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APPLICATI� FOR CONSTRUC�ON PERMIT <br /> _J _ ` `_ � <br /> �` CITY OF EVERETT•BUILDING DIVISION '� � <br /> / � 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> I}7 DEMOLITION ❑ COMBINATION �y^' q`UILUIN�GI ❑ MECH�NICAL ❑ PLUMBIN6 O SI6N <br /> � OJECTADDRESS: .ZZd� I7I�VA D w�� <br /> T�UmnS CNRNC JF�7 5'dh f�✓e A/ S�.i-l�c I.J/i qYi�J 7���/3 00l'S- <br /> owrfn y.riu�oa[ss on pm v�o�w <br /> 1fN�N� 4µ�ry�}1�55 fJlv !N ry�pM <br /> ��X}XtIC�IX1fIF5iClR� YI.�MRn155 CitY )i� h1ry( <br /> _L`��:L�e •' So�lS � Me���ie..y1 C_�-- 2i3- 531- 154�{ I.lCC00.5Lo,TfM� <br /> f.fN��4COY��R]QI 4nIMINH4 CiIY )if � <br /> YXryf G11r111KfM51• ) <br /> LSCr: 'J �J I - ZCl'i <br /> VECu�mGlfpllP�C1(M1 Vul�fY%M55 ryp )R M�p1f aMffl�C[N[(• <br /> N�I4PNCrCP11P�fiQ1 4�R/.fXFf55 CIM1 lIP fMC�lf Sf/.tfIIC(NS{� <br /> COa�n�Ct IYIK[W wOn6 — <br /> HEATING SYSTEM: ❑GAS ❑ELECiRIC C� <br /> IX`C(�'PfWMIx1N1)[W�P[iQQ110FMVq'.t0 ' [plt��fMR50M�M114�fMf1p <br /> _9r�Jll��icr.� r�C�r� L -- <br /> I HEREOV CERiIFV TNAT I NAVE READ RND E%AMINEU iHIS <br /> APPLICATION AND RNOW TNE SAME 70 OE TRUE ANO COAREGT ALL <br /> i�mrroauwi�wn�mrnar. PROVISIDNS OF UWS AND OROINANCES GOVERNING THISTYPE OF <br /> WORK WI�L DE COMPLIE�WITII WH[THER SPECIflED H[REIN OR <br /> Irr,u ntscmnnor�rn rmorFnrvrnawxMtawan�necnixotpr[5� NOT. TH[ GR�NiING OF q PENMIT DOfS NO7 I��IESVMG TO GNE <br /> im. Bioa p RUiHORITV TO VIOLATE OR C�NLEL THE PPOVISION OF �NY <br /> OTHER STATE OR LOCAL lAW REGUUTING CONSTRUCTION OH TNE <br /> �ERFORMANCE OP CONSTRVGTION TIUT I AM AUTHOR12E0 OV THE <br /> OWNER OF THIS PROPERtY TO PERfORM iME WORK FOR WHICH <br /> APPLIGATION I$ MA AND I COMP�V WITN THE S1�TE <br /> ru¢n�aioMrvnr� CONT GTORSIAW 2 �CWANDY96200WAG <br /> c139r 7s oa o00o p y, <br /> cmaimicn�»�iror�i�.mFnuen[s�tttt�diEMNR[n x ���1A< <' � �/-9 <br /> +unc um — <br /> CRY BUSnRSi IIC!xc[NO <br /> PLUMBING MECNIINICRL <br /> NO. TYPE OF FlXTURE OR ITEM FEE N0. TYVE OF EOUIPME/�T FEE <br /> WRTER CLOSET(TOILET) A/p-qMNDLG UNIiS --�T— <br /> 9ATNTUO iORCED Alq SYSTEMS <br /> LAVATORV(WASH BASIN� NE4T PUMP <br /> SNOWER UNIT HCAlERS <br /> K17CHEN SINN 6 D'SP CLOTHES ORVlfiS <br /> OISHWASMER RAflGE 1/00� <br /> _ IAUNDqYTRqV WA7EFHEATER <br /> GLOTNES W/.SHER WOODSTOVE <br /> UfilNn� META�FiqEPLAGE(WOO�BURNING� <br /> �RINKING!OUNT�M FIREPLACE IIJSERT�VJp00 BURNING� <br /> FLOOR DFnIN GAS FIREPIACE <br /> ORCNFLOW PFGVENTERS GAS RANGE <br /> S�NK(SERVI�E-BAR.ETC.) GAS PIFING <br /> E%HAUST FAN <br /> �— <br /> SUBTOTAL f SUBTOTPL f <br /> PERMIT f PERMIT S <br /> 10iALFEE f TOTALiEE f _` <br />, FOR OFFICE USE ONLY: `i�1 <br /> �nroirRm�re rw�nc�tppcK Lcesne4x ry�,xpnC+yywrn r�f nvnr�No <br /> 1, Oi� - �/S <br /> oa iovr i p��ni e vr.�r�yrt FEES VI1lU�TION fEE <br /> OrEs O n�u �— <br /> P�p�xyf. <br /> IIfIC.�111N11�11(n �001`WIIIING [�j[dllOG�l - <br /> IIViI\ 1'IIMflM� <br /> _ _. _ _ . ._____�__ <br /> OC1111`�V::♦ V��.� 1%�.fI��I.NIlU1U B�SiM[kl <br /> CIIpIT .I�n 4ff:M�4N'.�1 <br /> ��FS ❑NO . _.___ ___..___. .. <br /> i�Pf::M11'AIIPPL�C nflt(IN �UUII(I4�II'I�Nf�lfC�1 <br /> nl�ll� <br /> IIPLµAPM PLO D W�[l]Y . —.-. <br /> c��ll R�I'IUMI:cililClU=t . ..— — ��� <br /> tmfncpqa rievs�nr�vvoBr GTYOFEVERETT r�.n,mwn��.a . <br /> LOCAL S�LES — " — --- — '—"- '— -- <br /> u.,E TA%COUEISJ105 roT�L <br />