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APPLICATIQ1 FOR CONSTRUCIVN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT <br />I HEATINDSYSTEM UGAS fUELECTRIC AZ #—& � pm& <br />259-8810 <br />I I DEMOLITION . .l I COMBINATION BUILto DING l.1 MECHANICAL _I I PLUMBING 1191GN <br />(ny4[n WtAOPrq cv <br />mop— <br />L� LNQUNiM 21//�Z KL)✓�yGn7r ZS�'93i2(L — <br />tI.H.ANInn//�� n[]d <br />N/KM�t�[(T�(/M1/•�O�t/b/-b1�MMMMM.N/•'�/�'�`p/�w�I!f[/��,M}lx]R]mv(rr [ __ <br />@N[qy [QItMC1U11 wn !/I/CI�IV' 1 /I�LL'U x�f �l—f.V. ]IAl11K.(MY1 <br />jV&vlANv J&fary•Bar 95R . tst� 9U'c<�5i�1�L- -- <br />PlV4ANK:At fAN114CI1K1 w9 AOPIIld$ <br />(qlr 7r AKlnt EIAII IIOFNy1 <br />MtYl11NR[IR CdIl HAL1M1 WtARrlh6d <br />ow [II' AIONF- EIA1h II(.TN]L[ <br />l(NTPALI MKG (K NVA /�� — <br />lkFlAlnL� �Nl p(9;AM1 )Tf1LP 1 0 �[A �/ --. <br />VN(NKK[1111A[M eUlVNO _ r �a.� <br />nnN rKurvl:.xx rcrrlorcolArfl�/J•jlru+vAlr��/e_e_/owoe nn� rn_ rir�-_ <br />LOl -- AVLR <br />YA4(fl IwoM.4Ar <br />('IJ .J/�',�li/C <br />C�IctAIA:tIpItIM llNrc�.AWIK�l1111011FNU0[II— <br />CONTACT RN%WAND AION[IK). �a�) <br />I HEREBY CERTIFY THAT I HAVE READ ANn EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRITE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7175 TYPE OF <br />NOTK WILL BE COMTHE. GRA TIING OF ADPERMIT 0WITH micTHEn IrIED HEREIN O <br />DOES NOT PnESI ME TO DIVRF. <br />AU7 HORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STAIE OR LOCAL LAW RLGULATING GMSTnUC110N OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNLR Ce THIS PROPERTY TO PERFOnM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT ORS LAW 10.27 REIN AND 296.200 WAC. <br />.3 <br />VATOHY ASH BASF._,_ <br />__i <br />OTHES DRYEUNIT HEATERS-9.1.u. <br />RS <br />M <br />_ <br />S WER <br />VE IATION FAN <br />KITE ISINI'AnISP <br />__ <br />..RAND. D <br />DIFHWA, TER <br />WWD-S ER <br />_ <br />LAUNDRY Y __ <br />' <br />WOOD TOV <br />_CI OTIIE6 WA PH <br />_ -`7,J <br />I <br />METALFIREPLA WOOD BURNING) _ <br />URINAL <br />DRINKING fOUNTAI _— <br />% <br />FIREPLACE INSE <br />HEAT PUMP <br />AY NN L� <br />-- <br />ROORDRAIN <br />_,. <br />OA6 PIPING <br />BACKFIOWPREVENTEH$ <br />-_ <br />EXHAUST FAN- <br />Z <br />ROOF URAINS MINI FADE <br />_ <br />- <br />SINKISEnVICE-BAn,E1C. <br />f <br />SUS TOTAL <br />S_UB TOTAL <br />S <br />__ <br />PERMIT <br />f <br />"—' <br />_ <br />PEHMIT <br />$ <br />TOTAL FCC <br />{ <br />-'- TOTAL FEE <br />i <br />FOR OFFICE USE ONLY: <br />- �� <br />nny L4tcK NnMelN <br />r <br />7-3 <br />Nr(srr Nn <br />rnntll bllbA(M WAP O[IbAIX <br />FMr;teAGN <br />�� <br />3�Q <br />'-=-- <br />/'�� <br />FEES <br />VALUATION <br />FEE <br />Ilnr7w[ - <br />�� <br />101 AO[A <br />VAfNIr Blit <br />11 YES I.I NO <br />Au1tDING <br />I (02 <br />,r-7 <br />/ <br />ixt rcEronrcs <br />Ir ol.nllv.ury <br />/ <br />61If 0[nl lnl <br />L2 21/ <br />riP[Gt'I,.,rA moo <br />NV.cj <br />tNt4t <br />[ 1 YF.S XNO <br />MECHANW'L <br />-- <br />PUN Cl FCX <br />/�. <br />rK.COI'NR.vIMn <br />rFIt AIAMAnLUO�- <br />ARDITKXIN <br />- — <br />OTHIR- <br />_Yr`_ <br />n[n <br />/r'L <br />SIATEBUAIKNGSURCHAP.OE <br />[n.nl nv I rtA4]Ai l;F <br />V/ <br />CITY OF EVERETT <br />LOCAL SALES <br />PtmxC tY(�RKB <br />'�� <br />nAt( i/.///�,�j�� <br />TAX CODE 16 3105 <br />TOTS <br />