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APPUCAT140 FOR CONSTRUCIPN PERMIT <br />CITY of EVERETT A Bl11Lom DRRSION <br />3200 CEDAR STREET • EVERETT, INA 88201 •259-NIO <br />fMOUTION ❑ COMBBUTT ON ❑ BUILORIO �PI�7MECHANICAL ❑ PLUMOM/0 ❑ SIGN <br />PROJECT ADDRESS: '7 S'� z L50AJ f�' ""z C <br />A n _ - _ i_ t <X. 4/ 2DOf YAw"woO� Zpl.-778-714% <br />IfJ¢sTlA�noo PWaf 24t8 14,�995"575-61e=4T q$2D4 zph-"74L-7O/1 <br />TERART AAAA ADDIEn art TE IRK}E <br />AecLnfcT aDEsfrER urA At 5s Cm 7M RNpE <br />ryUrWCONTRACiPI NAAADOMSS ary iM n1dE STATE IKYRSER <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />C(paepF YgRf AMD 60VARE fDOilpf IrvOIYEO <br />CwAcl MASONAMn MJ <br />PitniKL2TDN �M1IA1KlY_K. S7TIM <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />sLOIJ <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />AROAosEo usE o<eul <br />i <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />rygRERTr IvgWN KLOW011ATIACIITrgcarasl <br />( <br />_IEsaaArup�a <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />lo* _ uoa or <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 />W 277RCW AND 4YS.200 WAC. <br />ANCfL TAK i o. TAAWR <br />\/(/kCTOR <br />�O �^�—� —f�{�� <br />Cd51RIgRW ROAN IfNOER. AOORf51.lElErygnE N1MMR <br />elOrlAfORE fMlf <br />CITv pOLlE53 LCENSE NO <br />MECHANICAL <br />NO. TYPE OF EQUNIVAINT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A7C —Al*OW UINNS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <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 />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />OAS RANGE <br />_ <br />SINE (SERVICE — BAR. ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />r— <br />SUB TOTAL S <br />SUB TOTK f <br />PERMIT S <br />PERMIT S <br />—77 <br />TOTALFEE 5 <br />TOTALFEE E <br />run vrnf.c we ..,.c,. <br />r,TSEtRACK <br />W.w S. TMCR <br />FIDE Sfip/{A <br />NA401CR MR/fR <br />IFf <br />RFCFMi Tq <br />usf I <br />LOT AREA <br />vACARr PIT <br />FEES <br />V UATON <br />FEE <br />OYES ❑W) <br />f—aRI L�YrAriON <br />RO Of O'REEORO <br />Lmils <br />5,1E0r KwnI <br />RoNBMIf <br />OCCLgARCv MIK SIM{S <br />OCCIRwr tOAL <br />pRMAERT <br />wc"A .m <br />--- <br />on p <br />❑vEs ❑RO <br />) <br />ADargRu nw arcK <br />T <br />TIRE SVR:wLFR REOD <br />RE ACd1 <br />OVER <br />{qE ALANA MDD <br />RFASM <br />STATE smR .RRCNAMf <br />AiN W. RKKIKR <br />ITRE rErO sr <br />nANSA, En eT <br />CITY OF EVERETT <br />OnE� <br />LOCAL SALES <br />TAX CODE IS 310S <br />TOTAL <br />