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APPLICATI� FOR CONSTRUC�N P@RMIT <br /> CITY OF EVERETT•BUILDING DIVISION '—IZ--OI � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257�8810 ��' <br /> ('DlO6—�3 <br /> -; DEMOLITION "-, COMBINATION C BUIL�ING C MECHANICAL `-'� PLUMBING '-. SIGN <br /> PROJECTADDRESS <br /> ql5 4'� °i" <br /> ov..,ra n�uuocnEss cnr rn� r�c [ <br /> K�vin U��en�zs_Knu�_ '1�15 Wcs4 Evcrti# 9s2o3 (H25�3�18-0754 <br /> -ru>�.r na_noouEss Cd�� I�' ���orE � <br /> flE�! rLL�nr� 1915 Modi�m St. EarertlF 96?D3 �H75)353-053i (Hzs)353-(�(o <br /> ��.��_ipuD[_�GNCR A1cRSOp�(55 CRr DV PrP4E <br /> r.v:in.�, at�oa .-e�u�nour[s, nrv te — w�c�re sr�tEnccns[. <br /> ����� � '��.� — _ <br /> I.I��I�n1.i:;iLCO'IIP�CIJP 1.I�IL�C�N�55 LIIY iN W�OIIE SiR1rLICC�ISe� <br /> �'1111AU'�vG(1NlflPCiOR II�IL�O�RES$ GIY .�P Pr�ONE SintELiC[115E• <br /> caomurr�+icsorv.cn+ HEATINGSYSTEM: �XGAS f�ELECTRIC �-, <br /> -n on•:onK+r�v sau>ae�oo*��e nr:o�vm cu rt<c.vu�wri ai,o rr c�e r._ <br /> �.��{p��},I� � r�4hn �huclur 2=� fLKnK1��4�34�_Q�l�c�25 3�12 24 � <br /> �4�_ .O�LI`�115�_y�yy�n��nr <br /> p� 1� �p,t " �nbN I HEREBY CEFTIFY THAT I HAVE READ AND E%AIdIHED THIS <br /> ���m.�'�P Yl�(,_�(�(. 1��759 ' " � S ' APPUCA'ION AND NNOV!THE SAME TO BE TRUE AND CORRECT FLL <br /> i n�� mcsi or ou��r,wc PHOVISIONS OF LAWS AND ORDINANCES GOVERNMG TMIS TYPE Of <br /> r�e5�denc� VlORK VLLL BE C01.1PUED YIITH WHETHER SPEGFIED HEREiI: OP <br /> «a+�c[sca,�no:c�n=oPc�+*vis�onuoe�o:�Jo1�uruc��moeoo•Esi � NOT THE GR�HTING OF A PER1d1T DOES NOT PRESULIE TO GIVE <br /> ,_., �_¢ccn.�o�L AUTHUPITY TO VIOLATE OR CANCEL THE PROVISION OF FNY <br /> OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> ,�5� - A � CI `� PEPFOR�dANCE OF CONSTRUCTION.TMAT I Ald AUTMORIZEO DY THE <br /> OW.NER OF 1H15 PROPEFTV TO PERFORh1 THE WCRk FOR YlMICH <br /> APPLICATION IS MADE AND I COIdPLY WIiH THE STATE <br /> CONTRAC70R5 LAV!10 2]RCN/AND 296200 WaC <br /> � v.u.i o r�v.mw <br /> `�5e�o35o02 � �o �os-v� �� '�/ <br /> co..�r�.:;.•�oriwn�ic��oc��.moaessraei=r�encr.u+�eEa X_ /LO�A �q,�' �''�'�'� <br /> sicrv�mn o>t[ <br /> Cliv OUS'.N65liCCNSC NO <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. iVPE Of EOUIPMcNT FEE <br /> � � LNATEPCLOSEi�TOILETI 0.C—ANNDLGUNITS ' <br /> � � �ATHT�� FORCEOAIRSYSTE�dS ' <br /> � �, LAVATJFY IlVASfi BASIN� HEAT PUMP <br /> � SHOWEP UNITHEATE(i5 <br /> KITCHEN SINK 8 DISP CLOTHES DRYERS _ <br /> � DISHWASHEF J RANGEHOOD <br /> � LAUNDRYTPAV WATERHEFTLR --t— �'� <br /> I CLOTMES wASHER ' �'�OOD STOVE I '�— <br /> URINAI �•1E1AL FIREPLAGE�VlOOD BURNING) _ ' <br /> DRINNING FOUNTAIN '' FIREPLAGE INSERT(WOOD�URNING� �__:_ <br /> FLOOR DRA�N � GA9 FIREPLACE I '_ <br /> OACKFLOVJPREVENTERS I GASRANGE ' <br /> � SINN 6EFiVICE—DAR.E7C.1 ' GAS PIPING ' _ <br /> — � E%NAUSTFAN <br /> — I �1� - � �.— <br /> SU6TOTAL S SUBTOTAL S <br /> PEFtd1T 5 PEPtdIT 5 <br /> TOTALPEE S TOTALFcE S �__ <br /> FOR OFFICE USE ONLY: - " ��� �` — <br /> cex�uc. r�aast�occa s�oisere>c+ nunn�m.urmen c�= amc,Prne <br /> �� . , � � Loio[�, -��3 5y/.a� <br /> ,,-__� I�otnnca �+C+�+tvre / FEES — VALUATION FEE T_ <br /> � :'�[5 t��o ou.�c l:' �J. � �� ��:� <br /> 1 rd�iqt4N � 0 f�:[LL-'�% SCECIp�DGII r _ <br /> ���� 33 �57 S o,� a ,, �I ti nn , <br /> ar.cv •a c�sw=�es occu�+u*�o.o u> vu / i[ r�o� �') �� '�� � <br /> /i -..cs ��O �� � <br /> �i��J-J nooniorw�viu�o�¢K ' . <br /> f��.i�.5nuwnl6it'QOU PEPSCN _ �— I <br /> Otulu I <br /> in(Y�nw.lu�0� P[AS�rv � <br /> SiAI[11U�1�1!�GiU�C��AR(�[ l /�(, ' <br /> ��„i�;���.:::� Piar�s�vnr+oacoor CITV OF EVEflETT �ue��t wcanc p�� �00 <br /> LOCALSALES � � <br /> � op�E� �-' TAX CODE IS 9105 TOTAL t � S �Cr�O <br /> _ . � / �_ �� ; �:� � 1- 7or�� � <br /> �, <br />