Laserfiche WebLink
APPLICAAN FOR CONSTRUSION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVFRETL WA 98201 • (425) 257-8810 M <br />❑ DEMOLITION ❑ COMBINATION BUILDING MECHANICAL -KPLUMBING ❑ <br />nr <br />,���� /�771Bit nXNr sr.rr lrcrns[. <br />rinuPNn conln.rlm �u.n NXx�[ss olr � tl^ r��=�—_ <br />�/J �„^�/ pp mlprr sl.lr lrrrutr. <br />CONInLLlrnlcrNNYlnw// <br />��1R.[= ZQlo7 _HEATING <br />nFiCNP <br />SYSTEM: GAS ❑ELECTRIC ❑ <br />MnM.N/IJ,S(�]ll�. n�{[nnl.n{NVp�y1[n <br />fnN1.C1 �•r n{rN1.M11•IMINr MJ <br />-- <br />,Zlc(o 6.Nib r*-# 1•c F _ <br />- <br />at <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />I'norn ust or Pnnnr'.r: <br />APPLICATION AND KNOW T14E SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING T141S TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING A PERMIT <br />ur..t nrscmr plp rrlorTnrr ron now aun¢ulwo car[sr <br />l AIM- p C .�.Q(-Z_S <br />AUTHORITY TO VIOLATE On CANCELS THE PROVISION OF A1NY <br />Tc .o-T A�IG /999063oSoas� <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER <br />qqy� LL <br />62iQ•d/p�Q�I <br />OF 7141S PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICA <br />r.ncn uno Mrunln <br />ON IS MADE AND 1 COMPLY WITH THE. STATE <br />COHLRA RS W IA 2) RCW D 296200 WAC. <br />/��Prh9 <br />x n.lp,[ , . <br />COnt m611rw 10.vIrMlrn..pvrfss rFlrM1lOVF HI �� <br />��doa fro a ffrZ4X-' �� <br />�• Z6Z <br />C BII t5lt(Mtr MO <br />—__i=r J /6D x <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF EOUIPAIEHT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET( <br />_ _ <br />A/C—AMNDLG UNITS �— <br />BATHTUB / <br />FORCEDAIR SYSTEMS <br />LAVATORY (WASH BASIN) /// <br />HEAT PUMP <br />�— <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />/ <br />PANGE14000 — <br />LAUNDRY TRAY <br />WAI ER HEATER <br />S <br />CLOTHS WASHER <br />WOODSTOVE <br />—_ <br />MINQ <br />LACE (WOOD BURNING( <br />DRINKING FOUNTAIN <br />NSERT E. BURNING( <br />FLOOR DRAIN <br />ACE <br />BACKFLOW PREVENTERS <br />WXHAUSTFAN <br />—�— <br />_ <br />SINK (SERVICE — BAR. ETC.) <br />�— <br />N /� <br />r <br />SUB TOTAL f' <br />f <br />PERMIT f <br />1-- <br />IT f <br />—�— <br />rnn n <br />70TALFEE f <br />TOTAL --FEES <br />IO4r / Inl .r'r. V.CN11 V1 <br />Orrs ❑ xu <br />nl U..rlul0yn A / v0 p nwHlrvG Sqf p N mm <br />nn[NAnu mnn —' <br />CITY <br />LD <br />TAXI <br />D'.n <br />ela nwr, <br />rwuPNr; <br />.onlXNu n.vclrrr. <br />oulTn <br />41.Ir Rin11H.1: 5'W:II.Mf <br />M1nw; VwX�wt <br />rfr <br />cze <br />TOTAL <br />