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APPLICATA FOP CONSTRUCT& PEIRMIT <br />CIT'1 OF El ERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 P (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION <br />1^ ❑ BUILDING /6M^ECt✓H-ANICAL ❑ PLUMBING ❑ SIGN <br />PRO.IECT ADDRESS: i.0 1^ -� Mriqt CUP, AM', <br />IENANr <br />441 AIg11E55 E <br />GFY <br />!IP <br />%1CMF <br />\PM A'C <br />ARCMrILt On nELGIEn <br />�-44iAW4E50 <br />Grr <br />Ins <br />rNBNf <br />%U4BWGCBfRRALfp1 II AGIPE55 GfY tIP PHONE SfMFIN:FNEfI <br />CONBMCI MICE N <br />_7 <br />9� <br />HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br />WOpN AND $OUARE FOOTAGE WWXVED <br />CGIIACT %nsoV Am PM F NO I <br />L -J- <br />ZO(L zSZ 1� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 1HIS <br />APPLICATION AND KNOW THE SAME TO BE 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 CONSTRUCT ON. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PERFORM THE WORK FOR WHICH <br />APPLICATION I COMPLY WITH THE STATE <br />CONTRAC t C AND 296 200 WAD. <br />G <br />X <br />nrgrosrD us¢ or auupNO <br />LEGALDESC%PR040r I EIIEYISH BELOW CRATIACH TWO COMES) <br />LOT BLOCK Or <br />PnpcG m I O titl40en - <br />SUZL to - z n - <br />CONiTnIKrIpIlOAN 1ENDFR.AIXNIE55.1E1f1YNINE MWRER <br />tL. AmnE ou <br />G1Y BU9HESS IKUR•- NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPEOFEOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />ABC —AMNOLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_T <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />13ACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT S <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE f <br />(J <br />FOR OFFICE USE ONLY: <br />rMHll VipALN <br />REAR SETBACK <br />90E SEIBACN <br />%WCIIECR NU4RfR <br />'IF <br />pf LFlP1 N0 <br />O/30 <br />USE EONF <br />101 AREA <br />NACANT WE <br />FEES <br />VALUATION <br />FEE <br />BUIIRNR <br />_ <br />I <br />_ <br />DYES O NB <br />HEIGNTIIMIIArpN <br />NBOF DWELLING <br />fREMBIBBRI <br />IIMI.A <br />%IIMPR1f1 <br />— <br />OCI NCv rp GEIM1[IS <br />O0CII.NItOA0 <br />BASFMEN1 <br />4FlNWN:A1 <br />OYls ONO <br />ROGTKINAL%WClVCA <br />rIRESPMIIXLERPE09 <br />RfASON <br />OIV R <br />rIPE AV.PM RFOU <br />Pf AiGy <br />$IAIE B14lOMC. SVfICRARf.! <br />TYrF or LCWSt <br />%ANPAP%IDYFRBY <br />CITY OF EVERETT <br />%rBlcm <br />LOCAL SALES <br />TOTAL <br />--- <br />-- <br />GALE <br />TAX CODE IS 3105 <br />