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APPLICATI� FOR CONSTRUC�N PERMIT <br /> CITY OF EVEqETT•BUILDING DMSION � <br /> 3200 CEDAR STREET•EVEpETT,WA 98201 �(425)257-8810 <br /> ❑ DEMOLRION ❑ COMCMATION f�BURqNG ❑ MECMAINCAL ❑ PLUMBNIG O t10N <br /> PROJECT ADDRESS:�}2 3 �'�/29.v� /'I✓N <br /> fd_S�l L�._,., w 1sL�.,' 12�3��+>d E`/[�ze�� cCtl 9F2nr ?_��- '24[1� <br /> OAMfA� V�rl�f55 biY h1' PMJ4( <br /> l�H\4\ YYI y1p($S I]tY )11' R�YII <br /> I<�Ku�G2lti C,16Ct• ���32 z�V 5E t`�t,t-'.%�-fr A�[i�. 4LS - �1�-9,770 <br /> ♦OCwrtUp�MYG•qn y4%Mf55 O�v )m vKM <br /> �NZwiU f'�IREL 27z.�3-7(r'� �Nt I.fY� ��4x�?�1�3 �46•627-33bb <br /> GtM�1NCOYtO�Llpl M\ryEIXM1�55 Cil• h� AMM t1�q14fM5(• <br /> � C�LIIN�'l1�7At� <br /> �rtc��+¢n<rn�mcwn �uurromss nn rn� — v,eyur s�utiKtMst. <br /> A��MIIMGCO41P�C1(A 4�4RpY1[5[ CrtY bn �w(Y�f 51��lIKChSf• <br /> C0M111�C�MK:f p NfI1M <br /> �7 %7G - MEATING SYSTEM: �GAS ❑ELECTIIIC ❑ <br /> orsc+unr vrnr�m sr�unnt.anwf Mva covnc*n asa1 um n»x.0 <br /> ' L ( ri � �*� ���� r' �. f""i�t'.1('(. <br /> tl�tC�-, '�l' �t ��i � <br /> ��/}�/ L�_�L�� LV�7{_: I HEREBY CERTIFY TH�T I 1qVE RE�O 11ND EIc�MINEO TMIS <br /> i.xnc�rous�.or nonnw� APPI�C�T10N AND KNOW THE 511ME TO BE TRIIE�ND IXMRECT �LL <br /> � �UC1��n l �ROVISIpNS OF��WS�ND OAOINMILES GOVERNING tH15 TYPE OF <br /> WORK W�IL BE COMPLIED WiTN WHETNER SPECIFIED MEREM OR <br /> �tr,�i�su��nnor.a�vnor[nniy.owveriavan�nu:�rwoconcsi pp7, TI/E GR�NTiNG OF A CERMIT OOES NOt PRESIMAE TO G�VE <br /> �o� �'� �Z axe �/R7 or �UTMORIiY TO VIOUTE OP CIINCEL TME PROVISION OF 11NY <br /> OTHER ST�TE OR IOC�L LAW REOVLATINp�pP'�TR�TION 011 TNE <br /> PERFOtiMANCF.OF CONSTRUCTION TM�T 1 KI�UTIqR12ED BY ME <br /> OWNEN OF TNIS P�OPERTY 70 PERiC.IM TNE W�7RK FOR Nh11LN <br /> �PPI.IL�TION IS M�DE �ND 1 COMPLY WITH TXE 5Tl1TE <br /> �ry��R�p CONTR�CTOR$UW 1B 2]RGW�ND 296200 W11C <br /> ��`�/- 4�Z-G//6ao� ' 7�i -'f y� � <br /> CfMitt111Cfpry101MlfM'hP1fIfYN54111(AqVfMATF�1 X /���/[ ,� �( '�� '�a' <br /> I <br /> _ �'GH\\Vh�. U��f <br /> t cC(.c., i •�.� /1,�� /99 <br /> bt�puw[SS Ucl nSt v0 � <br /> PLUMlIMO YECMIIMC�L '--- _ <br /> NO. TYPE OF FlIRUIIE 0111TEM FEE NO. iY�E Of EOIIPMBR FEE <br /> WATER CLOSET(TOILET) �_�p�a��� <br /> BIITHTUB FORCED MR SYSTFMS <br /> L�V�TORY(WASH OIIAIN� HE�T PUMP �— <br /> 51qWER �JNR HE�TERS <br /> — y— <br /> kITCNEN SINK 6 DISP CIOTHES DRYERS <br /> DISH!'��SNER RANGE HOOD <br /> LAUND4Y TRAV WATER HEATER <br /> CLOTHE$W�SMER WOOD STOVE �— <br /> UFINAL METAi FIREPUCE(WOOD BVRNING) ' <br /> i <br /> OPINRMIG�OUNTAIN FIREPUCE INSERT(WOOD BURNING� <br /> FLOOR OR�IN GAS FIREPLACE <br /> B�CNFLOW PREVENTERS GAS PANGE <br /> � SINN�SERVICE-BAP,ETCJ GAS PIPING <br /> E%HRUSTFAN <br /> SUB TOTAL f SUB TOT�L f <br /> FERMIT f PERMIT f <br /> TOT�LFEE 3 TOTALFEE f <br /> FOF OFFICE USE ONLY: <br /> IW)MiKiP�LM M�Rcf1R�CM LOfS(�I14e %�HO�fC�MIMPIn fff 11ff(MtMO <br /> z� z� �/D-aa/ 279•33 <br /> nst�rnr inum• v¢w�4�F / FEES V1lU��lOM FEE <br /> _���� �� Or[5 �u w� — — - T— <br /> ^,.��,�: Z9osL ! <br /> I�IIf.��ll�w � MOOf1WIl11M'i tll[pMUGRI - -1 '�' <br /> �y � IIV��[ I �'1.� f� �III,MiNf. � <br /> '1 7+i J � <br /> ___.___ ___.___ _ _ .__.__{-- <br /> IX:CIT�4'.".Y �•�.wl (N�.M1in�N�l(I�U B�iiM141 4f1:��1NN'II <br /> fi11011C 4�ni� <br /> D�f[ 4� <br /> �Mlirl�'.ICNPf�IO ��f�tlN I�IKM�IA1NCr11(,� <br /> OIMf� <br /> fiPl�U�VPI!J� Pfi�'1Y —... <br /> [Inl P�rqUNlf pIM]��nfr <br /> irrrn oacr nviswro�v�nn� CRYOFEVERETT r�wn��,wn� —� /J/ _ -'-" "— <br /> —� , ( � IOCAL S�LES •��y �---� �—��--- <br /> N ��•,t (, TAX CODE IS�705 TOT�L <br />