Laserfiche WebLink
APPLICATA FOR CONSTRUC&N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />320X0 CEDAR STREREETT A EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION r�-BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />3radl c_lat�--- MALeoi /�1c.Q�LyAT/1 �� r�-_2ezgo 45 zsa-is/s <br />u4m ss an ZIP —�q <br />)(IpNt - _ nr 4Mx!r 5t all tiv <br />M naNe <br />sh—�y cl� IGa Szs,A Ate- Iv. 64.,.ds 9B o2ro gNF <br />W4 -7BF-Gazo <br />g..It CI M I vpurn uw N4xp 15 aM1 Tr rr <br />Or 41Ny C(Alun lln unl nl4nl t•. Cllr !IP nqN( ,iIAlE 1K(NSEI <br />W CII n MCA1CCWI ntf1IX! Vol nufx!I CG bTY IR P11CNE SIAI[LKEMSE• <br />M1UMprvf. CVwuui l(n u•n nM!!1'A: CITY pin <br />' ngNf STATE I[(N$[• <br />C04IRY.11`m—1 of i <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />1[$aM(.R PA., tl I.P. nC.F hV'4 \'!!t <br />�1tLr YcSf _ir Gtw w• <br />.CS�iLMLL_ __ <br />murowOu:,F a mnlarr. <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 />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON ACTORS LAW 18 27 RCW AND Z96 200 WAC <br />DArF <br />uru ttumnllovn n.vT llty lv.oww nurnv aun.cn rno comE sl <br />for wocr or <br />wc[u.Lw}o y�Mej <br />7�f n 3L�� OD/ O/a0 <br />C016I Trar1IOAN LFNOF�nj AmnEss lTlEmrON(IalvnEn <br />CA`I 4101 41/: 1 4.5 3}Lz$'ui <br />zzool 661,b 4w!(J, MQIxN{/q �{ 7C('vFltc 960Y3 <br />an auvNF :s IKFNSL NO <br />PLume 0 <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />E <br />WATER CLOSET ITOILET) <br />AIC—AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />14EAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />WATER HEATER <br />� '. <br />CLOTHES WASHER <br />WORD STOVE $ <br />T— <br />URINAL <br />I METAL I.REPLACE (WOOD BURN <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC) <br />GAS PIPING <br />E)(HAUSTFAN <br />SUBTOTAL t <br />SUB 10TAL S <br />PERMIT $ <br />PERMIT $ <br />TOTALFEE $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FIUMt I,rTwK <br />nF An SFTwx <br />SIM S(IFA[x <br />IYAN aCa1 MAp(n <br />b O-7 -00 <br />FFF <br />11(C.FML NO <br />UMlOUF <br />murcA <br />vAva vt( <br />❑YES ❑Ml <br />FEES <br />VALUATION <br />FEE <br />BLMaNn <br />-7i <br />NFIGIrr LlwrArpN <br />NOaONEIIMn <br />UMTi <br />GtEM&DSn1 <br />O <br />NIMMI <br />' <br />ANCY <br />K"� <br />W a stow <br />Z <br />OCC• IOAn <br />pASEMFMr <br />❑v(S QM <br />WPIAMK•lA <br />FniE SHY, •n RFO9 <br />AiON <br />AIDN"DNALRANCMca <br />OINER <br />FRENMMnEOD <br />of AcpN <br />".IF nUrtOwl1 ]IllralARiF <br />i �-T <br />JL' <br />I'M OF III <br />— <br />mANSArnrov(nar <br />nAIF (F 9 7 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nlm x: PPoM, <br />TOTAL <br />