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APPLICATIeN FOR CONSTRUC�ON PERMIT <br /> CIiY OF EVERETT•BUILOING OIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA BB201 •259-8810 <br /> ❑ DEMOIITION ❑ COMOINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBINO ❑ SION <br /> PpOJECTAODRESS: <br /> '�F,Cj�' �R/+,FS �:/ '�E.:l� .J�.c. �vftf.� k/-� S�do3 G?�J 353� iai� <br /> oh..en s�s arv iM- nior� <br /> -f.�,�� ��"��_.D�;,,�_ �6� - <br /> IFM�Nf YM41pIf55 O1Y lY' Mp1E <br /> 1q[N�[L�OROFSKMII 441YpfIE55 Clry AI• ryqf <br /> GFMf114CON111.�L1q1 YNI.qYI(S$ (.IIY !N' ryqMf; 1111ElICENSf• <br /> 4FCN�MCI�ICWIPIC�M Y/J�/y�(XI[55 ry1Y !i�` M1y4 <11fFlICFNSF• <br /> ryUMMOCON�IIY.IM YLM1HA/16[ COY l�:• �—�— PIq1Q — SIIJElCENSE• <br /> CON�MC�1'M1Lf M WM�F <br /> ��j�) HEATING SYSTEM: ❑OAS ❑ELECTRIC ❑ <br /> O[YMFMVIY(�W �11EIWIMFNVqV[O . f.Ml�l'Iryfltpl.WIMCMIp <br /> � � <br /> �l ./ � <br /> ��f � � � - 1 HEf1E0Y CF.PiIfV TH�T I MAVE NEAO AND EMIIMINED THIS <br /> �PVLIC�IION AND KNOW iME S�ME TO BE TPUE AND CORRECT ALL <br /> w.oroseo ux or nwmm PqOVISIONS OF LAWS ANO OROINANCES GOVERNING TMS TYPE OF <br /> WORN WILI BE COMPLIED WITH YMETHER SPECIFIEO HEREIN OR <br /> �E�°E���������r�������^���K������^Es� NOi. 7HE OMNTIN6 OF A PERMIT OOES NOT PRESUME TO OIVE <br /> mt ...�ca d AUTIIORRY TO VIOUTE OR CANCEL THE PROVISION OF ANV <br /> 0T11EP STAtE OR LOCAL L�W qEODUTINO CONSTRUCTION Oi1 THE <br /> PEfiFORMANCE OF LONSiRUCTION.THl1T I AM AUT110111ZE�BY TNE <br /> OWNEfi OF iH15 P110PEt7TY TO PERFORM THE WOfY(FOR NRNCH <br /> �PPLIC�TION IS MADE AND I COMPLV WITH THE ST�TE <br /> wccuwo.NHe[n CANTP�CTORS lAW IB 27/RC�W MJD 2%200 W�C. <br /> canmuctqqiowR�mtn.�omfss.�EiEnarrtMwsn %�/�(��,�j-.�V�e�v �'��"'f7 <br /> � WNe�IIIF WIE <br /> Ct1Y AISMESS lC[NSC NO <br /> PLUMlIqO MEGIIANICIIL <br /> Iq. TYVEOFFlKTUREORIIEM FEE NO. 7YPEOFEq�PNfN{ �E <br /> WATEH ClOSET(lOILEi) NC-MWDLO UNITS <br /> BATHTUB IOtlCED AIR SYSTEMS <br /> UVATORY(W�SH B�SIN) �IEAT PUMP <br /> S/pWER UNIf IIEATERS <br /> KITLXEN SINN 8 DISP CLOTIIES ORYERS <br /> DISH W�SIIER IIANGE t100D <br /> LAUNDRY TPI1V WAIEfl IIGTER <br /> CIOTNES W�SHER WOOU SIOVE <br /> VRIN�L ME(AL fIIIEPUCE(4VOOD BUpNING) <br /> ORINNINC FOUNT�IN (Ifl[PUCE INSERT pY00D BURNING) <br /> FLOOR UR�IN G115 fllt[PUCE <br /> OACI(FLOW PREVENTERS GAS MNGE <br /> SINN�SEf1VICE-OM,ETC.) —� GAS PIPINC —r— <br /> EXII�UST FAN <br /> SUB70Tµ S SUBTOTAL S <br /> PERMIT S PERMIT f <br /> TOT�I FEE f TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> IIIfN11V�11�CF 11(�11t(IP�1CM $If/$��Q.�C4 M1WCIKf4MIM1111 fI� 11Ff.f�IM <br /> as[tmr �m'ix� v¢�x�v1[ FEES V1ILUATION FEE <br /> ��F�G������nl�tpr� u001m[llm0 9IEdMDG/li O� O�NIwM1 � <br /> IMI� v� � <br /> �'111Mi111{ <br /> fX:C11��Kr p�Vf�tWS IXCWVJIIIO�U !/.Sf�LN� 4fC11�Nf.4 —`— <br /> f110U1' <br /> p� 2 NR o.�x p�., -- <br /> rurtsmw+un�rcw ���nsw .ouu�unwc�+c. <br /> N� —I-- <br /> ai,Kn <br /> �x¢,u.v�Mntoo m��nv <br /> N�: il�if nlFllwnAwKM�I(H <br /> I�I`(Mlp1G� 1ry�Mi� ryy�rnor �'��O <br /> �� pTYCiFEVERETT ���Mrwr�ns <br /> �. v LOCALSALES -- - - ' <br /> _ u+rt ��`I-S 7 TA%CODE IS J105 TotAL__ ` � ;� <br />