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APPLICATIOS FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT •BUILDING DIVISION OL <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425) 257•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADD <br />RES�✓T�1,v/o�/ <br />//i /n.E-G�A1 sg.0 /�, 'c�.9ou,�lt✓ Q✓srErr -.. ys7- 27 �-Zzo7 iFNANT M .S fn ZIP P F <br />ARL mcf(O IpESRnAn NAM AD ss <br />aM[nAI CONInACIgI <br />R r 5-f&O <br />wFG NKAl GT1TRACIOn <br />wAN ADgTF59 <br />6/0o /z <br />¢ DGIE 55 <br />Gn <br />SevnreA <br />GIY <br />IM' <br />9PYgY <br />S•' <br />IXfNF <br />sxrsaoYYO <br />R1}L <br />11AlE IICENSF <br />t7M vAfesyC� <br />STAIF UCEw5EA <br />MITA®hG gIN1PAF,lDn <br />VA¢•DDIIEsS <br />qT <br />IW <br />RFD6 <br />$TATf Ik:ENSF• <br />cDNmAcI IN•c[ a ww. <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />a5q•BF Yg1Ut AND $DUAPFF 1•DF MVGI4D <br />v G v <br />/ <br />CGIIACI RR90NANp RFDwE ND <br />/Ai <br />O <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER 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 1 AM AUTHORIZED BY THE <br />PROPERTY TO PERFORM THE WORK FOR WHICH <br />ILICTIONSMADE AND 1 CQMPLY WITH THE STATE <br />LAW IS 2TAND 29 200 WACCONST.KtM1 <br />INFanoslDusE a eukDlvn <br />1lDAL DlStmPnw awTGcan ISFVWIIYIOW on AnAEN IWO conEn <br />Iwl eLocA a <br />P•ncn W-1D nAAnAn <br />IGWIFMIFR IDMw551[IUr�OMEMe/PILL <br />S! <br />PLUMBING <br />MECHANICAL <br />140. <br />1 TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOILET) <br />1 <br />A/C—MINOLO UNITS <br />—�— <br />BATHTUB <br />) <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />II <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 OISP <br />F <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />1 <br />WOODSTOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />BACKPLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />OAS PIPING <br />EXHAUST FAN <br />I <br />SUBTOTAL f <br />SUB TOTAL S <br />PERMIT f <br />PERMIT S <br />tOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />f MAI, VMWK <br />WMSFIeV.k <br />LOE SFIeKk <br />ft"DIEkI'lu"A <br />6 6 <br />FFF <br />nFFFen ND <br />uSE tDMf <br />Iol A1RA YACWT SITE <br />Ons ow <br />Ao aolrtLUHD SILFarmnl <br />ua1S <br />FEES <br />I VALUATION <br />FEE <br />- <br />IgIFM11MlAIgN <br />A1AlF D <br />OCI AN[r kU ry Sti•gf <br />gS1AN110•p <br />e•x•ENI <br />5 OM <br />wmw,A <br />4- <br />_.. <br />lelE SANNNIEA 1200 <br />IIFA.Sg1 <br />•ODIIRYI4. A W OXp <br />OD4n <br />O 1 OJ <br />FA+EAL,,,%I IDT <br />wk" - <br />5IA1l elAlDh(1 $1111ENNCF <br />_ <br />Irn F+cDNSI <br />______ <br />MANS! jrioer <br />x r <br />DAn /%f <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE 153105 <br />nlslr.wdw9 <br />— <br />— <br />TOTAL <br />' <br />