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APPLICATI(o FOR CONSTRUCTON PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT. WA 98MI •257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING n uorwamlr&I <br />_ __ _ m.rmAa PROJECT ADDRESS U UFUIN <br />OWF{R Meq ACURE1' CITY jp R,R, <br />EP <br />OENERK COMRACTpp MAfA Ss C I RIME STATE IAZNSF. <br />CIfY EP <br />Rlpl{ LYRE IICFNSL. <br />h NII CiWq ^a qq2 `I45l lurTr1'T"7I o1? <br />E1lNiRAGi pRDE MWMet -'1 <br />oo J- 80 <br />I <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CESCRIE WORK SWME FoorbE ff VWo <br />CWtACrpFRaON elq plVi NQ 1nl1 ,J / I <br />V,,}}L'06cbtl c)ie 215 IKI O4vL <br />654 �'3y0 <br />UIR"Isc'14 Willi LsJoeI cTI}(' dOC{.wo4L I-M <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 13E TRUE AND CORRECT. ALL <br />pRowsm usE M euLMRO <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL pEaCRpiFMI Ci pROpEgry lflgWH BELOW OR /.rTAG11ND COp4R <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT ROCK OP <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION <br />OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTR JCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED By THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />pAPCEITA%1D. NuueEp <br />CONTMCTORSu S.Y7 RCW ANO 2Bf.200 WAC. <br />-Ul-010 <br />I�� <br />CM9Lg3CfpNlOw IEMEILAOORE55. TElERgI(MILMER <br />X I+�"^ L�\wv/-/�^'—� %I <br />SP✓.1URE DATE — <br />cgveuc.anL.:ENSEKO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC — ATINOLG UNITS <br />- <br />BATHTUB <br />FORCED AIR SYSTEMS <br />1 <br />LAVATORY (WASH BASIN) <br />HEAT PUMP L <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />•I <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />I <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAINI <br />FIREPLACE INSERT (WOOD BURNINGI <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK(SERVICE — BAR. ETC.) <br />i <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />I <br />I <br />— <br />1 <br />SUBTOTAL S <br />PERMIT S <br />SUBTOTAL S <br />PERMIT S <br />TOTALFEE S <br />TOTALFEE S <br />i <br />UH OFFICE USE ONLY: <br />F POPE SETBACK <br />REAR SEI BACK <br />SCE SERACK <br />qµ py <CKMfER <br />n <br />i01--� <br />FFE <br />11FLEPT NO <br />USE TnRE <br />LOI AREA <br />vACwT61rE <br />a 0RO <br />FEES <br />VALUATION <br />FEE <br />NEKINTEMIRAT" <br />RO OF ERYCaq <br />UMTf <br />SIZE MCLOC✓11. <br />R MM <br />GOCCV <br />2uPPA"cv 1RMfgAEf <br />CCCtMwtEOAO <br />BASEMEN! <br />OYES aNO <br />YEENAN{:,AL <br />FRE SPgNhEp RFOD <br />pEAfoN <br />MORIWAL pLAN plffi! <br />oD3Ri <br />FRE AIM. BEOD <br />pgyory <br />STATE flRpq fM1Cl.pOE <br />TYPE Of cM+sr. <br />RANs.pppovEo BY <br />DATE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 0105 j.o.RL <br />puRK: rmma <br />