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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT < BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425) 257.8810 <br />❑ DEMOLITION ❑ COMBINATION 9 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />O. r <br />Ancl«ricropMDEvSEcNFn 41V AMwEss cllr <br />nr <br />r,K+Nr <br />N 660 1 <br />3 n1adj<rs Yo a7 ki. k— Alur C-737 <br />E4«.ff <br />?&Ao/ <br />Yas-3o3 -9oYJ <br />xw NERAI CONFf1ACra+ 4u1 AO1M1F55 Cnv <br />)Ir <br />Plx}I[ <br />S,.It I'crHSFr <br />MECIIAMCAI CONIRACTDP 4ML AMFFSS cl, <br />Ilr <br />PNCNF <br />SIAIF UCENSE0 <br />¢ w E- <br />PI 11MlMGONIPACATM MWESS / Mlr <br />3R.o o.e0 t// �iLY <br />IIP <br />PN F <br />STA1F LICENSFI <br />r.wmcI lxBc Or vAMIx <br />(O A drf o s <br />HEATING SYSTEM: ❑ GAS ®ELECTRIC ❑ - <br />OFSCPIBFWJPxANDSDUAPLFDDIADF.V WD <br />C'I TPANU; rNU <br />o_MI Sf <br />:7Ij< :� oa Sr. I< Sf-o A pip'.. <br />�3— <br />323S - O4 a <br />7jA <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 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 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 I COMPLY WITH THE STATE <br />CONTRACT LAW 18 27 RCW AND 296.200 WAD. <br />p. <br />rnOrOSf D O. [ D nll INr. <br />[EGAL MSCRIPTI ea PRor[RIV ISIIDMfl BLLow aP ATTACH TNp COnESI <br />IIII _ BLOCK or <br />1 (� <br />�c. I o r Cw) < mrx..T- 07 Cam) < c,,,., <br />rARCEL ur D MI4BEn <br />/ate G1.>7 0 � 000 <br />096, <br />CWSTFIMIIONIOAN IfMIFRADfIn:SS, TELIFI EMMBEn <br />DM[ <br />CItY BUSNESS MENSC NO <br />PLUMBING <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EWIPMENT <br />FEE <br />WATER CLOSET (TOILET) — <br />A/C—NHNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNINGI <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BNCKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />EEXHAUqTFAN <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT S <br />TOTALFEE S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: / <br />FMNI VTnACx <br />zo <br />nrAR SF.IBAC< <br />`Zo <br />SIM SE1BACx <br />5-S <br />rIANCIIECx NUWR' <br />/ y.s <br />FEE —�- <br />3aa. i/v <br />Rf CFIPT NO <br />USE roar <br />- <br />Im AB A �800 <br />vACA1RYlE <br />GYEB <br />FEES <br />VALUATION <br />FEE <br />BUInIw, <br />S <br />q 9 — <br />IlEiarn1l41unoN <br />D / <br />ND OF mEWNO <br />[INIIC <br />SIZE a-(ADORI <br />'— <br />rLII4RINfi <br />�% / <br />L,/_�_ <br />OCCUNNCY(MC)•FM <br />510R1 S <br />MCUMNI LOAD <br />BAN•iNl <br />CI YES li <br />MFIPUNKAI <br />--- <br />AO011(fV4 r1 AN C14Cx <br />-- <br />— <br />FIRE SPR111IUEP REOT] <br />nFASpI <br />OIVfR <br />FRE AIARM REO'O <br />Rf AS0 <br />41MI WILDING SIEKHAnnr <br />TYPEOrcorst <br />.<.J.✓� <br />.!L <br />r1ANS APruovfn nr <br />(1AIL /9 98 <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nlnur. vgllxs <br />— <br />TOTAL <br />-- <br />