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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 R (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION QS BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:- �1tt �P�NJ aVG•) �a/BR'�i WA• <br />�AIID_.{EPLN►['21iF>�. 49ttOl:6fM)µ�i., 6l.E�FR`y�.. 96LOi �IrZ5�39•i�flZSL <br />pANfn wul .Up11f S5 a-�— r rN(n[ <br />1[NMI <br />uul AV 15 <br />rlrr <br />nr m1'W1 <br />l+tts�1LlPt� <br />b-- w'soll t scc. <br />2Ltl et��6� <br />A46 1�a03 Ej�A�9btal '4 751 a <br />.ncmrtn on iRAmnn <br />w.11 Anrolf IS <br />uM <br />nr rN <br />ib S61 ► <br />GfwtNltu.m.C.rnp <br />wul qX%rar5srls <br />Clh <br />r rvwnr Sur[ IK(Ns( <br />MFC1IA.�.ICU41pACrUp Vwl AlMl ss On I rIMN[ [urf tICENIIE• <br />m llwp�,C In�..m(pon ��yyV�Ap AMAESS cllY 1., 1a11 SIAr11KF451• <br />Tom. V�� <br />cowmAc(MRCF ur W(MR <br />HEATING SYSTEM: XGAS ❑ ELECTRIC ❑ <br />tYSCrUnF W.]aR ANn 5nll.u[ (MunE pIVO\\Fn <br />CcauCr n asnN ANn ryNyyl .p <br />T <br />I HEREBY CERTIFY THAT 1 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 />CONTRACTORS LAW 18 27 RCW AND 296 200 WAC <br />K <br />I4 sto USE of mndNO <br />(EGAL ME RPnoNa i41Gp6nn lSNovn MLO w AMACN Iav COPI[SI <br />JOY MGCK p <br />J E *4 2 <br />5F T 30C ^^" <br />"` <br />S <br />A A AY�F'��u�.m(5 �S <br />rAperUAllr,ul �l—ulls(I\t f <br />-�?L3�0w03/ 900'�l 000� <br />c(namSrpW Ifl�NIrN(;R Aq>r1Ess. t[IEAgNEMM1En <br />!!GNAT\IRE nAll <br />C11Y mIVN[55l Cl Ncf 'A <br />PLUMBING <br />MECHANICAL_ <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />% <br />(TOILET WATER CLOSET ) <br />A/C --A/tm101O UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES CRYERS <br />DISHWASHER <br />RANGE HOCC <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />WOOD STOIR <br />URINAL <br />METAL FIREPLACE (WOOL) BURNING) <br />_ <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />_ <br />SINK (SERVICE — BAR. ETC I <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL S <br />SUB TOTAL f <br />-- <br />PERMIT S <br />I <br />PERMIT f <br />TOTAL FFE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />(11UN}V1p.fN <br />�s <br />PI"ASRok.. <br />2S <br />SIM Sr IRKx� <br />7.dY//f1 <br />&MANCMC4NU,,n 1 <br />Ifrj �r <br />J/ . <br />alfl f'I Nn <br />IISI AL{I1�f1� <br />!� S <br />10, lot. <br />�..T L�•1 (O <br />I.,." ", <br />GYr[ Anczw) <br />FEES <br />VALUATION <br />FEE <br />S ! 170 <br />110011111.1.14 <br />NO a nere NK. <br />Ions <br />.Zf o, ma:nl <br />0 S 4041 <br />UCl:1R'.1C. <br />4n n.liK.l1 <br />IX'.CIIr.N11UAn <br />RASIMNf <br />IIrI:NAMK.AI <br />AUdll0N.I M.404C11 <br />— <br />rIP[SMINMI[p F[U9 <br />prAt(}1 <br />_ <br />Olmr. <br />rlp[AWIw N(OD <br />4f.." <br />Sur( Pu4nMu 51RICN.p.'l <br />� <br />lrrr fK coN l <br />'/ <br />- r <br />n.N%A➢rpoq n Rr <br />U.lt 5�2A 9 <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nMI.,--_ <br />TOTAL <br />_ <br />