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APPLICATI�1 FOR CONSTRUC�ON PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257•BB10 <br /> f� DEMOLITION f] COMBINATION Cl BUILDING ❑ MECHANICAL Cl PLUMBING ❑ SIGN <br /> PROJECT ADDRES:� � <br /> '� �S/�. El�/a7l /i/r�y Ei,s,��Tl /.�/�s. re':o� <br /> own[n uutepLv�[5s crtv Iu' Puo�iE <br /> ��tLLE�/J(L12/� ss �D.da� 3_K�2 �a6.�f'Ir —l�/.s�fV.%,a 3 <br /> 1CN 1 <br /> y�� ,v2 y�.� <br /> A11LMiiCCiORpESUMP Y�M1/.O�RE55 CIIY Ia' R�K <br /> G N[RKCp11R�C1fIR 4�LL�DpPE55/� Litv IP RWME SIARLSEME• <br /> aK�A�� .�� (A� ��8�7' �D/�t �rZZ FI�',��I' //N' �sG� <br /> 4RCN�NK4CpI1P�f,1CR 4A�1COP65 CIiY Si' MpB Si�1EIXEIRC• <br /> ftU4ff11GC0�11n.�Lf041 Y�I��ppP($i C�IY II� fYqNC $I�ICIICIN$C• <br /> COqIV�RPNCEO� _ N �i <br /> ,. NEATING SYSTEM: ❑GAS ❑ELECTRIC i] <br /> cc scr��ee wonK u+o sou.nE roota¢wrwvco cdrt.c�vcnwr�.rro vr�o�a w <br /> #t , � �F � i ' �Ct � J — <br /> /�ilR'//A F N� / /J � r P <br /> �R%��' I HEREBY CERTIFY THAT t HAVE READ AND E%AMINED THIS <br /> WI�I�'� .�%CGr�+A� /�n.�� �R(��n/F�_l qpp�ICAiION ANO KNOW THE SAME TO�E TRUE AND CORRECT.ALL <br /> n��a�os[ousc o� uaDuu � pqpyISIONS OF LAWS AND Ofl01NANCES GOVEPNING iHIS TVPE OF <br /> S � WOFK Wlll DE C01.1PLIED WITH WNETMER SPECIFIED HEFEIN OR <br /> ¢:.�ocscnnr�orvavnovcnrviswr+ieciowa+•i*.c�*mcor�cs� NOi. TME GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE <br /> ior �� a AUTNOPITY TO VIOLATE OR CANCEL THE PROVISION OF ANY . <br /> OTHEF fTATE OR LOCAL lAW REGULATING CONSiRUCTION OR THE <br /> PEFFCf1.lANCE OF CONSTRUCTION.THAT I AM AUiHORIZEO OV TME <br /> OWNER �F 7M15 PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICA710N IS I.IADE AND I COUPLY WITH THE STATE <br /> r�nCu iM i U ruueEa CONTRACTORS LAY!18 27 RCYi.`NO 2Gfi9tN1 W4C. <br /> *CO�S1PVCtqNIWNlF1IXP.MMC55.iElCAqNEM1uBEN ����//NCf'� nf v�'//`� / <br /> 5 �1unE � ��IE <br /> CIIY BV5��IESS l�C(NA 1q <br /> PLUMBING MELHANICAL <br /> NO. iVPE OF FI%TURE ON ITEIA FEE NO. TYPE OF EOUIVMENT FEE <br /> YfATER LLOSET ITOILE7) A C—A H�DLG UtilTS <br /> BATNTUB � FORCEDAIRSYSTEIAS <br /> IAVATORV IWASH BASIN� HEAT PUIdP <br /> SH0IYER � UNITHEATERS <br /> KITCNEN SINN 8 DISP CLOTH[S DRYERS <br /> DISNYlASHEP PANGE MOOD <br /> UUNDRY TRAY Y�ATER HEATER <br /> CLOTHES WASHER wOOD STOVE <br /> I URINAL �dETALfIREPlACE1WOODBURNINGI <br /> DRINKING FOUNTAIN FIREPLACE INSERT ILVOOD OURNING) <br /> FLOOR ORAIN GAS FIREPLACE <br /> BACKFL01'1PREVENiER$ GASRANGE <br /> SINK ISERVICE—EAR.EiC.I GAS PIPING <br /> � E%HAUSTFAN <br /> SUBTOTAL 5 SUBTOTAL S _ <br /> PERMIT 5 PERMIT S <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> lPJNiS[�B�.CR �FARbEl9/LR Si0L5EtB�CI PUMCMFCKNU48[N ffE PCCEWiIq <br /> u�crax toru+c• v¢.rvrsnc FEES VALUATION FEE <br /> nr[s nrro �qp�� � <br /> .,c�.:�ni�u�r..arv worowcuwc mzcaeiocii <br /> ur otweo+c <br /> urur_r rnns+:acs occuvurtww a•ssucHr uccnu�cu � <br /> „ 9cv <br /> nvcs n ra <br /> �..:�:onn,ucnncoo ausai .00rtiwuci.wc�ccK <br /> OIMFM <br /> r��.t�UPYPE00 �SOM <br /> Si�iE W0.Dvq SUPCN�PGE <br /> �,veurcansr wHs�cvuovcoer pT�OfEVEREI"f weicwau�s <br /> LOCALSALES <br /> o•,E TAX COOE IS 0105 TO7AL _ <br />