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4PPLICAYI� FOR CONSTRUC�N PERMI� <br /> CITY OF EVERETT•BUILDING DIVISIOY � <br /> 3200 CEDAR STREET•EV�REi7,WA 98201 •(425)257-BB10 <br /> ❑ DEMOLITION ❑ /COMBINATION �' BUIL�ING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS:_�p�.N S�FF�sc,� F�/�/� wa qg�3 <br /> Sr�' '�, n�q� �e�r.n�. �. LcP<i 228 �0�1 AJ�- S�t/c/f EUt.2 tX 9570 <br /> 1� 8 y2sS/327yT <br /> ON+Tn 4u�ilCQF .�fv bv <br /> vJN[ <br /> 1[H�NI Y41 Y1p11(55 (IfY )IV p�ql�{ <br /> �T.Ix1fC101^1MyG�11�� u��1�OM1f5S f,�tv /rn I'NMf <br /> �l_� <br /> GINLI11lCOHffYC�C�1 4YIMMifSS Ci11 l�f I <br /> �rHl�( C1111 1�CfHSi• <br /> 4FCI��NIC�I<O41n1f,l4P y��l�Ip�F$$ flry )it' Nqnf i��liIICFNt[� <br /> n�vuBmGCONlulqOl� 4ul�qMF55 C�n _ In. —__.. �.�y..t � Sl�lfl�[tbtf• <br /> CUNt�1C�1'InCf OfW(N�R __ <br /> � /S.�JO /� -,—Q(� HEATING SYSTEM: ❑GAS ❑ELECTRIC O <br /> trtscnmv wonv�vo sMi�nr roarmt rvvano/ «rno nr nsrn.r�o��.ovr.�o <br /> (_0�5�/ror_�� /ab0 5/' (rui� G Jok�- LaPee�_ 42SSUS 2$7/ <br /> I HERE�Y CERiIfY TNAT I MAVE READ FND E%AMINEU TMIS <br /> vnanosfovgE rn punpy. -- pPP�ICATION AND HNOW TNE SAME 10 DE TRUE AND CORREGi qLL <br /> �ROViS10NS UF�pWS AND OROiNANCES GOVERNING THiS TVPE OF <br /> r> ��q� WORN WiIL �E COMPLIEp W�iN WHEiHER SPECFIED M[RE�N OR <br /> imuo[Srnmnor1—fe ��nni5rawnnnowa+•n�c�nvotonts NOi. TIIE GRaNiiNG OF A o�qMrt DOES NO� PqFSUME i0 GrvE <br /> �p,21�Jo,3��3zfl`«R ZI pr � GH ✓ � AUTMORITV TO VIOLATE C:7 CRNCEI TNE PROVISION pF ANY <br /> A O OTIIER SiA7E OR LOCaL LAW PEGUUTING CONSiRUCTION OR TNE <br /> L�✓• O PERFOBMAtiGE Of GONSiRVCiION TNqT 1 AM PUTHORI2ED OV iHE <br /> OWNER OP THIS PROPERiV TU PERFORM TME WOFK FOR WHICN <br /> ,S'�i� OZ� �]Q Z �6 APPIICAilO`! IS MADE 4N0 I GOMPLY WITH THE $i/TE <br /> PeMft uvO mmPtn �� CONLRRCTORS lAW IP2/l'�RCW AND 296200 WA(; <br /> CpISfPI��O1N1��^�t[55I[l(M1IOYFNVVPFII ��� � //�Z7_/ 8 <br /> x <br /> — `-T� uur <br /> f,i1�flUSIM[[.11[1��'1...i <br /> PLUMBING MECNANIC0.L -- <br /> _NO. TYPE OF FI%TUHE OR REM FEE NO. TYPE OF EOUIPMEHT FEE <br /> WRTER CLOSET(TOILET� lVC--A/HNDLG UNIIS <br /> BATHiUO fOPCED AIR SYSTEAIS <br /> LAVr1TORY(WASH BASIN) MEAi FUMP <br /> SMOWER UNIT HEATERS <br /> NITCNEN SINK d DISP CIOTHES�RYERS <br /> DISHWASHER R�NGE HOOD <br /> L�UNpRY TRAY R'AIER HEATER <br /> CLOTHES WASMER WOOD SiOVE r <br /> URINRL METAL FlREP:ACE ryV000 BURNING) <br /> DRINNiNG FOUNTAIN FIR[PLACE INSERT ryJ00D BUFNING� <br /> FLOOR ORRIN GAS FlPEPIAGE <br /> OACNFL0IV PPEVENTERS GAS RANGE � <br /> SINK�SERVICE-BRR.ETC� GAS PIPING —T <br /> E%HAUSiFAN <br /> _1_ <br /> ___ $UD 70Tp� f SUB TOiAL f <br /> PERMIT S PERMIT 5 <br /> TOTAI FEE 5 iOTA�FEE f <br /> FOR OFFICE USE ONLY: <br /> �:+�u��.r.wr, nr.nsnsy siusnn•cR ruwrn��.e��nrn r�r nrrrmrao <br /> L° 5 (j�U 3 /� <br /> " ' ��W � � imurtn vq�n�sn[ __ FEE VAIUAiION FEE __ <br /> � 7 C ❑YFS NO RVi[.iW. 1 OO �����)O <br /> ��11:�1�1'Vi�11ic1Y N01[Ytt��flliWl. cilkIXPlW'�I [ �� � <br /> � � � �i�0_S`._ I'I�.VflM1r'� .. ._ _ _ . _ _ <br /> �n.�.;m.�-.. w.,.�.wn cx�i�iaw�io.n m.wi..� _—_ _'___ __ <br /> 1 1.`_1. �/ 411����N'4 <br /> 1��1� <br /> � �__ ❑�f[ �ry/] � <br /> �:"t',+N•al[NN[q'0 nHv�`n - ��p�ttnu hNORf� <br /> _ O��4n <br /> fi�(�UPNPlQ�O flf��f1V _ <br /> c�nrxiniawns:innuncr 4 j`�� <br /> ,r��rcaicr rinxs�rm�v�nm� ,.c - ' '- <br /> ��. CITYOFEVERETT Mair.wrv <br /> ^�y- LOLALSALES <br /> 1 J�. '/J . .__1��.�� ���/� TAX COUE IS J105 ioTal �� - I --� � � ' <br /> — -_- _ -_ __-__ '.- —_.-�----•�.. <br />