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APPLICAT& FOR CONSTRUCRON PERMIT <br />CITY OF ET - EVE • T, WA 98 DIVISION <br />3200 CEDAR STREET • EITERETT, WA 98201 • (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION :R BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS; -db'R7 <br />_38az GrardAw- IKE if W4 3�1 vet-zSz-zJf73 <br />oamfn uulAmPrss nn nrnx '1 <br />Irnwr uAn nndHPs cnr nn mroN{ <br />A_ Rom: N.. nbrsL-3L3 �1f1 u/. Si.. .�rl, (�/�f4x9� 3/�r�aA-9�s3 <br />AWl.lfCTOpDf!PGIIC. Ml.n ndFlE 5 ClY )ir f.Kml <br />SQAhO <br />L{N(nµ CONIpLLIOn Vut AMln[55 CO♦ pf M1NIV[ i1.R UCINS{1 <br />VECN.MUL COMPACTOR VUI.fAPE ss OM1 !M PIgNr SI.rr UCEN5E1 <br />PI114a"I CdllP.Lrp1 NUI ANAESS CIlr lip pnONF SIAIr I CCAISf1 <br />coNrn.cl rnlcr ur Mm. <br />td2. <br />HEATING SYSTEM: ❑ GAS WELECTRIC ❑ <br />DfsCP nFY IIX.Nn SOUAPt 10Or.GE MMVEO <br />.L ONr.n nl nso4 Mre„(jy'no, <br />wAsn 3/�o-(z9-973 i <br />_— <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 WIIL 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 SLATE 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 I827 RCW AND 296200 WAC <br />A&i a4i�x"1� <br />INlpgsf0ust or elnldNn <br />LEGAL MSCIAPPM a PPOPEAY INIG Ujowon A11WH IMocOnrsl <br />toT BLOCK OF <br />PAPLrL 1d11) MPIPIn <br />lLOAN z/Ad3M-ESCS YItxIE7M <br />'s2w- <br />I rN-M/n� <br />fW;TION ONE MN <br />Lnr aVVHCS£�TN4 40 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE - <br />NO. <br />_ <br />TYPE OF EOUNNAENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />_ <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 BURNING) <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />_ <br />_ <br />BACKFLOW PREVENTERS <br />GASRANGE <br />—L <br />SINK(SERVICE — BAR, ETC) <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL S <br />SUBTOTAL S <br />PERAIIT f <br />PERMIT S <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />I RnNI VrRAt. <br />Pf APSf IR.L. <br />9 WIIIACR <br />n.gp1( NUWfP <br />�y�zbz <br />EEF <br />RfIFEE <br />usE tOMF , <br />IOI AP[A vACAn191E <br />FEES <br />VALUATION❑1E5 <br />GMISO <br />QOCTNO <br />M MUM q—?"IO.Is <br />L—,.o-rll. <br />_�wnm.w <br />un:xArx:AL <br />lG.G n'PPu1Nr <br />o�jEs GNP <br />PPEOD <br />Pf.CM <br />< <br />.wPOA,Mho <br />OnKn <br />ddO 6 <br />IME.URM SPt c. <br />11f.5nV I., n <br />SIAIE RIIPPMn SIAIX.AW <br />IrrEM COAST <br />nANS Arr,IEn Or <br />� <br />CRY OF EVERETT <br />MNmIMXMs <br />U N <br />OAT t U 6 <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />— — <br />— <br />