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APPLICATI02 FOR CONSTRUCAN PERMIT <br />CITY OF EVERETr R BUILDING DIVISION <br />3200 CEDAR STREET R EVERETT, WA 98201 r (425) 257-8810 <br />❑ DEMOLITION ❑ COMBM ATION)� BcUInLDMM ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: I%f�24o hA1Nlf-Ac A \(E <br />-1AQIc F AxAJ MACr• C'Cestr 1726 R.4�wNee .4.Ie ENrrerr W. Sf1o/ 4xf 2rf-13o <br />Go un RmIIESE LAIT 7M nda <br />AM,F,ECl0 mvGNER NAR ADDRESS <br />Cl" <br />lm <br />nMM <br />PACIAC GAQA6t5 TAIL <br />Ll(c LA."L DI <br />fvrgor I/JA <br />982D1 <br />421- 2S5IV/ <br />GENEnAI cwnRcIm uu1 RCMF55 <br />CITr <br />nr <br />PT"E <br />SIM 1".. <br />PAcrr-w >Sa3-A <br />WCIIANC.AL C.OVTRACTOR MNL ADME SS <br />CITY <br />IM <br />n,WF <br />VAIFLCENM. <br />n11NARMG CMIAAr,TM DAIL AgTESS CITY m VIgNF SIM LCENREF <br />CONrwT PM:E <br />T S�—ZiD , [)O <br />HEATMq SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CESCIME FO Nd1K AM SGDARF DTAL"RIYO w <br />CV�AIS 7.wcr / ETA[Irao L=ACAGr <br />C ACT PFRRON AND 1w NO <br />r OLSOA.r 44S' 2S;I-13// <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 WRXCH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW S 27 RCW AND 2N 200 WAC. <br />K 9��fY <br />RRD D V!IF DF IAAUD0 n �Ae.4/ot_ <br />IEGU DEscmRrRnIa RIFDEERn ISNoxN xLowwATTACN I\YD Cdrt51 <br />IGT sacs p <br />TMIICEL TAA I D MARFR <br />43E� 353 _02.0- 0o03 <br />CplilnlClION 10AM IF,AFR. ALORE$$1E1F1'FCI,F MIAIfR <br />s1GNAruIF Du[ <br />pry suxss LKENSc ND <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />W. <br />TYPB OF EgKPM INT <br />FEE <br />WATER CLOSET (TOILET) <br />AA:-MNDLO UNITS <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 />GAS RANGE _ <br />SINK (SERVICE - BAR, ETC.) <br />GAS PIPING <br />- <br />EXHAUST FAN <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT S <br />PERMIT S <br />TOTALFEE S <br />TOTAL FEE S <br />n <br />FOR OFFICE USE ONLY: U7 1 .. <br />I RI1Ni V1P5fR <br />a0 <br />WAIT $riRACt <br />A5 56 <br />$IC(5[1RACt <br />s' <br />nl Ar1 C11[C NIIV1rR rFIF <br />�SZ58 <br />I,f C{Ini NO <br />R${InNr <br />IDIARFA <br />vALAN, VIE <br />FEES <br />VALUATION- <br />FE� <br />_ <br />RIMpN or I� <br />!Z <br />6 <br />R-a <br />,5 <br />❑YFS �U <br />INIf N11NRAI 4I r <br />NOpIM'[IIING <br />SUEOr HDC", <br />_ <br />) <br />p:I:IMA4C.Y <br />bM$IIIA.I <br />MCIInAN11DAD <br />IIWDFNI <br />VFI'NANMAI <br />— <br />GAF$ NO <br />ADp11ONA1.n AN CINft <br />nM $%M1NAIEP PCD'0 <br />Rr AS(M <br />O1MfR <br />IINf AIARVRED'D <br />PFA$04 <br />&IMRAW.t <br />SO <br />$IAIF RVrtpND <br />i —_ <br />IIr, mrm,, <br />NANA AIMMrn RY <br />cITYOIFEVERETTJ <br />nmllr vR,«t$ <br />'}T_u <br />LOCAL SALES <br />-- <br />- <br />q <br />i-- <br />Zy'� <br />TAX CODE IS 3105 <br />TOTAL <br />Q <br />DAIf <br />