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APPLICATIA FOR CONSTRUCTSN PERMIT <br />CITY OF EVERETT F BUILDING DIVISION <br />3200 CEDAR STREET • EVEREff, WA 88201 • (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Cl MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS:_ 791G/ f- dnLdw4c i31-Vi7 _ <br />ONMER MM 10dKSS P11 lir P,9N[ <br />(tiAEBu OAST Fb Ei7X 3?D CT 9820/ �t $70 - 77 (0 7 <br />T[NANI TIM Aop1ESS rylr nP P.CNf <br />•RCNI[cT ORaLGMFR WII Ap ss alr --nr PN F -- <br />aNIRN CONIRAC109 YM A001"E55 CNT lir NTM[ SIAIIIK[NSFL <br />SECNAMCI,LcM, ACfO1 NASAO01K51 ryM1 le. MT04r SIAIE LKENSEI <br />%IIW%OCONIRe.'M NYI AOUIESS Ot, iw.,er lir F"MF StAIFIC[NSFI <br />p4al.jc AiApj�f_ L.n� Qf-ldK .2 CT'LjY i .C'lSR••.11'.J✓e »�. <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />aic; W.MYI WS "ImIgm 4vviwo <br />C NW.1 R AVN AW PHONE 1q <br />Ae <br />IN,OPos[o ITN a FIIApMfI <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 VAI L 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 I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW IB 227 PICCW AND 296.200 WAG. <br />X ��IV/ b <br />LEGAL aSC"t" OF RKIRPry IPAMI SILMOR AIIKN MCpElES1 <br />LOT IK= a <br />ANRL m 1p MMSER <br />C TNJGITMIOAINtf"RAIKNCSS F[LLHA%EIAATIFII <br />slotul o q <br />OIYSIMASSUcTE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C—ARINDLG UNITS <br />BATHTUB <br />' <br />FORCEDAIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY THAT <br />WATER NEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />1 <br />BACKFLOW PREVEMERS <br />GALS RANGE <br />SINK (SERVICE_— BAR, ETC.) <br />GAS PIPING <br />EXHAUST FANS <br />1 <br />SUBTOTAL <br />f <br />SUBTOTAL f <br />_ <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />51 <br />1 <br />1 <br />AL FEE f <br />' <br />FOR OFFICE USE ONLY: <br />FIT IffavTl,p <br />INN IMF <br />IOIARIA <br />YK", STE <br />FEE6 <br />Ows Ow <br />MRIRIf: <br />191 11MIA1,M1 <br />NO aONELMO <br />Rt[a Flodll <br />IMIS <br />IN fIIIANf <br />0.' No 1V FIM1f <br />Of:LWM111lOAp <br />Of:LNWNIIOAp <br />IWATIN1NO <br />SANASNI <br />pANC1 <br />ArycNAMICR, <br />ONO OM <br />IM SRNMtFNi,IL <br />11iAi[M <br />AppINW4 RAN LIYCA <br />1 L/VI� <br />CITYOFEVERETT RIII1 T. MtNRc <br />LOCAL SALES --- <br />o TAX CODE IS 0105 TOTAL <br />