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APPLICATI� FOR CONSTRUCT�N PERMIT/ <br />CITY OF EVERETT • BUILDING DIVISION Y� <br />3209 CEDAR STREET • EVERETT, VJA 98201 • 257-8810 � <br />f-�� �EMOLITION ' � COPdBINATION � BUILDING CI MECHANICAL f 1 PLUMBING SIGN <br />PROJECTADDRESS <br />1.P�POL{�[GS <br />M <br />PIIGtiL <br />� <br />IRJ<y� InuL�DOPEiS LiIY I�v PrqN[� <br />� ': Rir�� Ci S 4� �t <br />%--..�crono[sW,u� r.+uincent,s arv zir w�0ue <br />L....r�ucorvnaA��oia uuuooness crtr nv w�or+c ,ureuccr�sc. <br />_ `.>ijllli CiS q�'1��{ <br />/i.,-.:.�.r,,,,..�coxrnecro,+ �.u��nooac;s arv iiv nuouc s�uci¢uiss. <br />. ���.;.�cconraeaun ue�,�eooecss a�r ,. ruuu� surc�¢er+se. <br />r'.��::.i�[c:onn r;p5cuer,[ropuc[nrvoLvm <br />-_�n5 all heW �OOi <br />r r.r n o,e or owmnic <br />�iayc�re �C�� �—lGNi <br />^ LU%LVrSC0iP110NOFVPOPEFiYI511Q'NNC[IOWOF�R�CI� <br />i <br />�o� oiac+ oc <br />-.:.._ � u. � o nnvmrn <br />� -,n�.]�Rcn�co4vt� <br />C.'LinVCtiO�ILOa4lO:�EN MGPLSS.iCLEP110NE11UM6EF <br />PLUId81NG <br />N0. TYPE OF FIXTURE ON ITEM <br />—� l':ATER CLOSET �TOILET� <br />BATMTUB <br />LAVATORV�WFSH BASIN� <br />SHOV/EF <br />KITCHEN SINK 8 OISP <br />I DISHN/ASHER _ <br />� LAUNORYTRAY <br />� CLOTHES WASMER <br />UPINAL <br />DPINNING FOUNTAIN <br />FLOOq DPAIN <br />PERh11T 5 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />�;.f:•.r[.rrp:.;q n[ansOo.+Cn SipL5clCtcK <br />�-:� �:,,- <br />� ...�r, �.i..r:a�er� <br />=.. i�`:— `'I lu! <br />� �,� _. ..�,�N� <br />; ., <br />i �1:Cs�r.�,in Feoo <br />/r G <br />f�f�Lf.�f,CNSi <br />�� ry <br />HEATING SYSTEM: ❑ GAS f�l ELECTRIC !, <br />I MER[BY GERTIFY THAT I HAVE REAU AND E%A1.9NED iH15 <br />APPUGATION ANO NNOW THE SAh1E TO �E TRUE AND CORP[GT. ALL <br />PROVISIONS OF LAYlS AND OR�INFIJCES GOVERNING THIS NPE OF <br />VlURK WILL DE C01dPLi[D WITM VlHETHER SPECIFlED HEREI!! OR <br />NOT iHE GRANTING OF A pERM1T DOES NOT PRESUIdE TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTMER STAIE OR LOCFL LAW REGULATING CONSTRUCTION OR THE <br />PERFpRIdANCE OF CONSTRUCTION. TM 1T I A!d AUTHORIZED BV TH[ <br />OWNER OF THIS PROPERTV i0 PERFORIA THE VJORK FOR VlHICH <br />APPLICATION IS 1AADE ANO I C@.iPIY WITH TNE STATE <br />CONTPFCiORSLANliB27RCV/ ND276200NlAC. <br />'x �?�,�� !�(1:.� J • :y. o i <br />SiGxe pE Ue�E <br />cnv ous�.iass uc� ��sn:o <br />WOOD <br />GAS <br />TYPE <br />FAN <br />�o �-oac <br />�m:.i-i• vewrtsrtE FEES <br />nves n r+o owmm;. <br />no or o:2u�mu s¢ror oiw r <br />u�nrs �,� .1—. <br />� � l� VWAI6ING <br />oc::vr=u� �o+u wse+�er�r r,�EG�uwai <br />iU -.E�s �„o <br />�,E.,on •o�niar�u vw� cHcca <br />on2n <br />aUSON <br />s*nre ou�amuc sunc�unce <br />�uru�rvnovsoev CITYOFEVERETT vuo��cr:oaxs <br />Tl � LOCALSALES <br />-„ -�;1..�.� TAX CO]E IS 3105 7o7n1 <br />S <br />5 <br />5 <br />ACLEIvi NO <br />