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APPLICAT� FOR CONSTRUC�ON PERMIT <br /> CI1Y OF EVERETT•BU�LDING DIVISION � <br /> 3200 CEDAR STREET•EVEP.ET7,WA 9tl201 •(425)257-8810 ������� <br /> �,DEMOLtTION O COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBIN(i ❑ S16N <br /> PROJECTADDRESS. l)LF�7�_�� /�V. i• G �'U. �vfr <br /> f2�rny I� HfJQ-�i5 � 3'S�?! Hmllv /r, G✓• WA 9W1of! 3tF7 -ol.rY9 <br /> OWNFH f M�RIWPE55 C�O' tiP plpN[ <br /> tFMFN� MYIMMY1C55 �IiY jIV V�(INF <br /> �ACNi(GIO�MLGNFR M41�!%WE55 [ilY Jm pripryp <br /> GLNtMICWI(I�C�dI NuI.WIMk55 CIIY III` �l✓NE �--fI�IFIIC(NSEI <br /> Lil•rl., /;^Lzw 10147 3i� k�, �.6 GV, Wn �_ 9ff?o8" �?7-3�r51 c�n,aH�ro&&Jr� <br /> YFCN�N�CNC6NIPLLIOA 44��ppPiiS CIfV I�� i4qN( [I�iFI�CEASE• <br /> P�IIYBMGCp111LLpp1 N�IIAbqIF55 �IfY $IV CHDHF 9�tFl1CfM5F� <br /> CpIfMLI PIXCE Of MORR <br /> HEATING SYSTEM: O GAS ❑ELECTRIC ❑ <br /> oeuniet woaK�wo sw•�E roo�w;[wnxveo ca+*+er rcnsai u�r�r,e <br /> 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED TMIS <br /> ruwqs[ouse cK avn . APPLICATION pND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> VROVISIpNS OF UWS AND OROIN�NCES GOVERNING TNIS TYPE OF <br /> � WCAN WILL BE COMPLIED WITH WHETNER SPEQFIED HEREIN OR <br /> 1[wTotscnir:ior�cvmpe¢nn�5r�rvmeaowonen�Hrwoea+es� NpT. THG GRANTING OF A PEFMIT OOES NOT PRESUME TO OIVE <br /> im .eiace w AUTMORITY TO VIOLATE OR CANCEL TME PqOV1510N OF ANV <br /> OTHER STATE OH LOCAL L�W REGUUTING CONSTqUCT10N OR THE <br /> PERFORMANCE OF CONSTRUCTIDN.TH�T I AM AUTNORIZED BY THE <br /> OWI+fR OF TMIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAfION IS MADE AND I COM7LY WITH TNE STQE <br /> rN+cci ru io xweFn CONTRIIGTORS LAW 182�RCW AND 296.200 W�C. <br /> 57u7-ool -D�6 -O I o L / �/ <br /> Cb15T1111CiMM10�N1[W�FI(µ1p1f55.fC1f1'NONEMIYBER x�.�(�J� �/ ?�/q/ <br /> �_ SIGNAI VqE �p4[ <br /> L�lv BU4Nf SS IILFNSC NO <br /> PLUMB�N6 MECHIINICQ <br /> NO. TYPE OF FlIITURE OR REM FEE NO. TYPE pF EqJpyFJ(r FEE <br /> WATER LLOSEi(TOILEn A/C—NHNDLG UNRS <br /> BATHTUB FORCED AIH SYSTEMS <br /> IAVATURY(WASH BRSIN) MEAT%JMP <br /> SNO WER UNIT HEATERS <br /> NITCHEN�INK 8 DISP CLOTHES�RYERS <br /> OISHWASHER qANGE HOOD <br /> LAUNURYTHAY WATER;iEATEft <br /> CLOTHES WASHEN WOOD STOVE <br /> UHIN4l METAL FIREPLACE IWOOD BURNING) <br /> DRINKG�G FOUNTAIN FIREPLACE MSEf7T�WOOD BURNING) <br /> FLOOR DRI11N GAS FIREPIACE <br /> I OACKFLOW PREVENTERS GASRANGE <br /> SINN(SERVICE—BAR,ETQ) GAS PIPING <br /> 'cXHAUSTFAN <br /> $UBTOTAL 5 SUBTOTAI S <br /> PERMIT 5 PERMIT 5 �T— <br /> TOTAIFEE S TOTA�FEE S <br /> FOq OFFICE USE ONLV: <br /> f11f�NiSfl11�CM PfM$F1p�C[ $ICCSEIB�CR �IAMCI:fCRN11YRf11 fFf 11ffFI1�fN0 <br /> S <br /> mtlo�f m�.ure v¢e�ny�E FEES VALUATION FEE <br /> ❑vE5 ❑Ml —�— <br /> BlM1U� <br /> IMIC.11(1�411�IqV HO P UWfIIING 51If Of&IXi��l '— <br /> ums riu�mwc. <br /> m <br /> —__ '_ " .—__.__�'_ <br /> on�unevcr unr�vrn�is occw�H�io.o e+srucr�� <br /> cnwr urouMiui <br /> Ll�FS OMO —�— — --- — <br /> fIPi5V1�INMtf��EO'0 IIFTSGN I.DWII(1N�1 hAY(11(�4 <br /> auwn _ —'—. -- <br /> �iu(qunHpEao Pf�spv — . <br /> --{IGII.If RUOU�LSUf¢W�CF <br /> rtrcnrrovsr rinvs�rrnov[ner CRVOFF.VERETT 'M����r.wnnes <br /> LOCALSALES <br /> I�„_ TA%CODE IS J105 TOTAL j <br /> _ __ �— <br />