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APPLICATION FOR CONSTRUCTIN PERMIT <br />CITY OF EVERETT e 9UILUING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 E (425) 257-8810 <br />❑ DEMOLITION COMBINATION El BUILDING ❑ MECHANICAL El PLUMBING Cl SIGN <br />PROJECT ADDRESS: II„�i A,I. A7r 1,1LL Elvzi I-)T , 1-j6 <br />_ L6- t�l_IIJ Pn ��x t-z� j%S-707L Et�+cslT npF,+w s,c (yzs>- _ <br />owNFRGuuL AGONfs9 an enprA <br />2 `15 <br />RdAl%) CpNSTFL.iT1M1TRY <br />PA.20%*-2l <br />M�Irc� <br />&ILSm's-'na, <br />I INI_T In\Y.G <br />"NEPAL CMInACTM <br />M.pAfss <br />.�lrr <br />Clh ))Ip <br />pgNE <br />941E lKENR1 <br />IY ,Vie <br />/ R-M I:/ 5 O <br />,• lEn 12urAN <br />-Y2Z-Z9uI4TFZ <br />MCRWNa7nl <br />MAIL AE95 <br />ClNT <br />lC�NaE <br />SSOLA-ILDh J\P <br />) PLM-YY %TOIP TNL 4 <br />4 • ! S RD Ob i <br />[U r.Y Z <br />O"f4i CT„�a <br />%UI.IMG CONIRAI:i(1R <br />yyL ACCR99 <br />CITY /Ip <br />pNONF <br />•I <br />SiA1ElICENSEp <br />75, ecl9 <br />CONIMLI PROF p NVPM <br />HEATING SYSTEM: fi'fGAS ❑ ELECTRIC ❑ <br />MXMW ROPY INU 9011ANE FOOTA .v Wb <br />✓ SjIVj4F FfiM IL <br />CMTACT KllS A 1N01(,q <br />/c- �7 <br />L F,9mIC <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 WHICH <br />APPLICATI01 IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORSCONTMCTORS L�1rYAC. <br />X A. <br />Rgrouou m TR%RMG <br />3 ') 8 <br />LEGAL INKMPTI (X R Rh IS ITT LOwM ATTACH Two CMESI <br />Lot 3 RIMK a <br />Z, - LZ- 9,g <br />b 57-017 •rR,'Y <br />PAM:EL uR 10 M11MFP <br />CM9TRUGTKM IO.W IFMEP.ApnESR. tEIFVHpHE 1MAEP <br />PO. Sox <br />DAT[ <br />ah RUSIIESS ICFNY NO <br />PLUYMNO <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />T'R OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC—MMOIG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK E DISP <br />I <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />/ <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />FLOOR DRAIN <br />BACKFLOW PREVENT'RS <br />GAS RANGE <br />S!NK ISERVICE —BAF ETCJ <br />GAS PIPING <br />EXHAUST FAN <br />._- <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTALFEE f <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />TRM1ir TP.f• / <br />prAP 9r TPYR <br />S-SF Ie.ER <br />%ANfI�[R RII.IFP ���� <br />EFr <br />RrFTf NO <br />usE)Mr / <br />_ <br />LoIARA <br />vACANt WE <br />OYES O NG <br />FEES <br />VALUATION <br />FEE <br />RtR11MM: <br />�— <br />NEgNt11WT.l�Oy-/ <br />%�V•( <br />WppV[IIING <br />IIMIt <br />eljE pf Nf1W1 <br />® SIC. <br />I•IIIMPpf <br />; <br />000MAY.Y N]p511vg5 <br />f. <br />J-I <br />CCNrAN11J00 <br />R.3F.FN1 <br />OYES <br />— <br />410IANIC.1 <br />— <br />—�- <br />AUa1NW.IrNNaY[t <br />'IRE sMNN NPEO'O <br />pvfAr 4 <br />WK. <br />'IRE AUP PI <br />R Asnv <br />SIAIt 81MV I9U11CNAME <br />lyre Brl ,l <br />r,WIArmowoe, <br />G.TE /•%�i3I� <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />rnelcwgRP9 <br />TOTAL <br />