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���---- <br /> APPLICATIO�FOR CONSTRUGTI�1 PERMIT� <br /> CITY OF EVEAETT•BUILDING DIVISION <br /> 3200 CEDAR STiiEET•EVERETT�WA 98201 •(425)257-8810 <br /> ❑ L�EMOLITION ��MBINAT�ON �O BUILUING �ECHANICAL PLUMBING ❑ SIGN <br /> PROJECTADDR[SS� 273�I /Z St �Z O�-''i� .�s�'� <br /> . <br /> F ratf H»v i�l( /1 rNnoi�y 310't Co�g F.uer-eTt'� Wa. MKa01 42$"303'�121 <br /> o�w[n Mul�0U1E55 arv / t . vwr.t <br /> Vq <br /> IFMaN� uu��E55 Gtv 8P w�pnF <br /> •I1C�h[C1011bfYGNF� YUI�AF55 [i1Y )�� h�(nf � <br /> 4' F+/} — S am� HS FFqov G _ <br /> OENEMIGOu�IVdfIX1 Mu.ADlMF55 C��Y I�� PiN)4C 54qUCENSF� <br /> £N�• CAtt IR o�bM! $4�F lKENSE� . <br /> YECIUbrf.�LCbAu410P 4ul�fAi�F55 <br /> £:NR MAi�vT�JhUCE -SAm& �6 RUoi�£.. _ <br /> PlU40HCCONIP�f,IM M�II�D[.'�F55 C1IY IIP 1'�IpqF SI��fLKEMSf• , <br /> SQ/4-� _'_ / <br /> CONIMC�PA��F OF WOFM HF.NTING SYSTEM: ❑CdAS ❑ELECTRIC �1 <br /> TW�l� , u TS --- . <br /> UESCPiBF WJNN uN SW��E�001I.OF NVIXVfO CpII�Lf VI PSON AMf�MONf NO <br /> (:N�loc2.�nr. nn a� nradc� f000isj�Qa.nai�. I U I-- � � � S �ia.s-3n3 -il.5q <br /> nlu.wb�rT��x�,.reS -� — -- <br /> I HEREOY CER7IFY THAT 1 HAVE RERD AND E%AMINED TMIS � <br /> (' ��nA7 f,t` ��}�' /�T M F�N APPLICAT�ON�ND NNOW THIi SAME TO OE TRUE ANO CORAELT�LL <br /> ���Osro use or amio��m pROVIS10NS OF UWS ANU ORDINANCES GOVERNING THIS TYVE OF <br /> ��F��{µ� ���a�{,�y�Qvi'I'S WONN W�IL BE COMPLIED WITH WHETHER SPECIFIED NEREIN OR <br /> iFwioesrn�m�wwPaw'enn�srwwue[iowau�uonwo[ar[si NOT. �NE G��NTING OF A PERMIT OOES NOT PflESUME TO GIVE <br /> 1O1 eian �� AUTHORITY TO VIOLATE OR CANCEL THE PROVIS�ON OF ANY <br /> UTNER STATE OR LOCAL UYI RECUUTIN6 CONSTPUCTION OR TME I <br /> PERFORMANCE Of CONSTRULT!ON.TM�T I AM AUTMORREO BY THE <br /> OWNEH OF TMIS FROPERTV TO PEPFORM THE WORK FOR WHICN <br /> pPPLICATION IS MADE AND I COMPLY WITH THE ST�TE <br /> MNTRACTORS lAW IB 2I RLW AND Y96200 WAC. I <br /> PMCEL���D NUM9F11 I <br /> ��aqr,�o3a-000 �, Az� <br /> CpISi1111G1�OM�0INIFN�FN.M[M�ESS.tEtEl'MOMEMlueE11 %�_ <br /> NON F- =�cH.roac o�¢ <br /> CRY BU$ SS UfUK[�N <br /> PLUAIBIN6 MECN�NICAL <br /> NO. TYPEOFFI%TUFEORITEM FEE N0. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET�TOILET) NC-NMNO�G UNITS <br /> BATHTUB FOPCtD AIR SVSTEMS <br /> LpypTORY(WAtiN BASIN� MERT PUMP <br /> UNIT HEATERS <br /> SHOWER - <br /> NITCHEN S�NN d DISY _ f.L0711E5 Of1YER5 <br /> DISHWASHER RANGE HO00 <br /> WATEF HEATER <br /> IAUNDRY TRAY WOOD STOVE <br /> CLO7HE5 WASHEN METAL PIREPLACE�WOOD BUPNINGI ' <br /> y— <br /> UR�NAL FIREPIACEiNSERf�WOODBURNING) _ <br /> DRINNING FOUNTAIN GAS FIREPIACE <br /> FLOOR ORAIN GAS RANGE <br /> pACNFLOW PREVENTERS GAS PIPING ' <br /> SINN(SERVICE-BAR.ETC.) E%HAUST FAN � <br /> y_ <br /> $UBTOTAL f SUBTOTAL f <br /> PEHMIT f PERMIT f <br /> TOTALFEE : _ TOTnLFEE 5 <br /> FOP OFFICE USE ONLY: �aU�'� �� <br /> r��r�n�tu�uunrn _� �rf ���/��'���e <br /> (f1(111fViRAf.R 11f�115F�B�CM SIpFSFIB�C1 �� <br /> iount+ wcr.r�tsn[ FEES _'_ VALUATIOH `FEE_T___ <br /> iiscroN� orFs nr«� <br /> nu�Mrr. <br /> —_' _" __.. �.__ <br /> __-__'_—..._'_—__"_ � <br /> nF�fdn P��I�noa 'MU O�t�wEtUMfi SiR M GlW4i ruluPwr ' <br /> 6C111�1V'r Y!�•I�lin.lf U:C.111'1Nll(11I� B1iF4(MI 4f1.1�I.I�X'4 •.• ._•.--. - .. — .. <br /> �GPWI' ❑�!5 OMI �... . ..__ . _... . ... <br /> ___ I.ppINW�1l1�N�'ITf� <br /> lIRf5V111iIrcLE1111E0'D �1l�tfY1 ---�-' -��� � ' ��'"'� <br /> m�qn -- _ _�... �._. __ <br /> i��[�URM11Lb0 A������ <br /> i��ll flUI1u�115111N����l'.� <br /> imrnrr,a�i<�—' nn�s���rrovrnnr CITYOFEVERETT ri'nin:vnx�.--�"" - .. "_ _ ..._ <br /> LOCAL SALES -"'—'—-� —� � �- 1 <br /> ,..,. 7AR COUE IS J105 TOTAL . ._ _ 'L"_____'_�___ <br />