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APPLICATICA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT E BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 P 259.8810 <br />I-) DEMOLITION Il COMBINATION BUILDING fl MECHANICAL rj j PLUMBING ❑ SIGN <br />PROJECT ADDRESS <br />OWNER 4AA ADgK69/1 1 B�pP �}�, nr P"OPIE <br />c Y{C6�Y �]-L ThI L1T vl. ill,.,l YLiEY.I\ cli" ZT'i--nu-1 <br />OEMRµ CCNiMLrOR <br />4M WME59 <br />pry <br />Slr <br />FICHE <br />STATELICENSIA <br />MFCNANSAL CONIMCIOR <br />MAA00ff,,nnE54 <br />ary <br />ZIP <br />MKIIA <br />STATE LA'II <br />RDLEM LdTRALIOR MN AawE99 pry ZIP PTgNE STATE IICENSEI <br />CONIRIP.IPRC_FDiyAIM <br />HEATING SYSTEM: ❑ GAS fl ELECTRIC ❑ <br />NiOOlADEyNVOL\ED `_ <br />OESCpBE CON, <br />0041AC1 PERSON AW 14T AD <br />I HEREBY CERTIFY THAT 1 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 WILL 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 '-AW REGULATING CONSTRUCTION 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 />CONTRACTORS LAW 18 27 RgC1W-AN6 200 WAC. <br />X_ /�(a�,`j <br />PROP09ED USE a MALOING <br />.J'-n V O bE UJ71}"L A?Y p <br />L DEscwPllOrT ai rTTOPE <br />EEDA TDYI 1 SELDWM-AtTX"TN0QoP%SI <br />LOT_RLOC+S' 1 w t• �( (� F 1`- <br />PARCFI IAS ID MMBER <br />LdISiTNICgOTl LOAN L�NOER, ADa1E99.IELEMgFENWBFR <br />rT <br />DATE <br />a" ROLNEESSS LICENSE TAO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />WATER CLOSET (TOILET) <br />NC—AMNDLG UNITS — M.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS—B.T.U. M <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAI FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />T <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL S <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />TOTALFEE <br />FOR OFFICE USE ONLY: -k- /7, <br />Eggli�Z-c ACK/ <br />gFAq Sa N/ <br />OCE SFIBAy. <br />S <br />Pl/.N CNEL ; <br />FEE/O�3U <br />'E 17/ 11 <br />us wA <br />K <br />Lor AnEA <br />WANT OrE <br />rim IT w <br />FEEB <br />VALUATION <br />FEE <br />BUILDING <br />I0 T7� <br />nEIGTU LIW IJ.To <br />/{J�IJ <br />NO a o'MLIIND <br />LMns <br />52.Y.J S ST .AC-- <br />l S F <br />O PR/A <br />RUTABMO <br />// �i <br />O'roC ll"ANCr wosioAks <br />GCCWANI IOAD B45EMEN1 <br />q 11 TES IIM1O <br />LECNANIC4 <br />ADaIION.LL RAN CNEQ <br />- <br />nREAL... Eon <br />O <br />WASO4 <br />DINER <br />LIRE SRYNaER PEOD <br />No <br />RFASOV <br />STATE BUT11I SUICNMGE <br />rrPE acogsl <br />�- ti <br />BANS ATN9rovEo ar <br />�J <br />DLTE 3 95 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PuTI aves <br />TOTAL <br />_ <br />