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" ' LiPPLICATI� FOR CONSTRUC'�N PERMIT <br /> CITY OF CVERETT•BUILDING DIVISION � <br /> 3200 CE�AR uTREET•EVERETT,WA 98201 •259•9870 <br /> f-I DEMOLITION ��1 COMBINATION fl BUILDING fl MlCHANICAL il PLUMBING �l SIGN <br /> PROJECTADDRESS � <br /> �-1� � I��-� fl��P 1.�.�. � F��o o�P�f <br /> awr�cn uu�uion[ss c�rv � nr riwuE <br /> ��,�ia�,�M��.�cM,�!�,���3 n��-<< ;�- ��, �„�.� ,��cn �---�-%r�+—z� �ya��3��-��� <br /> ,,,,o„E <br /> �ncuncctonocs¢xcn u�iunoncss cnr nr rnm.e <br /> cEN[nelcoN�nettpn Pul�OplEss e�lv )�r r�ron[ 544ne,usE• <br /> �=:,�,rnv r�s �,�a;,rict� ����Jk��N� aPfTCC�4lx���c�� <br /> r�Eu�+rnc��co�nnecmn MetIAWnE55 nrv tm vuoi+i s�e�Euttxse. <br /> -f������ �t���� ��.�.��x�� ,t � .�-�c��s �� a��� ,�. � ����t����3� _ <br /> rw nmcoxinr.mn �iunnness am ¢�n rua�e, stn�eucee�st• <br /> �� , .p un,,ki �'��/It7'f� `�. 4, ��`��-�1f3-Mt�, lu�cilSi'I�,�cY�_ <br /> corrtnect rmce or wonK i ' <br /> HEATINF SYSTEM: �GAS �I ELECTRIC �l <br /> oescniaewcnH�Nosau�nccoo��ceurvn Eo ca��� {rfi�so��nrmrYon.�q <br /> —fs` � �� 7 I <br /> — — "1��0� �k".��. <br /> I HEPEOV CERTIFV TNAT I HAVE READ AND EXAMINED THIS <br /> rnoroseo useoF yi��ea� • A�PLICATION AND KNOW THE SAME t0 OE TRUE ANO CORfiECT ALl <br /> �-�� t r04..�L�A n PPOVISIONS OF LAYlS AND OR�INANCES GOVERNING THIS TYPE OF <br /> Y M r x WORK WIIL OE COIAPUED WITH V�HETHER SPECIFIEO HEflEIN OR <br /> i[cniocsrninnp�prvnor¢nrv�srovmeaow.o�� ec� iwocav�es� NOT. TNE GRANTRlG OF A PEPMIT DOES NOT PRESUME TO GIVE <br /> �ot_�oiacn ' of � AUTHORITY TO VIOLATE Ofi CANCEI THE PflOVI£ION OF ANY <br /> ` �f \ n' ^ ^ � (Q � (�` 'n� OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> C � "�_�Q I� � V� ll"� �ERFORMANCE OF CONSTRUCTION.THAT I AM AUTIIOFlIZED OY THE <br /> 1 � � OWNE�� OF TMIS PROPERTY TO PERFORM TNE WORK POfl WHICM <br /> � I y�� a. l � FPPLICAiION IS MA�E AND I COMPLY WITH TME STATE <br /> renc[t rnx i .eu, �n CONTRACTORS LAW/B.2]flCW AND 296200 WAC. <br /> � (,� ,'7r)- ��- ��7-a'xr) �� � � � <br /> �mxsmu:nov�ou��crmen.�mn[ss.�ri[nwrv[e�uuacn X i ' ( <br /> Slf✓ui(I 0�1[ <br /> Cirv0U5�NE55tqEu;C NO <br /> PLUMBING MECNANICAL <br /> 1 O. TYPE O�flXTURE Op ITEM FEE N0. T'PE OF EOUIPMENT FEE <br /> h WATEflCLOSEf(TOIIET) P/C-NFiNOLGUNITS-H.P. ! <br /> � BATHTUB FORCEDAIRSYSTEMS-O.TU. M E.A. ' <br /> LAVAiOpY�WASH�ASIN� ,r- NEAT PUMP --I <br /> SHOWER UNITHEAIEqS-O.TU. M <br /> NITCHEN SINK 6 DISP CLOTHES DRYEflS _ <br /> �DISIIWASH.R —� OtNii:ATIONFAN <br /> qV TRAY ' RANGE HOOD <br /> — CLOTHESWASHEa -�- I WnTERHEAIER <br /> URINAL WOOD STOVE <br /> DRINN:NO FOUNTAM 4E�AL FIflEPLACE(WOO��UfiNING) <br /> � FLOOR ORAIN PIqEPIACE INSEHT�WO00 OURNING) <br /> OAChPLOYlPREVENTERS GASFIREPLACE <br /> SINK(SERVICE-�AR,ETC.) GA$RANGE �— <br />� _ GASPIPING � <br /> E%HAUST FAN <br /> SUBTOTAL. S �— SUBTOTAL E —/�- <br /> PENMIT 5 AERtdIT E /l" <br /> TOTALFEE S � TOTALfEt f f <br /> FOR OFFICE USE ONLY: <br /> rnou�semecn� nc�nserwce /e'ri:eq smescio�cn nu�aircKuuu/am rrr nccnrruo <br /> 7C? '� NGG�� S SJ ��e _ <br /> usC rr•n:n � �u�enu wtern 5�r FEES VALUAlION__—F��ErE�—_ /r,—�/ <br /> �. -J / .5 .318 r[s n r.o nunnwo J CG'! �L� <br /> j = � <br /> uero�uuuiunor� rrowow[iwm siieormuvr� - ' <br /> � urma 1 � rw+rmr�n �i <br /> b2 4�6 s5 _ j_ <br /> CCCIIf'ANCY Iq(ItS�lMYfS OCCVP�NItOI.II �AS UENI MECII�IIIC�I /!.O` <br /> r.noo� � <br /> �'�3 J_i 2 ��Ycs i� ------ <br /> nnc�ununean ne�sa� �rwniai.anu�arr.e <br /> on�pn <br /> rmesr,nuei[nntan n[.sp� <br /> su�[ou�m��+r.sunr.u.nr.c �I�;i) <br /> �L <br /> �rreorr.nr+sr rinNs�rrnovtoor CITYOFEVERETT runur.wnn<v �� � - <br /> � LOCALSALES — -- — <br /> �-� _ i„n�`Z{ Q-1 TAX CODE IS J105 7oinL I <br /> __-________ _ —_-__-_—____- --_—__- _._____' __ <br />