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APPLICATIA FOR CON8TRUCAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 E (425) 257-8010 <br />❑ DEMOLITION 8 COMBINATION ❑ WILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />IEN.Nr e,1 4M IIOp[Fy rlly )w pgNF <br />///A�d7t a �iuraxDi¢ists /7/ Zr i:9 sr y� 3 LL M«fc yu 67ib <br />•ncl.nc�r�qP oFvcNEn •n s—�pr, iE i — niv ter rNP4( <br />CONtP..CI PIYCF U( MlY1F <br />2 AOD <br />HEATING SYSTEM: ■GAS ❑ELECTRIC ❑ <br />GESMIF A9O fS.(Tg <br />J4rr, <br />EGNIACT K PAM AMAIN M <br />SSL <br />/,HST,4// Net✓ iY7`EX/,e./_,LI,. <br />'N '~ e� <br />I HEREBY CERTIFY 714AT 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 VAIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEWIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF :.NY <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 27 RCW D296200 WAC. <br />X e4glpr, <br />P V. RUSE OF MADM <br />LEGAL DESCIIIMM Of fN 141`l I9OINN KLa«CIA ATIACII TYID COPIEsl <br />IGI Q 1, q-T-(P /ImocN a to pr - <br />pf ILEEllI %i rJNF a ���� �� <br />r'p /�1� <br />O I Q '- 002 — o" <br />PARC[L TAXID NIAAKP — <br />CGIISIMICTI L CAN L rWf N. AOIMESS TEurA AIIIIlEP <br />DAn <br />CUV IDSINF SS LICE NSL M <br />_ <br />PLIIYBINO <br />MECHAWAL <br />NO, <br />TYPE OF FIIITIIRE ON REM <br />FEE <br />I NO. <br />TYTE OF 10111611FIT <br />FEE <br />WATER CLOSET (TOILET) <br />AA;—AMVDLG 11 M <br />/ <br />BATHTUB <br />/ <br />FORCED AIR SYSTEMS <br />7 <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />/ <br />SHOWER <br />UNIT HEATERS <br />/ <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />/ <br />DISHWASHER <br />,/ <br />RANGE HOOD <br />/ <br />LAUNDRY TRAY <br />WATER HEATER <br />/ <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />/ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />/ <br />UAS RANGE <br />SINK ISERVI--E — BAR, ETC.) <br />GAS PIPING — <br />EXHAUST FAN <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT S <br />PERMIT S <br />FEE <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />I PGN iA <br />D <br />nFA.sr,w.R <br />VIALsfr . <br />rl•N Cn[C•NV <br />(ff/�� <br />P{rFM1 ND <br />usE rp4r <br />Im.PFA <br />/5 �U <br />v¢ANl 91, <br />❑Yf5 y p M) <br />FEES <br />VALUATION <br />FEE <br />—�— <br />RIII fMM: <br />Z <br />PFIGIII UVITAU" <br />WOID DING <br />I I41I4 I <br />SIIf Or NUGRI <br />AI.S-/j.r-2yay <br />rlll\TWG <br />_— <br />OIX:IM•1C.Y VI !•1 )IrPlf <br />-3 J-/ <br />nn(sna4Nlfuu[Po — <br />CC'Vr1N11 UAI1 AAS(Vf YI <br />❑YfA Ar� <br />n1.sfY1 <br />VII:NIM1N'•1 <br />.CDINw.I rtAN OxcN <br />O v <br />— <br />mrwn <br />".E ALARM PLO <br />Rf•Sm <br />SI.IF 61.1"1; 51111[IUMA <br />--- <br />_- <br />�!� <br />rvrr Dr cal4l <br />y <br />nA4s.rrnnvfDPr CITYOFEVERETT <br />LOCAL SALES <br />RAIL x% TAX CODE IS 3105 <br />rlwl¢«nac <br />TOTAL <br />---' <br />, <br />O <br />