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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITV OF EVERETT•BUILDING UIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMB/�INATION ❑ BUILDING ❑ MECNANICAL ❑ pLUMBING ❑ SION <br /> PpO�IECT ADD ESS: �r.�� _��/P,ry7� �� <br /> �� .�J�E.�;�,,,�/1/'�' /� �n���_h'�/'_«������Sf1�33�9 <br /> /�/}� f//'N �43S11—rm `���_�2(J �, 0 �3�b / <br /> I(NAM� 4MYNM1f55 fJ1Y /II` ry�ry( <br /> �IICI��IGIMpfSqM� YYI.VMri(55 G�Y j11. .. ryqyE <br /> ��r --- - - <br /> ��n�icoH�n.cim u�n�an[ss —cn.— jn• ' nKxn: �i+�nKCHs[. <br /> u[CN�uSqCp1�0�ClOn 441�qM1[55 Orv !M` - 19qNf S�MEVCFNS[• <br /> ROYlNGCp110i1GIW YMIJIIYIf55 I�IY---jp� -�- - Plqry[ S�MEIK[NX• <br /> cw�rvc�rncEa�n� ,�� � —'-_ <br /> IIEATING SYSTEM: ❑GAS U ELECTRIC ❑ <br /> �ocscrHe��l.i '�/G�uo[m�oiv[���� n, /'� cc��rc�ni.wn�unrinrwuo <br /> ` � I �S L� �M4 � <br /> � <br /> C � " r` `y <br /> .� I IIEi1EDY CERTIFY 1N�T 1 1111VE REA� AND E%AMINEO TIIIS <br /> fvpllCAiION AND IfNOW THE S�ME i0 BE TRUE AND CORRECT A�� <br /> n�doSfDUSE a mniuNa PIIOVI51C1NS OF lAWS AND OROIN�NCES GOVERNING 7HI5 TYPE OF <br /> V�OI1N WILL OE COMPLIED WITH WHETHER SPECIFIED NEREIN OR <br /> l[G41tE5CNnIpqplTpSOM1�9qMIpC10wp1MIKp�MOCptES� NOT 7HE OtlANTING OF A PERMIT ppES NOT PRESUME TO CIVE <br /> iot ua:K or AUTIIOIIIIY TO VIOL�TE OR CANCEL TME PROVI510N OF ANY <br /> 0T11ER S��tE OR LOCAL LAW{iEGULAT�Nu CONSiRUCTION OR THE <br /> PEIIFORMANLE OF CONSTRUCTION.TN�T I AM AUIMORIZEO BY TME <br /> �} OWNEII OF 7MI5 PROPERiY TO PERFORM iH[ WORN FOR WH:C11 <br /> �C L�I �-��V/ � �PPLIC�iION IS M�DE �ND 1 COMPLY WITH TNE STATE <br /> wncEuuiourve[n CONTMCT f15l�WIB27RCWAN0296P00W�C. <br /> 9 /�/ (�+ <br /> cws�mic��io�rvurnxn.�wnEss.in�nar�c.1wnEn '� /121J`'7 , �/�—/ � <br /> �� - OAIE <br /> CIIY MISIMf SS ICENS(MI <br /> PLUMBIN6 MECIIIINICIIL <br /> NO. TYPE OF FI%IURE Op 17EM FEE NO. 1YVE OF EWIPMENT FEE <br /> � WA1ERCtOSET �OILET —i— <br /> ( 1 ' NC-MINOLOUNITS <br /> / flA7H1U0 ' fOfiCEUAIRSYSIEMS <br /> IAVATOf1V�WASIIOASIN� � IIBATPUMP <br /> 51pWEf1 UNI�IIEAlERS <br /> NIiC11EN SINK 8 OISP CLOTIIES DRYEf15 <br /> D1511 WASIIEN �MNGE IIOpD <br /> UUNOf1Y TRAY WAIEI711GIE0 <br /> CLOIIIES W�SIIEfI W(q�)$�py[ <br /> UOINnL }_ MEIALfIf7GPUCE�WO000UBNING) <br /> ORVINRIG fOUN7AIN fIf1EP1ACE RISGflT pY00�OUIINING) <br /> fLOOfI Ofinlll GAS fINEPLACE <br /> OncY,FLOW PnEVENTERS ' C✓SMNGE <br /> SINN�SEt1wCE-OAl1,ETCJ —�— GA51'IPINC <br /> � E%IIAUST FAN <br /> $U0707A1 S � SUBTOTAL S <br /> PERMIT S PERMIT S <br /> 70TAlfEE S 70TALFEE S <br /> FOR OFFICE USE ONLY: .y�. ,� <br /> flqNlifIRKN 11(/.IISiI11�CM $qFSFISKM 11�Nt.1(fRM f� - f[�� S Mf.fMIW <br /> 'f/� � <br /> � '" J % <br /> uscto.r 7 1 �oi�m� ��x�yq � FEES VAlVA710N FEE <br /> �`' ! ��� ❑.rs af�c� an�wn � �7t� <br /> I�FIC1111IM1��1pN�� 1�'pIM(4l�'q StFpMOMI �- � <br /> � ���1 � sF nu�nMn ---- - a �o;� <br /> UCCV1'�NC� NJryS�MIf IXCU'�NIIU�U q�gqM� <br /> f.�O1T � O.ft � 4(Il1�Mf4 � <br /> 1 � _ /�i <br /> 1�1�'.iML11111[UO �f�iON �W�IRIN�IHM1CIhfN � " � <br /> ���.w <br /> O��Hn <br /> 111�IA1A1�411[00 �1f��fYl <br /> SI�IIIIIAIM111VVY.IOIN{[ t/� 1 <br /> �, <br /> IY1'f W f,QNfl Ih.�NS��'MqVff10Y <br /> CITYOfEVERETT nimrvan.s <br /> LOCALSALES ---- - -�— <br /> _�-/J ��+�E3�Z7 5-� raxcooeisaias ror�� ,�/�� ;��; <br />