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APPLICAT& FOR CONsTRUAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425) 257-8310 <br />O DEMOLITHM ❑ COMBMAT" U EARLDINO , O MECHANICAL ❑ xUMBMO ❑ SION <br />COM1MCt rwcT a " <br />HEATING SYSTEM: AS ❑ ELECTRIC ❑ <br />C(K.T11Fi W.iNt PNO iO11.Pf r(br.nl MVOIVFP <br />Colt rrt^�MIMYININ <br />-)dai aQh sus-334 •0435 <br />_ <br />-•nJs�,r'�r� ✓iol1� <br />5 1 %- <br />Csx 4LS- 330-33t3 <br />/li L �iblYOl S� 4119 <br />r' <br />SQ-R- <br />1 HEREBY CERTIFY THAT I HAVE REAL 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 WRL 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 1 COMPLY WITH THE STATE <br />CONTRACT LAW IB 27 RCW AND 296200WAC <br />K <br />ucl p o M."3p11O <br />/C <br />MUALIE Mr M IPiolfPnt H KLOw w ATIKH Two Can it <br />Lot elocP p <br />�— <br />p b <br />L MKIO MARK <br />CUIRNPICT. IdN 5G R IFPMONF M,lM^lP <br />'/ <br />al sICFNGf NO <br />xulwRD <br />- <br />SECHANCAL <br />PE <br />TYPE OF FIXTURE 011 REM <br />FEE <br />NO. <br />TV" OF E0111PHBR <br />FEE <br />WATER CLOSET (TOILET) //I <br />MINDLG PINTS <br />BATHTUB <br />FORCEDAIRSYSTEMS <br />LAVATORY (WASH BASIN) <br />4P <br />HEAT PUMP <br />-A, <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SIW A DISP - <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD — <br />LAUNDRY TRAY <br />( <br />WATER HEATER i <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />$ <br />SUB TOTAL S <br />_ <br />PERMIT <br />f <br />PERMIT Si <br />TOTAL FEE <br />f <br />TOTA FEE f <br />FOR OFFICE USE ONLY: <br />,"TAXTPA" <br />ri <br />M./ytP.0 <br />Qft ,.o+. <br />srot ulwy <br />-7 <br />n.H CPtfM1 NUNYP <br />la2lJ29 <br />t!! <br />7.3.3a�o <br />IIFfiRI <br />uut <br />Ior.Pl. <br />'K., snf <br />rs D M) <br />FEES <br />VALUATION <br />HE <br />Pi A'MNf. <br />_ <br />W <br />3 ialc <br />O t t L9: x% <br />L(��+yL <br />1(I({Nr 1�VH.riO4 <br />30.6 <br />Np aPPYl1�K. <br />Mil[ <br />Slf 104 r1 <br />3f> o <br />ocum.v:. <br />V1 rvGLwU <br />cx:c,mANnn.n <br />P. APG1L_S <br />NicH.Nrn <br />Ia}IHIN4 H.N [IHCM1 <br />Rm ll.: INPL9D <br />MAGnI <br />NP <br />7m MAPM Pl00 <br />PI.G()v <br />SIM <br />nrcMcalGr <br />__ _ <br />nANs.rrnrnfon` <br />o.rH �`\ <br />CRY OF EVERETT <br />LOCAL SALES <br />TA%CODE IS 3105 <br />rnnuc wauc <br />O <br />TOTAL <br />_— <br />