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APPLICATI� FOR CONSTRUC�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 GEDAR STREET•EV[RETi,WA 98201 •259�BB10 <br /> � � DEMOLITION f 1 COMBINATION I i BUILOING '�✓MECHANICAL � ' PLUMBING ! ! SIGN <br /> PROJECTADDRESS � <br /> � <br /> [C, i�r In�� ��• - C_ �i �,7i r R,–]1�. 1 <br /> owvm M.n�m�rss nn r�r ma:r <br /> Ir�A� �l (��\,��('�G� U-�.– h�� _1M��2�- �VV. CA�v_{�t1 ���.� (��.���.i11—�3�Y— <br /> rtueu� v+ri nrnartss cnv rm nrov� <br /> l.l�,\� <br /> urt:�mrnoaorsr.vn� u�uenm.ss a�v tm nro.e <br /> r.vatnr.�<m�vuotpi vu�umntss cnr � nr nmvc suruicrast. <br /> 1.:��; '�I.�it���i� ,�[.-,� �qt'�, '���iJIZ�F.e �c�n `lYL`1`/ �1c�c)Z47U��� ti'��eiltZi:,-ilia£,? <br /> u¢ruwui m�nn.am uu��nnncss arv nr rv�ove sr+*r i¢rr+ct. <br /> r�uvnrvGro�itn6IIID 44�eIXM�FsS P�r )N n�o•.i s���4l�rtvg�.. — <br /> CON�IIAC�1`f11LE W K(Nlll_ <br /> t1 � — HEATING SYSTEM: �GAS i !ELECTRIC I i <br /> �xsr,mnc xanv erm wwnr romecc�vvo�vco cmn.ci rr nw•�n�m n�rnn rro <br /> A�( �1_� <br /> (-�-(,� ��1�_ ���.. � , � " ( — _ l,'��, �, -��.., ,�I-� rr <br /> `� �' I HEREDV CERTIFY TNA! 1 IIAVF PEA� �ND EXAAIMED TNIS <br /> 1' � APPLIC�TION AND NNOW THE SA�dE i0!tE TRIIE AN�CORREC�ALL <br /> nrorosro usc w n�ninpa PROVISIONS OF LA1V5 AND OROIN�NCES GOV[RNING TIaS TVPE OF <br /> – WORK WILL OE COMPL�EO Wllll WML�HER SPECIPIED HEREIN OR <br /> �tc�iascmrirc�amar[nrvivrovmaziowau��unnwoca+[s NOT. TNE GRANTMG OF A VEPA9i WES NOi PRESUME TO GN[ <br /> ia� ���x a AUTHOPIiY TO VIOIATE OR CANGEL TNE PROVISION OF ANV <br /> OTHER SiATE OR LOC�L lAW PEGULATING WNSTRUC110N OP iHE <br /> PERfORMANGE OF CONF t(CTION.THAT I AM AUTHORIZE��Y TNE <br /> OWNLR OF THIS P '/, PEfiFORM THE WORN FOR WNICN <br /> 4PPLICATION OE//� D 1 COh1PLY WRH TNE STATE <br /> ruic[�uxipmivarn GONiRlCTO .aLA 7Z(IC AN�296200W�C. <br /> � � L <br /> 7���� �C – � :G( . �. �. ��% <br /> CON51l111C1NM Ia�N I f Nf1Cf1.NMM�f55,itl[A10N[M14PF11 <br /> �,SCIf.11I.11111L � O��f <br /> LI�V 9UVNFSSIIC[M1�cC�1[l <br /> PLUMBING MECNANICAL <br /> N0. TYPE OF FIXTUFE OP ITEM FEE N0. T'7E OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn A/C–A/HNDLG UNITS–H.P. <br /> BATNTUO FORGEOAIRSYSTEh15–�.TU. M EA <br /> L�V�TOAY�\MSH OASIN) �{EAT PUh1P <br /> SIIOW[R UNITMBATERS–OTU. M <br /> NIiCNEN SINK d OISP CLOiHLS ORYERS <br /> -- DISHlY,15HE� VEHT�LATIOHFAN —' <br /> -- L�UhUfiY iP4V RANGE HOOP <br /> __r_ <br /> CLO711E5 WASHER WATERHEFI[R <br /> URINnL WO00 STOVE � <br /> ORINHING FO�MTAIN METAL flREPLACE IK'OOD pUNNING) <br /> PLOOR UR41N FlREPLACE INSEFT IWOO��URNING) <br /> OFCKFLOW PREVENTERS � GAS FlREPL4CE t\\;i��-� ' <br /> �— <br /> SINK�SERVICE–�AR.ETC.) CAS RANGE _ <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUOTOTAL $ SUDTOIAL 3 � <br /> PERMIT b PERMIT S �� <br /> TOTAIFEE S TOTALFEE S 5 ' <br /> FOR OFFICE USE ONLY: <br /> �nov��nn.r.. nnncnnen siMs[�n�[x nenouryr �unrn nr nrcnr�po <br /> ,�j 3/oL <br /> u�r;ovr ia��nr• v�c�r��urt FEES �ALUATION FEE <br /> iirrc :'��c� mmowa – — <br /> I�f�[:I1�11411AiIOY NO(XI�Wf1111M [U[OlfllOfi�T1 <br /> ivro: rmvowr, ' <br /> '_–_ —_—�_– <br /> VCLl1��41:Y N.���t1i�P15 l�Lf111'/.NllO�(1 p1ClMLN� 4ff11�Mfi11 <br /> f.l�011f' <br /> II\f4 �iN�1 <br /> IIf�L�1��VllfO� �f�[Ri 1ry�11�(14�IIl�VL1�fCM _ <br /> nmrn <br /> n�s�mm«irnmm� �m�sav — <br /> uir nvnon.;sonouimE <br /> ��rr i+�nnci nmaernrovrnnr CITY OF EVERETT �� ���^� <br /> LOCALSALES --- -- ---�--------------- —"' <br /> " _____ , _ . I„n��_ _ ___ _ TA%CODE IS]I05 TOTAL _ y_ <br />