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APPLICAT& FOR CONSTRUC014 PERMIT <br />CITY OF EVERETT R BUILDING DIVISION <br />3200 CEDAR STREET R EVERETT, WA 98201 A (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION P,I BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:.7eS/9 �'�I�4gOf- L.!(l• 611_?lT_c _ <br />i[MANt MM •fMYlr55 fln 11> " 1 <br />��>✓ IS%usit ,3`io A��!� CLra.7�latr �,fs-�T:>L L%n. 9s�1L: � 975-`�ofo <br />A"yTCt 0n M90n[n UAR.DDAFSS Cln lln r"Knl <br />GrAGnAI CONInACIOn uMI MI "s C11\ pr' • r - CINv • <br />�GDrTu l�D u+5r� rt�0- /3dir lov sr, Able- tn,-.)~Etfb�`s 415 39�i-592c <br />WcnAbcAJ UWin•CIVn Vul Atp'Ess an Wll Nr ".IF I4CNst• <br />n uWlhc cONlu•rirn VA¢AMPlrss cnr I" - 1'-`4 surr,",,f I <br />cl rryACI IYIICt W wMR <br />ya <br />.— <br />HEATING SYSTEM: PSGA5 ❑ ELECTRIC ❑ <br />Mscaer wOM1 ANn sOVANr EDOIAGt wvavt0 <br />N <br />coNl•cl MnsON_ n.o•11•- <br />t3a:oTrsiSS f1S - 712-5Y3r <br />//qL <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 />CO O LAW 18 27 R% OW AND 2200 WAC <br />X(`A <br />t•fNA E I[ <br />nnoroSFouu MnMmNG <br />LEGAL MSCMPIIMI M FTOMn ow Gn •n•cN two cor[sl <br />toy kocp <br />Pu'crt wl IUNn <br />5/l / Boo Oa,,l O/oLo <br />C ICINM110AN IfNMn Nlnllt Si tf 111NgNF MIIYn{II <br />ca, ly,"W[$ I A f N+1 4U <br />PLUMBING <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WA TER CLOSET (TOILET) // <br />A/C—MINDLG UNITS <br />v <br />BATHTUB �� <br />✓ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) % <br />HEAT PUMP <br />e- <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 />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />_ <br />FLOOR DRAIN <br />r/ <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GASRANGE <br />SINK (SERVICE — BAR, ETC 1 <br />✓ <br />GAS PIPING <br />A' <br />EXHAUST FAN <br />SUBTOTAL $ <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />TOTALFEE S <br />TOTAL FEE S <br />cno ncr,re Nee nut v. <br />I rKwy vynA + - - �- - <br />S <br />Du tONF <br />11[pnr llWrAtgN <br />/�A G <br />nf•n 5y Ip4R vM s[IeACA I <br />' ,S <br />101 AMA IA All 91F <br />Ole - <br />Ho Ot pwflllNG SIT( Mel W'tl <br />IMIt I / <br />nRN artcR NOW1rn rtr <br />�� o /[r <br />FEES <br />ZV <br />3?a <br />VALUATION <br />of rrmr No <br />139101 <br />FEE <br />n114111NG <br />-_ <br />4zI�- <br />_ _ - <br />- <br />- <br />OC17=-Ia'tln+ll'ol] <br />OF CIIPANI IO•n <br />' <br />R•tfWNt% <br />4i1'N•Nf.•1 <br />�_- <br />AMRIK Al MANCIC(A <br />nn[sNm1NURMOD� <br />MASm <br />OIrNn <br />IN ALAWWOD <br />nr •SOv <br />Sylf R1MIO�M151MCI4yyT <br />/ <br />,r �y <br />L/. <br />T <br />Iron OF r,OnSIit <br />nANs •ryaavrnm <br />CRY OF EVERETT <br />nmKwTKwc <br />_ <br />_ <br />n <br />OVE /%�i/ <br />LOCAL SALES <br />TAX COPE IS ]105 <br />-- <br />TOTAL) <br />�I <br />