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APPLICATI�N FO�d CONSTRUC�ON PERMIT <br />CIN OF EVERETf • BUILDING DIVISION �C��� <br />32�0 CEDAR STREET • EVERF.TT, 1"!^ 98201 •(425) 257-8810 <br />❑ OEMOLITION 6'.� COMBINATION ❑ BUILDING CI MECHANICAL ❑ PLUMBING ❑ 51/3N <br />PROJECTAODRESS: g90D ST!-! A�.�c�—���L� `^�� `�ga0'y — <br />�o,�el.a.��mv„o�as $Jo��-Ct�4y1:s�L.E.,Lcsh' -g`°.�°-`�— -- <br />OVMFn vu�epOnESs cm I�ne rqM[ <br />IFN�NI 4111 �fNMl55 C.ItY /IV N�O!�F <br />�T^.NRfC10��KiP�fn i1�O0uF55 Cilv p� P�m41 <br />f�s �1o�c�__��Y�N..StL_Si�1«_i�wtiYSJ%��� �i%��o��y33 F/F_ 7tH�r-_Q6aMB <br />c(rvUu� cabm�u:x� � i �onnpss P� lin ��.t sun ucfMs{ � <br />JFCII�r.lCnlf.(14I�1�I:�UP 4��1�f+.X�F55 f.IIY rif� f'ilb.f Gt��LLICFNSi• <br />1'111401!.GCO�I�H�I;�M 4��1 <br />�1�� <br />CO�IIII�LtI'Ilif[ Uf Wn11M <br />oFscn:oF w�A..+o sau.�t �cwi.c[ <br />S,rS�'��C <br />AF�,� i i� s� <br />1[ W l o6C.au.np� o� rnp9 <br />ioi oix« <br />CJNSII���'.f�(rilO�Nlfllf�F41 Mlx�C55 �CILMIONf NU411FI1 <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />%— WATER GLOSET (TOILET� <br />/ BATHiUO <br />LAVAlOHY (WAFH BASIN) <br />SHUWER <br />KITCNEN SINK E DISP <br />D�SHWPSHER <br />�AUNDRY TR4Y <br />CLOTHES WASHER <br />URINAL <br />D�INkING FOUNTAIN <br />F�OOR DtiA1N <br />�ACKFLOW PR[VENTERS <br />S�NN (SERVICE — DAp. ETC.) <br />FOR OFf-ICE USE OhLY: <br />rnrvr•.rroer-+ nrnnsnn¢� <br />.tta^r ��o��aE� <br />I�FIGIIIIIMIIAIiOV I 40 Cl ItW[111NG <br />.,�� <br />��.vr��...rwa-�.e.n.rs acovw�io�n <br />i iuc �uea ain o <br />FEE 5 <br />I•�Ipr�F <br />HEATING SYSTEM: ❑ GAS I� ELECTRIC ❑ <br />cavuc*: i �uo•�.nn n��Hr vo� <br />I NEREOV CERTIFV THAT I NAVE READ ANO E%AMINEO iH15 <br />APPLICA710N AND NNOW TME SAME i0 �E TRUE AN� GORRECT ALL <br />FROVISIONS OF LAWS AND OROM�NCES GOVERNMG THIS TV?E GF <br />WORN W�I L UE COMPLIED WITN WHETHER SPEQFIED HEPEIN OR <br />Co�esi NOT. TNF. G�pNTING OF A PERIdIT �OF.S NO7 PRESUM[ TO GNE <br />AUTHOHITV TO VIOLATE OR CANCEL TNE PRO�ISIpN OF ANY <br />OiMER STATE OR LOCAL LAW RECULATING CONSTHUCTION OR THE <br />PERFORMANCE Oi GONSTRUCTION THAT I AM AUTHORIZED BY iHE <br />— OWNER OF THIS PROPEPTY TO P!AFORM THE WORN FpR WHIC4 <br />APPLIC4TION IS MAOE AN� I COMPLY WITM THE $TATE <br />CONTRPGTORSLFW IB2i RC�WAC <br />�__ �t,�u�u _ a e%7�9� <br />CihflVVn65ltt:PRf �i0 <br />FORCED AIR SYSTEMS <br />NEAT PUMP <br />WOOD SfJVE <br />GAS <br />9o[sr�R�P rU'OiEcxuuuprn <br />�i) / '�y <br />v.u�+twE FEES__ <br />❑rrs ❑uo nm.n�vr. <br />5�![OtfllUG9� — <br />riaueyc ._"_'__ <br />wstuevi wr�.i�nx'u <br />prts ❑ua -- <br />n, q nrnai n �u cnrc+ <br />_ �,,.,�� <br />uq a�nw��,c snnounu <br />CITYOFEVERETT ��'ai�r�i�+� <br />LOCPLSALES --- — <br />TA% COOE IS J105 j TOTAI <br />�EE <br />SUBTOTAL S <br />.—�— <br />PERh�Ii S <br />TOTALFEE S <br />i�� art'Firrr�o <br />YALUATION FE�_ <br />