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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION \ J <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425) 257-8010 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDBIG ❑ MECHANICAL ❑ PLUMBING ❑ BION <br />PROJECT ADDRESS: <br />G�f EG/GpG7l 3�9 IA/GT �p <j/Lt� CUA 9Pi0/ <br />uwvtn — A,i. pry lm — <br />I////SAL Ca'2T 30^S ✓Y�TMJnF AlF Fl/EXE7J l/IA rA32^/ <br />IrNANI V.M 41pT 55 fJry )m <br />�8�� %T/ES TJP.PL1,�Td�]E,(!T �ILIII CE/a9/L G r YEP_Ell j�93:f7/ <br />AnpxTrcl onaslprcn IApwfss pl. )Ir - <br />GFNLnµ CONrNCT5 <br />AU [ <br />-n6s cNr <br />llr <br />rlxyr <br />Sgll llCfx5F1 <br />TAFbuN'C4 CGVingipl <br />Vn1.rXmE55 <br />01 <br />lm <br />11"t <br />OAIF UCE.SEr <br />MIIVIIMGCMlPACtM <br />VFII.GpIf55 <br />pfv <br />llr <br />Nr(}ff <br />51E1E 11CFM5f 1 <br />Cp11nRCI rpCfp WONR <br />%j /MHTP.J�1'1 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />aSCnIBr NVMR4rI5WrnL rrpllGf Kp <br />�iL �/ZAT/ V✓` 7 S a / F <br />CMI.Cr ITNSpYeM nN�m µ1 <br />/.9PY i/ /71G , <br />_ACGES: FA�TT r17/ <br />L _ OIE357 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TIfE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 711IS TYPE OF <br />WORK WILL BE COMPLIED WITH WHLIHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I 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 />CONTRACTORS LAW to 27 RCW AtjD 296200 WAC <br />/ <br />rnGTnuo ast a euluNn <br />—tYlfCV <br />¢mL ascamnpNp rnorfnq lsNorm RTow GN AnN:N lwo conLsi <br />Im eIGCR or <br />IW1CC1 to IG Nruan <br />COw51ntCTTNNI0ANIfN n,Y LS5.THLmIp1EM Fn <br />SiGMe N0. n.Lrf � <br />CnY MISINLSS L..:1 Ntt NN <br />MECHANICAL u <br />PLUMBING <br />NO. <br />TYPE <br />N0. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSAA;—A9MDLG <br />UNITS <br />BATHTUBFORCLD <br />AIR SYSTEMSLAVATORY <br />(WHEAT <br />PUMP <br />SHOWERUNIT <br />Fm. <br />HEATERSKITCHEN <br />SINKCLOTHES <br />DRYERS <br />DISHWASHERRANGE <br />HOOD <br />LAUNDRY TRAWATER <br />HEATER <br />CLOTHES WAWOOD <br />STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />FIREPLACE INSERT )WOOD BURNING) <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />I <br />GAS RANGE <br />J <br />SINK (SERVICE — BAR, ETC.I _ <br />GAS PIPING <br />EXHAUST FAN <br />_ <br />SUBTOTAL f <br />SUBTOTAL f <br />_ <br />PERMIT f <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />I n(INI V IAAIR <br />WAIT srle.Cx <br />$Ia 5C1eKw <br />MAN CIRCA N,NAR1n <br />rff <br />nl rf"I NG <br />usl rrwr <br />ml•a+ <br />vnCANT 9TE <br />FEES <br />VALUATION <br />FEE <br />-- <br />OYrS ❑ NN <br />nwtAxr. <br />T- <br />No p [nvrulNc. <br />Slll p el n1 <br />HEIGHT Ix 1l.r04 <br />_ <br />.�y95� <br />uxlls <br />, <br />a. <br />ry welrG <br />owwwcr <br />C•T1GUn <br />IM�(x 511RI( <br />a:nmexl lom <br />nsrAR41 <br />Vff,N.Hlf..l <br />A0 <br />'INF 51'gNwlFn nEG9 <br />rRAs11�V Hy� _ <br />AMIlPNAI M1.NpKCA <br />`1/O 70 <br /><JrtLj54VSii6.1j [//iF' <br />rl .1AWREao <br />Vww <br />IIAlf <br />o <br />CSy(C jUJ—�+C'"/� <br />eNx UMf sIIIKN.nnf <br />r.Mp CmNl <br />ITANS ArtpGvrGRv <br />CITY OF EVERETT <br />�uelr. wxxMs <br />LOCALSALIES <br />TOTAL _ <br />;70 <br />uul /cam �j S <br />TAX CODE IS 3105 <br />