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APPLICATION FOI( ONSTRUCTION PERMIT <br />CITY OF EVERETT IT BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, VIA 982D1 IT (425) 257-8810 <br />❑ DEMOLITION 19 O COMBINATION 0 BUILDING ❑ MECUANICAL ❑ PLUMBING O SIGN <br />PROJECTADORESS: _�JMjLfADs.T,)dft fit8*YTCIA, qg'ko - <br />�!a¢Ni wBaE. •u•Tl,ub law ygil BIQLNST. �lyAl�pt BGFLrAI �uSs '1LV--a�.1,-LL11 __ <br />uq }Y33 Gn !r [ <br />¢IYYi —"•n <br />Niw(ss <br />(m 1« moYr — <br />f�LHEITY,H.AI�MI��t;�,P.s. <br />KI+Rt(Cn OfyO�Fv <br />LeQ4o ug 3�f�L..SEq�oo4' w�K-R1�.LLpp <br />.Chne.3 <br />Gn r.gne <br />_' <br />6F[IIM COYrM[ipl <br />YUL WDn(N <br />(n. :.r rrgY( SIYI IK[YS[• <br />WCUAwJL Cn%m Ton-- <br />uA KV'(3f <br />an Tn `--r:p.[ trA•r (K[r3fr <br />PIYYIwG 24MtnYal}1 <br />YYl •AIRD <br />Gry (Y — WPt liRil YFY3(• <br />HEATING SYSTEM: 10 GAS CT ELECTRIC fT <br />MESCP MOI*IAW&MJ.[ IMIK.[«.MAD <br />V' Ql3 L'TIAHI di NEw Alrtn(.L_AQILL S:!QV\(r <br />cm,K.r rtnfoYwq rvp«C vp --� <br />pp •meµ <br />slmtpN. •(OTAV G L. <br />ISOrOf(D u5[ a OwrwD <br />AVCO SEQUILfi <br />u.4 cLfcYnrry;o<NIOrTKII Is«D«N IF(0«DAAnK.IAoccns. <br />LOT Olar— n <br />IMTACMED <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 IRS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES ROT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMINOE OF CONSTRUCTION THAT I AM AUDIORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH INC STATE <br />CONTMCTORS LAW 10227�ACW AND 2% 200 WAD fV LL 1 <br />x' .Y 'r ' 1 <br />SAI � <br />--- ------ <br />AVlgl*Y ID MAMFR <br />rqN IDINIFNO(A <br />SKT.f D.ic <br />{`7 LyrF/('. LL,C.,T%<: <br />- <br />GIr IYLKWIKfY+(w ' <br />PLUMBING <br />MECHANICAL -- <br />NO. <br />YYPE OF FIXTURE OR REM <br />FE! <br />NO. <br />TYPE OF RQUIrIRNT <br />FEE <br />WATER CLOSET (TOILET) <br />AID -AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />UVATOHY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK X DISH <br />CLOTHES DRYERS <br />DISHWASHER <br />• RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURS <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK(PERVICE - BAR, ETC) _ <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL E <br />SUBTOTAL_ E <br />PERMIT S <br />PERMIT S <br />TOTA,FEE S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: 1111t 71- <br />rYCli t[TI\•Cr <br />«(An •31.K• <br />SKi ff 11KR <br />%w Ct nyvnrw ^— r{f <br />u5[Zcr•/ <br />lol •.(A <br />r•parry¢ <br />FEES <br />VALUATION <br />FEE <br />71, I_ <br />ulD Yn <br />'— <br />�(Z <br />v(�nvi llY.'I.I ESN ( <br />MTl••YfIlM4 <br />fVf \N:\Wll <br />�I� <br />� <br />H„AA AI <br />— <br />••r r_• <br />K999\ppp�A•'C, <br />=V'.. MOT <br />IA •I <br />4- <br />OKs Ono <br />---- <br />/J�� �- <br />•- <br />•u•Iwnn Ar nrd <br />Srcr..\(L. ddd <br />A.w <br />nx nl rcYt• <br />Woos rr�.mt. <br />CIT2 EVERETT <br />' <br />FPS <br />LOCAL SALES <br />-j—; <br />TAX CODE IS 7LD5 <br />TOTAL <br />•'7Jro� a <br />ir <br />/-0JDn(a nIS <br />A <br />0 <br />or <br />sys bed <br />UJ4�_ -�7Sb <br />-7 X � J <br />- - - --/os- `ic <br />