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� <br /> APPLICATIO► _ FOR CONSTRUCTI .N PERMIT� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION � COMBINATION � BUILDINO fl MECHANICAL ❑ PLUMBING ❑ SIfiN <br /> PROJECT ADDRESS: �I�� C N�N01)� 1���_._ <br /> ovmen M•a�ouness � un --i�r riroNe <br /> ,fj��tc EVEkS�o�J �311 //z'�zt su ��(� �UFFEIT �S��oY--- ���/^ 2`l� • i091 _ <br /> 7ENANT MMl�0f1f1055 CIIY 71P PUONE <br /> �aaC CuE¢sa�J ?30 ���''��._�CL F_vEr�n --?s�ny ----zc(z 3y� io91 <br /> •ncw.tcronoesroNrn u.nuwnEss cin in• r��or+e <br /> Llril(,N IN�yL �.1N' PL N6 �gp�i�CL___ %-�:[��l ___LDlt�1'� <br /> 6[NEO�ICONIfULilNi MepMN�I1L55 f.ilY JiP Pil(lNf $IM[IICFNSE� <br /> ��11,lTNMES �/l�P YS�'r /SN�AVf /1.'t �ElYnd•JJ _�i'��5�..._.__ Zrh'a FLi�rGtl Pot�crH� 1IVN� <br /> .IEC1111NIC�l ONIN�CIIXI M�II AfNN1E55 CIfY !��' P110Nf SGIE UCENSE/ <br /> I � E�7J�JG, Z�U� �zISrS( SW LyN,vw +� ._J.�D��_. . _l•�'l1�LU!• ��30 /�nP/LFll3�l�U _ <br /> PW48M16CONIP�f,lIX1 NMlNN111E55 ���Y 71�' PIIUNE $IATEUCENSE• <br /> 0� FPest .�Stld C�vmwt�� /Y�D�P� _2�':�.��_._3(�D__� -�.`��`���vtaFP�S�GS _ <br /> CONTRIICT PNtCE OL WOPM � �_�� IIEATING SVSTEM: �'GAS ❑ ELECTRIC D <br /> ����1 L�f.� <br /> OESCRISE MA11N�NO SW��E iDOUOE INVOIVED C(M11ACI Pf I15011 ANp Pl1011f NO <br /> .�f�Ik.�GL Y � ? f2 � `�/.rN �EL'_�1�����e[<� <br /> 7 S-Es �� � GJ'�.c1�<�£ • -- <br /> 1 HEREOY CERTIFY THAT I HAVE READ AND EI(AMINED THIS <br /> APPIICATIDN AND KNOW THE SI1ME TO BE TRUE ANO CORRECT ALL <br /> raovoseo use a euiu�+a PqOVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TVPE UF <br /> �lN(iI! F�m�t.. 2t� � WORK WILL OE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ita���ariroren Is��+aeirn+ en�cNrwoco ies� NOT. THE OIIANTIN6 OF A PERMIT DOES NOT PRESUME TO OIVE <br /> �oT aiaK a AUTIIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> � OTIIEf1 SiATE OR LOCAL LAW RE6UI.ATINO CUNSTRUC?ION OR THE <br /> /� PERPOHMANCE OF CONSTRUCTION.TNAT I AM AUTHORIZED BV THE <br /> G OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> 6IS �D/)D/) gC/� APPLICATIOIJ IS MADE AND I COMPLY WITH THE 6TATE <br /> U CONTRAC10R5 L 18.27 RCW AND 288200 WAC. <br /> PMCEI T/J!I.D.NUMBER <br /> CANS/RVLTd/IO/WLENOER.�0011E54.TE1EM10NENUMRER X �I //��/�� I <br /> 9ON�1 OE�I /fn' '��n n^� D�TE . <br /> II�l <br /> CIIY OIISINf:551 N:FNSC NO '� <br /> PLUUSIN� MECIUNICAL I <br /> NO. TYPE OF FlIfTURE OR ItEM FEE NO. TYPE OF EOUIPMENT F�_ <br /> WATER CLOSET(TOILET) � NC-M1NDL0 UNITS _;_ I <br /> BATHTUB ' ^ FOf10ED AIR SYSTEMS ' I <br /> �- —;._ <br /> �j" UVATOHY(WASH BASW) i HEAT PUMP _ ' I <br /> / SHOWER � -- UNIT IIEATERS _ ' <br /> / KITCHEN SINK 6 DISP i CI.OTHES D(iVERS _�_ I <br /> I DISHWASHEH -�— � �A�NGE HOOD ' I <br /> WATER IIEATER � <br /> LAUNDRY iRAV i _L___ — I. <br /> CLOTHES WASHER —� -- WOOf�S10VE '_ I <br /> „�, � �,�N�� _ MEIALfIREPLACEpNOODBURNING) _`___ , <br /> - DRINNINOFOUNTAIN �i -- FIRf:PLACEINSGRTNVOODBUPNINO) ��_ I <br />� -�- - -�— GAL�IREPI.ACC ' ' <br />� - FLOOR DRAIN _./__ _ _ , <br /> BACKFLOW PREVENTERS � ^ GAS�aANG[ _ � <br /> SINK�SERVICE-BAH,ETQ) ---�— '}f�_ _GASPIF�NI : _ <br /> _�__:_�- r%HAUSf F/.N +_ <br />� � <br /> i <br /> ---•-1 -- -- � <br /> �— _ __ ' <br /> _ __ _- <br /> T <br /> T I <br /> 1� <br /> SUBTOTAL S 1 SUBTOTAL S <br /> —'��—�— PERMIT S � <br /> PERMIT f � __ --- �-- <br /> TOTALFEE f '- TOTALFEE f ' <br /> FOR OFFICE USE ONLY: <br /> LRONTSEiP�Ctl / PF.�115F10� � � smes r.K rie���u��a(m�i,- rf (� J �FCfIPINO <br /> � � �� - ---_� --- f� ' l -- <br /> � - - <br /> uSETONE iotene� ^ vec�N�sn[ _ FEES _ VALUATIDN FEE <br /> .is ❑YES ❑ H(I plllllllllb '" "-- -'--— 1��� _� ( ' <br /> ___'__ L <br /> 11E�4���UMIT�IION NO Of UwCLlINO 51lF.O�BIUG/11 � <br /> , � IINIf$ ` p�p1,1�11N1i � <br /> r.1 O $iL _.._..--------------�— --- -- - k�,{--- <br /> i <br /> OCGtIPANCY 1qMSINtl[f IX:CUP�NIIWU lf�SEMF.N1 � � Mff]uNIf.N � <br /> 6Nf10UP I ❑YCS �NO __-_ ____.. ..______-_ __ __ I I �� I <br /> F/ V� ` —.—. �IIDIIIIIN�IPI�qC111(M —__ // ;� <br /> FIRESPIIiNKLERREO'� ���Sa� - - —�`-� <br /> _—__" "___.'_'"__—_ - ' <br /> i <br /> o�inn <br /> ----- t-- <br /> fiRE AIAPM REO'U �f�FqN --� �/,/� <br /> SiNC0111111IH(i91111:I�M1fiE '—_ _'� ��� <br /> ___-_ �� _� _ <br /> �rneorr.or+s� rinNSerrrwvFnm CIIYOFEVERETT � <br /> ,�um¢wonxs �-'--- <br /> LOCALSALES --�---�-------�-- - �-- �-----/-/- <br /> ---- _ <br /> ��� u.�F�lf'/97_ TAR CODE IS�105 70TRL _ _. _ ---_-.f`_[�-- -�-7'-,`. <br /> / - ------ --� _ _ .- - - <br />