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a, <br />APPLICATIN FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 F (425) 257-8810 <br />❑ DEMOLITION jg COMBINATION ❑ BUILDING CJ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />owN[n <br />uul•wR(ss <br />Gn <br />)m <br />M1AJM( <br />S_nreo <br />ns ��T 7 <br />�r f�t.� R .iiz <br />- <br />g"TA6 <br />_yas_�.7;2 <br />y740 <br />1(MW fA/1 / <br />Y•II •Ipnf[5 <br />nrl1 <br />)Ir <br />M1gvl <br />N�A <br />•RLNifGt OF nEyG•Rli <br />4ul •Onnf 55 <br />Clh <br />)Ir <br />r,r(vF <br />J C.f J'6;A� <br />__ <br />_ <br />_ <br />WN[R4;WTnACIOF <br />VMI•IXNIl55 <br />Gil <br />)P <br />..At <br />541E IICYN4r <br />!X JNFJ4 <br />uECMANK4 CfW1Mf1(M <br />4ul•MYIFSS <br />On <br />)V• <br />Rg4f <br />SiFW IKFNSEr <br />n 11YBMGCONIR•f,Tp1 <br />4A5 ARMIE55 <br />CITY <br />)Ir <br />rlgNf <br />541E IIC(FSF• <br />CLINIn•CI IFLf p Mp11t <br />�7 <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />ascwRF vgnN •Nn ..I roOIAG(m wo <br />CONl.cl nnsnN •Nn ON No <br />�- <br />I HEREBY CERTIFY THAT 1 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 Wit 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 AN COMPLY WITH THE STATE <br />C04TRA SLAW 1827 N �962DO WAC <br />rxgrosfoust nr awfTANn <br />LFGAL D[SCINPT" Of PROPLnTY IAIpWN n4onaR AnA if IMOC SI <br />to, BLOcs m <br />PA EL Ono mWln <br />yW. <br />t <br />CWF?RIILIKINIO.N If NI1Fn 4%nCF5 R1[I'INJNE NVVFRI <br />'IGN• nul <br />OIY &ILMFS IK.LNS[ 40 <br />MECHANICAL <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AVC — MINDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />I <br />KITCHEN SINK S DISP <br />_ <br />CLOTHES DRYERS <br />/ <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 />_ <br />BACKFLOW PREVENIERS <br />GAS RANGE <br />SINK(SERVICE — BAR. ETC.) <br />GAS PIPING <br />�— <br />_ <br />E%HAUSTFAN <br />SUB TOTAL S <br />SUBTOTAL S <br />PERMIT S <br />PERMIT $ <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: tfWL &li1f9 <br />111[M11 Vin•f4 <br />1r An 5f1PAC1( <br />51p[5[IIACII <br />n•NCII[CF MIMVn <br />rF[ <br />IIFffIrI NO <br />uSF toNF <br />IouR[♦ <br />vAc•v Pit <br />OFFS ONO <br />FEES <br />VALUATION <br />FEE <br />—�_ <br />_ <br />nIn11MNf. <br />`iLi :�, <br />IRKLNI IIMIAIN`• <br />NO p fMRllMp <br />INIIS <br />SII p MOG'll <br />nIKMiNf. <br />—/V— <br />Pic v_'r V niNotf <br />p.Y.lA4N110AO <br />IASFV[NI <br />❑r(S OM <br />d V[•FCAI <br />AOdIMh.I n W CIfLM <br />---- <br />rMKSMINNURMll <br />_ <br />11[•i(Yr <br />Film"-- <br />IIN[N Fil O'O <br />M•FOV <br />MWslmpNnSIM.Wt <br />- <br />-- <br />Irn pfONcl <br />nAvS •rrmvrom <br />Gv[ <br />CITY OF EVr:RETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />rvnl lc unnls <br />-- — <br />TOTAL <br />— — <br />