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APPLICATIO�FOR CONSTRUCTI�1 PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98207•257•8810 <br /> ❑ DEMOLITION ❑ COMBINATION �,BUILDINO O MECNANICAL ❑ PLUMBING O SIGN <br /> PROJECT ADDRESS <br /> S5� L- Mc.C�,l} QJt, <br /> owrven uu�woness 1�`/ NE 541PpJ' un :n narE 1 YYIe <br /> ' — ' ""',` }^--,_„—y�--� �;���ay�+�* '�1 <br /> T[NANi Ny�ppp[SS CIfY IV qpryp 1,// I,` <br /> �Y�%� YC���r <br /> •RLNIIECIOf1pE51]4CP MAR�COPES$ GiY $p p��E <br /> GCN[RKCp11ffl.�Lipq MAlt�pppE55 CIIY ZV q1plE 6i�iElILEME• <br /> S7'.:��AJ Ca�SY1:�Trni.:cJ,lr STuNAC.1oZZF.s <br /> NECIILNiCe��pN1MLL011 NMepp0E55 C�fv Sv pql{ SUiElKENSE• <br /> PIUMBRqCAN1P41p11 M�VIA�OPE55 GIY 2V PIq1( Sl�1ElCENSE• <br /> CQ4INALiPPILEO�WIXII( <br /> _ HEATING SYSTEM: �GAS ❑ELECTRIC ❑ <br /> ocsciuoe wonK uro sou.nc roornce nnavco coxr.cr rrnsw�uro w�or�w <br /> �-�co ;{- s'Fp � <br /> >oYal <br /> . 1 HEREDY CERTIFY THAT I HAVE READ AND E%AMINED TNIS <br /> —� �PPLICAiION AND FN04\'THE SAME TO BE TRUE AND CORRECT.ALL <br /> veoroscouse a eur.unc PROVISIONS OF UWS AND OROINANCES 60VERNINO TMIS NPE Of <br /> S ��'� WORN WIIL BE COMPLIED WITH WHETHER SPECIFIED HENEIN Oq <br /> lEO0.�E5CPW1qNWPP01'ER1Y15110WNlElOV/0111III.M1IMpCOPIES� NOT. THE GRANTING OF A PEPMIT DOES NOT PRESUAIE TO GIV[ <br /> io� 3 _piaR a S -O AUTHOflITV TO VIOLATE OR CANGEL T1E PROVISION OF ANV <br /> OTHER STATE OR LOCAL UW REGULATING CONSTRUCTON OR 1NE <br /> PEPFORMANGE OF CONSTRUCTION.THAT I AM AUiHORIZED BV 7HE <br /> OWNER OF TMIS PROPERTV TO PERFORM THE WORN FOR WHICN <br /> APPLICATION IS AIAOE AND I COMPLY WITH THE STATE <br /> nenc[usRi r�uuoEn �, CANTRACTORSlAW7B. 7HCWAND2%200WRC. <br /> � n (10r Lt�r !"(>O ' <br /> CONSIUUCiIONl0.WlENOLP,�DDRF.55.1E1[RqI1EMJMBFII X � _ Zl � � <br /> �. �(i. �» '\/��L 5. NRE O�IE <br /> CI�YBUSY4 tICEMSEIp <br /> PLUMBINC MECM�NICQ <br /> NO. TVPE OF FI%TUflE Ofl ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> 2 WATERCLOSET�TOILET) �' NC—ATINDLOUNRS <br /> 2 BALHTUB ' � I FOpCEDAIRSV51EM5 <br /> LAVATORY(WASH BASIN) /// HEAT WMP <br /> SHOWER i UNITHEATERS <br /> I KIiCHEN SINK S UISP j CLOTHES DRVERS <br /> �ISNWASHER I RANGEH000 <br /> LAUNDRYTRAY � WATERHEATER <br /> ! CLOTMES WASHER WOOD STOVE { <br /> URINAI � METALFIREPLACE(WOOD6URNING� j <br /> DRINKING FOUHTAIN ! FIRE%ACE INSERT(WOOD OURNING) <br /> FLOOR DRAIN pA5 FIREPLACE <br /> BACKFLOW PREVENTERS ! QAS RANGE <br /> SINK�SERVICE—DAR,ETC.� OASPIPINQ /// —�— <br /> � � E%HAUSTFAN � <br /> i <br /> i i <br /> SUBTOTAL S I SUBTOTAI f <br /> PERMIT E i pERMIi f ��i <br /> TOTALFEE f d TOTALFEE f <br /> FOR OFFICE USE ONLY: � <br /> iPd�i5416�'C�z/� nE�N5EqIB�CR LO[SCIBeLN AANO�[ryCKyI�NUBER iFE IrtCEiCTMp <br /> `�_ LO � C.WD _D �J�3. (�C <br /> us[zor�c io�ence v.cunsrE FEES VALU�iION FEE <br /> �L.- � `� 7.cs nw �� OF34 <br /> Hcicr�r uurt�rqu uo a mvcwrp suc a niocn i <br /> UNpS / p 1 v �^ C %UNB:NG �'•'/ <br /> � O V J <br /> OCCV�.VtiY NJOSIOP(5 CCCUV�NiIO�D B�5[YEIII YECIYMLK j <br /> -3 J•I o�es � <br /> rmesm�r�,nEna[an nc�sorv +ow�nxuvuucMttK <br /> oTMca <br /> rwc.uarnncoo nE�sor� <br /> Si�fE BPM1p1q SUHLNu�p �O <br /> rrre or cp.sr. nexsuvnoveoer qTY OF EVEREIT nreit wrnea /)�—( <br /> �� LOCIIL SALES , <br /> o•�� 7 TA%CODE IS J105 TOTAL <br /> I�Z <br />