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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF RE EVERETT • BUILDING DIVISION <br />32C0 CEDAR STREET • EVERETT, WA 98201 • (425) 257-3810 <br />4 7/0 Mcze. (oKd A� <br />❑ DEMOLITION ❑ COMBINATION H BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: ghyrhJ7; COA- <br />b0Ulr .�117/hS%f Ff/CKS , 47/0 t9/IfiUdA,V7 /d !t✓Efj41-rDOA. 98703 2S9_2747 <br />pWFa uuL•OOUF55 Oil Tr 1x 1 <br />1FN.N1 <br />M.ry .IIp1K 55 <br />GF\' <br />)Ir FYgYi <br />LU/0L_(j(JG <br />Z , 9lz S. <br />7^ /}UE. tb <br />k✓fRCt�7cu/!-9Bzo3 , <br />175 25z-43376 <br />•11U•RCF <br />KSIGMP <br />WAIL AfKslsS <br />OFY <br />br M1 F <br />_ <br />'DuVA/Wc• <br />GENEMI CGNTNCToA <br />At NXY1F55 <br />Cxl <br />hr Awnr <br />54tE LICFMF• <br />4FCNAIxLAICWMACTLM 4Art ACOaF55 OM1 Tr NgxC $lAlf lKEN9Fr <br />PIII4BK.Cd11P1 im AIM A00PEss Gn TIP 1N r SIArr I CEASE <br />C(NIRAc K;t Ut AVOK <br />/IG Coo <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC Ct1' <br />IxscroaF vqm ANGsw.aF rool.Gt .lwlxo t _ <br />/Mj %U EN/G O /7.iCa <br />/ z- F. <br />CoNI.cI lmS .w rxn,r N) <br />16yu, '/✓D -1 -2 rz-8776 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME 10 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 RCWAND 296200 WPC <br />X_ &0 ,J7/C7f' J d9/99 <br />STNAILOV GAE <br />FNgIN)9ouSE Gl mlXd4G <br />LOTS S7 TO S/ au< /5rj!& AOD <br />r <br />LtGAL Mt FAPTKXIIX rN+ontPrrlNglNlflGOxon mAcx lwG coNE6I <br />tof 57.6/ mm._400 <br />"9e _ DIJ DOO <br />PAACfl IA..0 EANf*P <br />COlA TIAXTIM IOAN IFMIFGdAg . AnLSS THENE NU4RF0 <br />[G1 flU4NLS5l Kf N5[NO <br />PLUMBING <br />MECNnNICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />ME OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />_ <br />A/C—AfHNDLG 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 />015HWASHEF. <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 GRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR, ETC) - <br />GAS PIPING <br />I N <br />I <br />EXHAUSTFAN <br />SUBTOTAL S <br />SUB TOTAL f <br />_ <br />PERMIT $ <br />PERMIT f <br />TOTALFEE $ <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />rnONr vrNr. <br />w1 <br />M.P SrrllAstt <br />SImvl AC. <br />nx It 4Pra <br />FEESD <br />rFEF. `/ <br />PFrrmI NO <br />list zm <br />III 11AS <br />vACANIIE <br />VALUATION <br />FEE <br />_ <br />IIHGn11 W11AlgN' <br />( <br />pr tW ulAt; <br />N/L <br />Sill Or 9lCGat <br />q <br />NII4PM0 <br />OC:)ITp�AYCY v,\MIIMIti <br />OL'.CUMNI IOAG <br />aASIWNl ./ <br />Its <br />4FLItAM,4 <br />N.M drICY <br />IIPE"11 .11PRI <br />is A."AGd1irN111 <br />_ <br />01401 <br />��—�— <br />FAIL ALA WPtu0 <br />Of ASCU <br /><IAII MladNll SIXKNAME <br />-- <br />_— — <br />I'm m'tAT <br />�_� <br />M ANS ArIYIGvrn flr <br />GAIE /Ig9 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nmlr. LNoa•S <br />— <br />TOTAL <br />-- <br />