> B�CRFLOW PREVE ERS GAS MN6E � <br /> —� <br /> SINI(�SERVICE �N,ETQ� G/S PIPIN(3 <br /> FJ(IIAUST FAN <br /> SUB TOTAL f � SUB i0illl f <br /> VERMIT f —� f E�M�i f <br /> TOT�IFEE S TOTALFEE f <br /> R OFFICE USE ONIV: <br /> arn�c+ nc�nscie�cR sroESE�e.c+ n�wa�/rn rtf �+cc���a <br /> tM 1m�M� ut�r��v�E FEES V11LU�TION F� <br /> � '1]vf5 �p xo lMdxlt .. <br /> IIIItMl�iqN NOG��MFIIIM SI(EG�RWIII <br /> UM�i IYIMIMfI <br /> � <br /> M�MCY NJdfIMFf OCCIT�M��O�U l�SEMFMI K�y��yF.�� <br /> o.o ❑�n - <br /> smwn�.aoa nc•sw .oa�xM.in��o+r.. _ <br /> Ol�h� <br /> NAPYPFOO AF��fM <br /> i��IEM1ilOM�5�1�1L1�M1fif — <br /> ar.a.s� n�ws�mrovEner CIiYOFEVERETT n�K:�'�� ' <br /> LOCIIL 511LES —� — <br /> ���E T�lf CODE IS�105 TOT�L �. <br />