Laserfiche WebLink
APPLICATIO#FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT • SUROM DIVISION <br />3200 CEDAR STREET • EVERETT, INA 9S201 •2"10 <br />❑ DEMOLITION ❑ COMSMATION P(SURMHO ❑ MECHANICAL Cl P MAINO ❑ WIN <br />PROJECTADDRESS: RLdb L % sa i 9,+dz,o lzvd <br />1 z 177 1�p3 Pa..L.rL,.l T y7s- 611-s383 <br />RDIMR, IPxfm WVIAP ss Glr ZP' RISt STATEICCl . <br />cL TwT %RE w-- <br />S <br />HEATING SYSTEM: Q OAS ❑ ELECTRIC t7 __ <br />e[ILTIeE how wYD Xa.µff ibf MVOlvfp <br />L 1 5 ffF><// OIL ! Iw�7l-OvF- <br />flMi1C1 XP5pN YO RUI[ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />wfvoxoux a euao..o <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 GRANONG OF A PERMIT DOES NOT PRESUME TO GIVE <br />IEwLTxsrsTmwaRnffwn lslaww eflowd Artftx Two TXKxR <br />LOT eLDcx a <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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WIN THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 2f6.200 WAC. <br />IIIfRI TM I D T A <br />X LC '7 3y-/ 7 <br />LderrA IXW(f IfMfP.Poorwss.TfIER04rPA�e <br />sdAnAc wrc <br />GIY w1151ME55l CfxA W <br />IFLIIIMNG <br />MECHANICAL ---- <br />N0. <br />TM OF FIXTIME ON ITEM <br />FEE <br />NO. <br />TM OF EOIIIF/IIBR <br />FEE <br />WATER CLOSET (TOILET) <br />AC—AMWLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY IV/ASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK f DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />I METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAB FREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />.1 <br />SUBTOTAL f <br />SUB TOTAL f <br />PERMIT $1 <br />PERM f <br />TOTAL FEE f <br />I i I <br />I TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />rroxr SFreKll <br />Pcw sFrsrclt <br />sroF SFreln <br />mwowcT / <br />/ <br />rEr/�7 <br />!(LF1'rw <br />IIMi <br />LOT1r1Fe <br />v�cNlT 9TE <br />FEES <br />VALUATION <br />FEE <br />30o <br />❑rF3 ❑ 1,0 <br />IN�OxrlPwteTgN <br />MCI pwFTlM4 <br />yRd RIRIRI <br />Ml[ <br />(f, /VD <br />%IMMi <br />i <br />Y gF;SIMff <br />Of:cUMNTTao <br />yrCxfMCµ <br />I <br />Q <br />Otts O"o <br />fOdrKwy nix Gxl Ce <br />%R ,1I1E09 <br />xf •iRlG <br />OP.b <br />anTrn <br />Fe1F I3MMPE09 <br />PF�[pI <br />OI(U. <br />.._/� <br />rrrt aroxsr <br />nAxi Der <br />CRY OF EVERETT <br />nrw r. rAllxrt <br />LOCAL 8ALE8 <br />TOTAL <br />ouF P. I i. ,9 <br />TAX CODE IS 310S <br />