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APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETf•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201•259•8810 <br /> ❑ DEMOlJT10N O COMBM�TION ❑ BUILDNIO �MECMANICAL ❑ P�UMBINfi ❑ SION <br /> PROJECT ADDRESS: �_��[(l/.LCL <br /> Frr� Ea,�r�,;�,E _ <br /> Fq Yul 55 PO' bn ��Ur� <br /> 1EM�N� uY1 I.fIpfM55 C.IIY l�p fIqNF <br /> •RfN�ICiC(1MS�GN(.1 YMIYNM�fSS CITI ll�` MqN! <br /> 6fM114CONINL�IX1 YN1yMY1155 f11Y )h` � IvxM (I��IIS(NSf� <br /> �f'`�� � �I r '/ �(`'{1.�//L /'A C /J Cj <br /> r�ti R� � �/�/TC'J��•!lL�1J��r.. _�!W � HVl C-�V-'��JJ�U�L�r <br /> YELNWiC lCM1n�C�d1 4�NI.fIV�E55 � fIIV �I' 1'1 f�/.�FIICEN � <br /> Es� �Lc! Et�aE�J'���fl�q'8z�'� <br /> Al14RNGCOM�R�L10H 4�MMqC55 GI♦ M1IDNf S��IEIICENy� <br /> [Ovf1UL1Mn 1/MV�R � <br /> � •'�_ HEATING SYSTEM: ❑GAS �TELECTRIC ❑ <br /> pfSC�MFwpql�xpipll�l�r�t1GFFvaK(1 —� flMl�(.��vn5c]N�MrrqKrq <br /> I�r(��/�f- OT t`!�'f��f'lC-�Gf1 /D ' _ <br /> � `�r,LI �C 1!/�/' S�f�j <br /> I HEREBY CERTIFY THAT I NAVE READ AND EX�MINED THIS <br /> A/� ./ ��I�- APPUL�iION ANO NNOW THE S�ME TO BE TRUE AND CdIRECT ALL <br /> �/Y IX^�� n _SIEIC7�l/T 'G'7l P�OVISIONS OF UW5�NO ORDINANCES GOVERNING TMIS T'PE OF <br /> /,�//�TY IS�GF✓� I' /r _ WpRK WILI BE CqMPlIEO WITH NMETHEH SPEGFIED HEREIN ON <br /> lfWlEfSCpV�qNOl�AC 4RiYryqM1lElOWP1I.O Hrwo�cnn[s�— NOT. THE GRANTINO OF A PERMIT DOES NOT FRESUME TO OIVE <br /> �ar �iaR a I1UiNORITY TO VIOL�TE OP CANCEL THE PROVISION OF ANY <br /> OTNER SiAtE OR LOGLL UW REOVLATIN6 CONSTRUCTION di TNE <br /> PERFOPMANCE OF CONSTRUCTION,TNAT 1�M�UTNORIZED BY T1/E <br /> OY/HER OF TMIS PROPERTY TO PEHFORM THE WORK Fpi NMN;N <br /> APPLIGAtION IS MADE ANO I COMPLY WITH THE ST�TE <br /> �EirM�o��q CORSL BBWA �200WAC. <br /> L� <br /> cws�mic*iw�o.rii[r.o[n.u�m[ssn�[narhM�unrn X .!k �� 'G Q. ..} <br /> s ne� w�c <br /> m�crw ss�wrnsc Ho <br /> iLUYlIN6 MECX11NC11L <br /> NO. TYVE OF FlfITUNE OR ITEM FEE N0. iYPE OF EOIII/MHR FEE <br /> WATER ClOSET(TOILET) NC—AMNDLOIXIITS ' <br /> B�THTUB T FORCEDAIRSYS7EM5 _ � <br /> UVATORV(WA�N BASIN) � IIEA7 PUMP <br /> SMOM'ER UNIT NEAT[t15 <br /> NITf.MEN SINK d DISP CLOT41E5 DRYERS <br /> OISNWASNER fiANGE H(b0 <br /> UUNDRY TRAY WATEP HEATIER <br /> CLOTHESW�SMEN WOO�STOV[ <br /> URINAL MITAL FlRCPIACE�WOpD BURNING) <br /> _ DRINKING FOUNTAM FIR[PLACE INSEflT�VJOOD BURNING� I <br /> FLOOR ORr11N GAS FIREPIACE <br /> BAGI(FIOW PPEVENTEN$ GAS f1�NGE � <br /> SINK�SERVICE—BAR,ETC.) --�_ �SPIPING i <br /> EXIIAUST FAN <br /> — I <br /> SUB WT�t s sue rot�u s /S <br /> PERMIT f PERMIT t <br /> TOTALfEE S TOT�LFEE f / <br /> FOR OFFICE USE ONLY: <br /> TM.IAIR�f�. 1R��NIP�CX S�CfSCiP�CF M1�Hp�CfKMIW�fq�� �If Mf.[If9M � <br /> d ' <br /> osvra1v m�•n�. v.ur��s��r FEES V�LU�T�ON FEE <br /> ❑v[5 ❑rx� n�m�wn <br /> 11(IC.III II411�1h7H NO IY 1�'NI.IIIN(i tll!Of 1110C'll � <br /> owns rmoniw: <br /> __ �-- <br /> pcovrwcr xiavrnis uccwor�tm•o er,:turw urouxKu <br /> G�W� <br /> n.rs ❑wn ---- — — — <br /> IIRES�qWR[PR[O� �F�FCM ��1f➢�H�NHA�vLnfCX <br /> muin '__ _ <br /> flA(W11MPF00 �f�inH -- <br /> vut non�nans�inn�.nnt <br /> �mrorror�� rinxsr.rrnov�nnr CITVOFEVERER �'�������x�•v <br /> LOCALSALES -------- ---- ---- <br /> �„�� _ TR%CODE157105 7oi�L _ ____ _ _ __` <br />