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r � APPLICATI� FOR CONSTRUC�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •(425)257-8010 <br /> ❑ DEMOLITION ❑ COMpBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: �/��I ' r —�' /.3tJ£_�j��'S_��`iF4 F J�r <br /> Si F✓F > .CF.✓d,[ f .C✓nr.��c� _s� <br /> OM.FR uul�I11Mi55 Cirv A� v+ONf <br /> �s a a - s ��" c�F s- �.��s ,-Ty c� � 9����_ <br /> �� V111�INWfS$ (.IIY !IV hY.1hi <br /> �O�O V�-eN ���CG7 <br /> Mf.TTtTOR9ELC.qFu � O.9p5a f.uv ---pr - — <br /> i soo 9 • r"`�.` <br /> �f/0 � .�'r/C Ct,Fs : ��F�t F L/ _CJ A �(�'C�_�_—__ <br /> �. w.�:.nun�ss cm ��— nr <br /> .f�orr si.n ncrn::. <br /> �GJ �YFtI 4J�.c .c 7p �'nrv._ '.��r:.l✓C7.Jl1� <br /> uFf.ruwPtCC.�nn�('tun qn��rA�i55 nrv I.P nu��.r [uqUCEuS{. <br /> I�III4PNC.00�11P�f1� M��I�fNM(55 C1�1 l�✓ I�r� <br /> �•.( S�NlI�C[M1Sl. <br /> CON�NCt1'n�C[U�WOnn <br /> �O ,�) �./ HEATING 5YSTEM: ❑GAS ❑ELECTRIC � <br /> ovx�n�acw�ny ..usou. �raoucnnivco ,/ coa�uS..��so��u�.��..nvr..o - <br /> �� ,cLLP—[.. � 1--G_/YO V'lJN�/qCl— <br /> --`t-•��b'SG' F'� ya=' G�!a • c.rr�7� <br /> I HEREOY �°RTIFY iNp7 I HqVF READ AN� E%RMINED TH!S <br /> n�����nc., us[or qinmiw� tiPPLlCaiION pfID NNOW THE:.aR1E TO�E Tq11E ANO COFRECT q�� <br /> �//� �' �F.ry � � P90VISIONS OF�AWS AND ONP'NANCES GOVERNING TIIIS 7YPE OF <br /> —LL WORN Wil L �E COMPLIED WIII� Y�HETHER SPECIFlED HEREIN OR <br /> IEL�I O[SrnO�tIPY O�1'npf�(prv�SIqWN BtlOw ON E11�O�t W0 COIhf.51 <br /> NOi. TNE GRAN7�.NG OF A PERMR UOES N07 PRESUME TO GIVE <br /> �m_ e�oce or AUTHORITY TO VIOLATE OR CANCEL TME PROVIS�ON OF ANV <br /> OTI/ER STATE OR LOCAL:AW REGUTATING CON5T9VCTION OR THE <br /> O n /D PERFORNANCE Oi LONSiqUCTiON TNAT I AM AUiHOqRED BV THE <br /> " OWNER OF iHIS Pf10PER�Y 10 PERFORM TNE W9RK fOR WHICH <br /> APPI.ICATIGt1 IS MADE FND I GOMPLY WRH iHE STATE <br /> vuq¢ui i o mrupw CONiHACiOFS lAN't B 21 qC W pN0 79fi 200 WnG <br /> -_G3a�.�--�'_' �G , oOn.� . y�/� <br /> :(Y�CI111F11(MIIO�NIlNI1F11 yMIf1C54 ICIfAIONE M14Pf�1 ) �' ��(/J/ %�' <br /> �rZ'LiG �IC✓11\UI�I�I���`il✓ / V <br /> CIIY 0V5111/S[1�CE N\I'.O <br /> PLUMBING MECN�NICAI � --- <br /> NO. TYPE OF FII(TUflE OR ITEM FEE N0. TYPE OF EOUIPMEM FEE <br /> WATER CLOSET(TOILET) A/C—MIN�LG UNITS <br /> I BATHTUB POpCE0AIR5YSTE615 <br /> LAVAiORY(WASH BASIN� NEAT Pl1MP T— <br /> SHOWER UNI7 NEAiEfiS <br /> KITLHEN SINK 8�ISP LLOTIIES ORVERS <br /> �ISNWpSHER RANGE HOOD � <br /> L�l1NDPY TRAY 4VATER NEATER <br /> LLOTHES WRSHER 1YOOD STOVE <br /> URINAL METAL FIREPLACE(WC00 BURNING� <br /> �RINNING FOUMTAW fIRGPLACE INSEFT�VJOOD BURNING� <br /> FIOOP DRAIN GAS fIREPLACE � <br /> BAfNFLOY/PP[VENTERS G45RFNGE <br /> SIKK�SEHVICE—BAR,cTC� GAS PIPING �— <br /> _ EkHAU$TFAN <br /> _ SUD TOiFL f ' SUP TOiAL 5 <br /> PERAIIT S —�— PERMIi { T— <br /> _ _ TOTAI FEE 5�� tOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> rnn4ivlp¢v nnncr�P�[� 5�o[Sfip4x / r�uiryq[�npynln rFf nttt�rruo <br /> Zo� ZO' � (�o3yS /,��.�o <br /> i�sFtorr io�u+�. v.na�sne <br /> /—/ __ FEES __ VALUATIOl: __ FEE <br /> /' mn ❑v „�(} _' <br /> I�FIC.��IIiN�1110�^ �I�If-:4� �" ; <br /> �/ M1OOtI�Wflliuf. SiIFOfPIM.'li ���Y_ L Y.�_ <br /> S 88 $f ^�°°�., 2/ <br /> (IDlbe�Vl♦ Y••.i.va� WCuo�N�IO�O P�5(vft� . . .. . . <br /> m � <br /> Nf I I�I...il nl //-♦ <br /> - _( ❑.<< � - �� ' <br /> uui;unv.,oi,r�r��_—_ nr.vaw .ownr.wi r:.sn�rc, _ _—__ __'__' ._ <br /> r,iurr._ __—— _ —_—_ __' <br /> �iac<i.wunw�o " nr.�o� _ ___ <br /> _ _ uq nw�.^...:ynu'um:x LJ ,�ri/� I <br /> irornr,to.�c� ' n.cu�navr�or _—"—'— . - .— � •••t/ � <br /> �� � �� CITYOFEVERETT ���ai�cwnn.a �� <br /> __�—`J LOCALSALES - — ---- �J n q <br /> _ ___ m�t �OZ3 � TA%COOE157105 TOTAL_ __ �JZd ' /D <br />