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APPLICATI(� FOR CONSTRUCTAN PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 �257-8810 <br /> ❑ DEMOUTION ;5 COMBINATION il BUILDING ❑ MECHANICAL fl PLU�ABING ❑ SIGN <br /> ��PROJECT ADDRESS <br /> ���0 CvnerS�.� �� Cvcic�-��- 1.,,� �8 ?0� <br /> OwNEn uuteDpn[Ss Prv IW 1Y�ox[ <br /> �'1 ��.CCfC�� f3 �Z4 �'•hrn-�� C/UC�I- L.iM� 9`d2��; y�.� ��?C.Q` 9.j� � <br /> iENellt N9L�WPE55 C�iY IiP Mlqi� <br /> ♦PlHif[CiO�C(SIGNCII 1AAitA00RC55 GIIY ZW RpN[ <br /> ��C1 ����/�t����l <br /> c.crienucorviwcion uu�nooa¢ss crtr z�n nqre sr�re�kcrrsc. <br /> I.ILCr�ANiCAICONiR/.CiIXI YA1�Apq1E5i LIiY $IP p11WlE $IA1[lICL115[• <br /> 1'1U1.1111NGCWI11i�CfOP MAIL�ODRE55 GIIY ZIP {`IIONE $iAi[II��NSC• <br /> COryp�A.;i PPqE OF WOPR <br /> HEATING SYSTEM: ❑GAS f-1 ELECTRIC� <br /> DESCFiOEWORMN1050U�FEiCO1AGE1HY0.YFD COt �LL�CR 1µ01Y1q�51q <br /> c.dd c� �. M X 2Y rl �c ol. O^2 � <br /> �,-,�t u, +�i.� ., Sa f� _ �3c�, <br /> �1N� I NFREDV CERTIFY THAT I HAVE READ AND E%AMWED THIS <br /> APPLICATION AND KNOV�TNE SAh1E TO OE TRUE AND COPRECT.ALL <br /> rnnrosm usE a ewiortm pROV1510N5 OF LAY�S AND ORDINANCES GOVERNING TMIS TVPE OF <br /> WOPK WILL DE COMPLIED WITN WHETHEfl SPEQFIED MEREIN OR <br /> i���,+iocscnwrweornaorcnrvis�awnoaaxrn�n.cNiwocorics� NOT. THE GRANTIHG OF A PER�d1T DOES NOT PR[SUh1E TO GIVE <br /> io* I 3 p�p�K pr AUTHORITY TO VIOLATE OR CANCEL TNE PROVISION OF ANV <br /> 7 OTHER STATE OR LOCAL lAW REGULATING WNSTRUCTION OR THE <br /> c�n«4�h .�+ v f�p.,l�a� I P��G rt4 pf c��� {o � PERFOR1dANCE OF CONSTRUCTION.THAT I Ah1 AUTHORR[D DV THE <br /> p � 01NNER OF THIS PROPERTV TO PERFORM THE WORN FOR WMICM <br /> �)I�I' 1�.J C CI ('f4��4� ,q�/��.,�,�, �of q�� (W �:� APPLICAT!ON IS h7ADE AND I C061PLY WITN THE SiATE <br /> nuL^[�LxiouuuBEn n�,N `4 (�.�h/ CONT�TORSLAW18.27RCWAND296240WAC. <br /> ti� --���� < <,�� s U�S�.,M en �� G —7 , <br /> coasmua�or�io.�+iumcn..00ncss.rzicarwrrcrNuotA x / �Q/�u�l r ��� l � <br /> siov�mne p�i� <br /> �nn ousw�ss uccnsc iro <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF FI%TUflE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> / WATERCLOSET�TOILET� AC—ANNDLGUNITS <br /> BATHTUB FORLED AIR SYSTEIdS <br /> LAVATORY�WASH BASIN� HLAT PUIdP <br /> SHOWER i UNITNEATERS <br /> NITCHEN SINK 6 DISP CLOTHES DRYEPS <br /> DISHK'ASHER RANGE MOO� <br /> LAl1NDRY TRAV 1YATEfl HEATER <br /> CLOTMES IVASHER l5'OOD STOVE <br /> URINAL ! IJ' SALFIREPLACE�WOODBURNING) <br /> DRIIJKING FOUNTAIN FIH[PLACE INSERT(1YOOD OURNING) <br /> FLOOR DRAIN GAS flliEPLACE <br /> 9ACKFLOW PflEVENTERS GAS RANGE <br /> SMK�SERVILE—�AR.ETC.) GAS PIPING <br /> E%HAUSTFAN <br /> i <br /> SUB TOTAL 5 5'JP fOTAL 5 <br /> PERMIT S PERhtIT S <br /> TOTALFEE 5 TOTALFEE 5 /�` <br /> FOR OFFICE USE ONLY: — O/O'7- 3 <br /> fPCW 5[lp>CN / HE�PS[iOACN / SIpE5E19ACR / PU MICMNNIBCP fCE FECCIPiNJ <br /> � 20 ,, a o�-oa S l . � <br /> us�-�+rQ / Lot�aEe trtantvt[ FEES VALUATION iEE <br /> ❑vcs n��o emm�m: a O <br /> ��.a„rrr..u��i�� rworowuurN c�•coro�oan <br /> uxrts 336 f.F. Pwuon+c <br /> Gc� � <br /> -� •.�c�ct.-,[? oCGuruuioeu ws[�+crvt <br /> ��Pu. " I NCCN�NKAL <br /> :3 ;�Es � s <br /> r.cuo,i�•.vcnr.coo ee�son — wourorvuvi.wcu[cn i <br /> 011�ER <br /> 4ii�LetPP1AP[OD 11E�SON <br /> Si�IE BULLORq SUPCIIYiGE <br /> nrt o�cosr rues�rrnovm m CITY OF EVERETT >uoi�c�w��r.s <br /> LOCALSALES <br /> �'N o+rz TA%CODEIS3105 707AL I <br />