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APPLICATI� FOR CONSTRUC�ON PERMIT <br /> CfTV OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8810 <br /> O OEMOLITION ❑ COMBINATON ❑ BUILqNfi ❑ MECHANICAL �Q( VLUMlMO ❑ SpN <br /> PROJECT ADDRESS: /DS�S E��K�,lC��7 G/N�Y <br /> �(,(J/4�I"tC ��C /OfIS (�/fllSNrt�aC�/IFS' SY'UIFeTT `fk20i <br /> �� i�ooncss nn rp r�c <br /> TENYIT 4M14%Wf55 CIiV pp p�pqF <br /> IiRO�T[LTd10[y[iNfM 4N�WnE55 Ci1Y )in rK1Nf <br /> �A �Fe'nY Car.r: /7/� /[Y1�L s � GJv���7,- wa .33�-�if <br /> OEMfPµCONiP�f,tOP Mu�MME55 OIY !if p�qY[ SqRIKfMSi• <br /> EECNWCIICWIP1CtU11 441�OD�f55 f.�lY Irt' M�ONf SL� <br /> F lCENSE• <br /> 2�14m P�uMo�� s�x,g`�',�o�lC ��vu�.- u,w�fza� ?4P-8f4� /I�,//Pla1ElEozzco <br /> %Uy/qCOM1NqlCP 4�Y�dYY55 Cliv li� YHONF 511ffICEFSF• <br /> cwra.c�omce wau MEATING SVSTEM: ❑GAS G ELECTRIC ❑ <br /> CESCMi W.KM�no SOU�<r�OO��GF MvolKo cpvr�cr rtNSM�Nf�rMrrt vp <br /> HST/iCC .OAT/� nd <br /> „�Kl��/Ci.��FatinY iin , <br /> I HEflEBY CERTIFv TNAT I HAVE READ AND E%AMINEU THiS <br /> APP�ICAiION AND NNOW TNE SAME TO BE TppE I1ND CORRECT ALL <br /> rnolos[ous[a ennMNn PPOVISIONS OF LAWS AND OPDINANCES GOVERN�NG THIS TYPE OF <br /> /L C u-Q G WORI( Wil L BE COMPLIEO WITH WNETHER SPECIFIED NEREIN OR <br /> tFMuo[umvnp�aroaq�nrvisrnvmx�owon�*��cN*wo[oriEsi NpT. 7NE ORANTING OF � PERMIT ppES NOT PRESUME TO GIVE <br /> im e�oc. or �UTMORITY TO VIOLATE OR C�NCEL TME PROVISION OF �NY <br /> OTHER STATE OR LOC�L L�W REGUUT�N6 CONSTRUCTIpH OR THE <br /> PERFOR4ANCE OF CONSTPULTION.TM�T 1 MI AUT/qNqEO BY TIIE <br /> OWNER OF THIS PROPERTY TO PERFORM TME WORK FON WHICH <br /> APPLILATION IS MFUE AND I COMPLY WITH TME ST�TE <br /> nwcEl�u i D mre[n XONTR���RGW�NQ 2%100 WI1C <br /> / <br /> Ld511ry1CIqM10Y11FM1FR.M[MIE55 t(lEA1MhMUMBEn �'�i /o-� -9�" <br /> s,cnem�[ n•rt <br /> OTY M1yME55lIC(MSC YO <br /> M.IMIMIKI MECXIINICAL <br /> NO. TYPEOFFlIfTUREORITEM FEE NO. 7YrEOFEOUDMENT FEE <br /> WATER CLOSET(TOILET) /yC—MINOL6 UNITS <br /> &�THTUB FORCED�IP SVSTEMS <br /> I LAVATORY(WRSN B�SIN) MEAT PUMP <br /> SMOWEfl UNIT HEATERS <br /> KITCHEN SINN 8 DISP CIOTHES URYERS <br /> DISHW�SNER RANGE HO00 <br /> UUNDRY TR�V WATER HEATER <br /> CLOTXES W�SHEH WOCO STOVE <br /> UHINM. METAL FIREPLACE(WOOD Bl1RNING) <br /> DRINKING FOVNTAIN FIFEPLACE INSERT�WO00 BURNING) <br /> PLOOR DAA�N GAS FIaEPLACE <br /> B�CI(F�OW PREVENTERS GAS RANGE <br /> SINK(SERVICE—B�R.ETC.� GAS PIPING <br /> E%HAUSTFAN �_ <br /> SUBTOTAL f SUBTOT�L f <br /> PFRMIT S PERMIT t <br /> TOTALFEE S TOTALFEE f <br /> FOR OFFICE USE ONLY: � <br /> {M1NiiFTP�f.R PfM5i1l�CM $IOFSFtMCR 1'{�N�IiELRNUMXiP fff PFff���NO <br /> usErour im�nH v�t�u�s�E fEES VAIWtlON FEE <br /> OreS O� —� <br /> PV�MNf. <br /> KIGN�PYi��liO4 40IXOWFWMG SIZEWNa�I —' � <br /> rvix rurunrvc <br /> ___ " '___ _ .__'_""_y_— <br /> p���ti�Y KI N�I��41) LYI'li�'�NI IU�D B.�SFYE\I V{I'N�Mf�I <br /> OvfS ❑MO ' � � � <br /> iIXESPNn�4EHPC0'0 nL�V(Y: �Op1ip4�iM1I.tiQVCR <br /> UI�pP <br /> iIRENAP4PL0'� Pf�c�Y --- <br /> c��if q11�IU�N1:511(K���11(:f <br /> �rarorrw+�+ r�nrs�nnapvroer CRYOFEVERETT n�eiir.wrx�xc "-'�— --- -- <br /> LOCALSALES -- — —� — <br /> u.�t TA%CODEISJ105 TOUL <br />