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APPLICATIOA FOR CONSTRUCT�N PERMIT� <br /> CITY Of EVERETT•BUILOING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8870 <br /> O DEMOIITION O COM6INATION ❑ BUILDING C�MECHANICAL ❑ PLUMBINO U SIliN <br /> PpOJECTADDRESS'.�]r- a�, �o�' AU6 �C EJE.'2cT lJA �tHad'� <br /> OwNFn uull.ppnr55 pn I�r nqnC <br /> L1myn MA�.��A� r-� �1aJ1 IDw Av6 � Ev�,$ysi�(�� ���-���'� <br /> �rru+� u.n wmss r.nr nr nKwc <br /> /.IICURC�p1M5R.rvfO 4�1IMMR55 f.ip l�P � RIOM[ <br /> f.Mf11ALONIMLIM 4.1�MIpf55 ql� J�P P�Nnf SIMEIW[NSE� <br /> ��J <br /> MFC11uM.4f.�N10�C�p1 Y�iIIMIDi55 fRY )�� AKW'f iU�fIKLMQ• <br /> ry11VPMGCfM11Mf,IM Y�ilApin(55 CI�Y ll�' PIMM�E S���ElKfNSf• <br /> fOx111I.L111NCi M Wf11M� <br /> -Q_ HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> aumwtMwM�wnv�i.nf�a�u rwvo�vrn crn��c�rrnsouumr�q.nw <br /> S�K,raL� $hk YR�PA�)F �,Q�t�[�= _ �ARr�� 1�1E�K <br /> -r �S�a Cr,Z o = Z' - l� <br /> I HEREUY CEf1TIFY TIIAt I HAVE REAO 11N0 E%�MINEU THIS <br /> _ — APPIICATION PND KNOW TNE SAME TO C"c TRUE AND CORRECT ALL <br /> rndVvnusEamm(n�a PROVISIONSOFLAWSANOOHDINANC�ESGOVERNING7HISTYPEOF �, <br /> WORK WIIL OE COMPLIED WITN WHF.THER SPFCIFlED HEREIN OR � <br /> �rr.einrumr�wuor�m+cmriv�nnowmen�u��woca+[s1 NOT. THB GMNTINO OF A PENMIT UOES N01 PNESUME TO QIVE . <br /> i��__p��.h � AUTNORIIV TO VIOLATE OR CAN�EL THE PROVISION OF ANV � <br /> Ot11ER STnTE OR LOCAL L�W RE�ULATINO CONSTRUCTION OR THE �� <br /> PEfifOfIM�NG°OF CONSTRUCTION.TI1A11 AM AUTIIORIZED BY T/IE ' <br /> OWNEfi OF THIS PROPERTV TO PERFORM TME WORI( FOR YMICH <br /> APPLIC�TION IS MAOE ANO I COMPLY WITM TNE ST�TE <br /> w¢ci m�o.�u.n+m CCNiMCTURS UW'p 27 RCW AND 298.400WI1C. <br /> �uo��x�-����cmq /�. � ,� � � <br /> canim�cnon�au1�rrmrn.u�mrss.�rim�miunrn X_r+✓/.�n �V!'l/ /d - / 7 - <br /> sK.H(�und ou[ <br /> f,IlYOU5�Mf5ilK:lMS[Iq <br /> p�pyg��p MECHANIC�L <br /> NO. 7YPE OF FlXTURE Of11iEM �EE NO. 7YPE OF EOUIPMENT FEE <br /> --'_ --r— <br /> WATER CIOSET(TOILET) NC—NHNDLO UNR3 <br /> BATHTUO � FORCEDAIRSVSTEMS +_ <br /> UVATOf1Y(WASH BASIN) HEAT PUMA <br /> SYIOWE(1 UNI7 HEATEFlS <br /> KITCHEN SIHK 8 OISP CLOtRES ORYERS , <br /> D1511Wn5HER MNGF HOO� � <br /> LAUNORY TMY ' WAlEf111G78f1 _ , <br /> CLOTIIESWASHER —��— � WOODSIOVE I <br /> Ul11NAL b .M.��f1EPlACEM'OODOURNING) _ '�i <br /> DRINNING fOUNTl11N iiIEPLACE INSE7T(WOOD BURNING) '� <br /> FLOOR DRAIN GAS FlIIEPIACE <br /> BACHFIOWi��c.r_NTEHS ' GASMNGG � <br /> — —r— GA$Plf'ING r— <br /> SINN�SEflV�CE—BAl1,ETC.) _ _ — <br /> — � EXIIAUSI fAN ' _ <br /> —_i �— <br /> __ __ � <br /> SUB TOTAL S ' SUB TOTAL f I � <br /> PEPMIT S � PERMIi f <br /> TOTALFEE f TOTALFEE f <br /> FOR OFFICE USE ONLY: <br /> f11(WlVip¢M M�Rc�ipqx SUf.5f�P4K �'I�N[IRftlM�4I1fP �ff KffM�NO <br /> 5/va°3 S <br /> us[1a�r iounn vrr.urtsn[ _FElS V�LUIITION _ FE�_ <br /> ❑r[5 ❑Na nmirvrm. — --'--_ � I <br /> I�F16���I�41d�N1N IqV(M'(ll�� 9tEMM1%YII � <br /> inn�c n�i+mmr. <br /> ocamerx:. w�narnis orcw�niw.n n.v4rn� urnuxK.i--___— —___ ___—i— <br /> Gr�ar� _____ __' — � <br /> ❑v6 ❑NO ; <br /> lRlf$�r�IM1If1f�Illf� Ilf�[IYI �INN�N1N�Ih�Nfl�ffF � <br /> nll�fll <br /> 1�11I.W��Mflf00 nf�S1Yl <br /> [uR Nnlf�mG SUN u�nf.E <br /> rvrr�rm�a � nnr���rrnnvrnnr qTYOFEVERETT n�nncx+�nv: --" — <br /> LOCALSALES ------- - ---�— -------- — <br /> I n�iE TA%CODE157105 TOiAL <br />_ _ . _ . . . _ _ _ _ . ._ .. _ . J <br />