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APPLICATA FOR CONSTRUCON PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR S FREET P EVERETT. WA 98201 R (425) 257.8810 <br />❑ DEMOLITION ❑ COMBINATION G BUILDING Cl MECHANICAL ❑ PLUMBING ❑ SIGN <br />PRRO�J�ECT ADDRESS: <br />89V "—r /A t k% <br />lI N•Yr <br />•(IORf S$ fJ r! <br />Im <br />Px'yn <br />�_pfepvTsrFJ l%0W Ast <br />UA '7bo77 <br />4q5 "7 4SLz _ <br />•M:MYICr pR Df LU'nN <br />VA.I AMMI Si CITY <br />!m <br />M1Iy? <br />_'fa 6e Blnv <br />t-1� $t !rc s <br />_ <br />M.�,-77S=Ylolb <br />p NEnu CwlnACIM <br />4Ail AIXIrR 55 Clr\ <br />);f <br />rvRM RIAII IKTNSI <br />C <br />It <br />WCH•NKAI CC r...A(M <br />V., MCC I55 on <br />To, <br />PIUNF %,AIf IKENTEI <br />n <br />%IMMGCw1RAffOP <br />VIR AIF)K55 CITY <br />'M <br />PHpYE STATE IKENSF0 <br />cwm•o MNcfawam IZS��i <br />HEATING SYSTEM: KGAS ❑ELECTRIC ❑ <br />d��SIwwRR..F�W AAA. WAM IW�yyII•nt..VED /�`c <br />LfJ� WL �1n/� X PE (`LJ <br />CwIACI gnSw AMN W <br />_jptmr� tsrR_ rz <br />D� E _was 3g a l�saa- <br />srd 4PV Fn,2 <br />r+KnostD st a d�m}dvr <br />I HEREBY CERTIFY TEAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KN )W TI/E SAME TO BL TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WII 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 M E AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW P T RCW AND 00 WAC <br />IEGAIIYSCdrrKMCIA F*aPEnry lSnpMl attarw Mt¢H IPOCOMt SI <br />mt RIocR a <br />-fee b -mr <br />rAucn un D MMRI n <br />_3 -oz3tI exby <br />CalSrdKrgxlOAxl(NDFn AD(MISS III(fNONI NUVRFn <br />pNA ullE UAII <br />CnY P11VN[SS lS[MSt ND <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 />AVG—AMNDLG UNITS <br />BATHTUB <br />NFOPCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />Hpq PUMP <br />,SHOWER <br />UNIT TEAS <br />KI HE SINK A DISP <br />CLOTHES T'ERS _ <br />DISH SHER <br />RANGE HOOD <br />LAUNDR TRAY <br />WATEP HEATER <br />CLOTHES SHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE(WOO URNING) <br />DRINKING FOUN N <br />FIREPLACE INSERT (WOOD NING) <br />_ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENT S <br />GAS RANGE <br />' <br />—T <br />SINK (SERVICE —BAR,E ) <br />GAS PIPING <br />_ <br />EXHAUSTFAN <br />+_ <br />SUBTOTAL S <br />SUBTOTAL S <br />PERMIT $ <br />PERMIT S <br />TOTALFEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: 0s <br />IIIDN15Ei�/ <br />�1�./ <br />PEA 1PACR <br />SIM rITAC` <br />MANC.'E"WVRIR <br />IFI <br />S710� <br />me m1w <br />I'm t`O/�1 <br />— <br />IorA <br />A� <br />vCAN1511E <br />ORES W <br />FEES <br />VALUATION <br />FEET <br />IIM IMf• <br />_ <br />'PJW <br />0 j 1 i <br />HIM., IAI� <br />p <br />Nnp NG <br />iMn51�`� <br />$REpll I O II`t <br />a va <br />MlAnlnq ----- <br />— <br />-------+-- <br />- <br />DcomAcr <br />v, ^,.�;gle <br />accuwNl low <br />RASIAYNI <br />Wf:HAMC•1 <br />•pdtMY•I ry•NdIICR <br />— <br />'ME IERIIE" <br />7-7r4AlA <br />•[ON <br />02p C/'1UNAd of ) <br />mHfR <br />FMf AIARU RIGG <br />` -TIY <br />Rt•$rn <br />�� I• �7� <br />SI•IF Pwown s�mcHAnnt <br />_._ <br />�`-- <br />./�c� <br />7 <br />trM prpMr <br />MANSAMMarnnR <br />DATE Ov <br />CITY OF EVEERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />Mml r. wtMSS <br />— <br />TOTAL <br />-- <br />