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APPLICATICA FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET a EVERETT. WA 99201 •259-BS10 <br />❑ DEMOLRION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING SIGN <br />PROJECTADDRESS: 170o W MRRIp1E V1EW DQ 91L�-y1 <br />OPNEP M AWIESS PIr llr np( <br />kA MUINT/IIK OFJ4vIDVr fT 2411 i uF� TT AVC-EVE Z59-9'SC-c_ <br />,f.T YM AIMESS fJIY RpAE <br />FAIRWINDS VAC-14T 6RokERac�� 4�E� Zca- 531 2 <br />M Trc;Tw fSKINER M4 AfXWSS CI !11' `WA" <br />GENERA, CONI1Yclm W4AO ss tln IN' ngNF S'AIE ICFNSFA <br />N Fvee S(613 Co IN(- Pe Dox 33743 Scn wA Aqv- 5 62N 4zY3 MEYeR = rk21 T D6 <br />11ECl4MCAtC TRACIM YYl ALf111ESS C.f it nKM %IAIF IKXIVSE• <br />PIIMIMGC'ONIPACIOR YwAtXMSS Cltt IF ngNE STATE ICFYSEA <br />CONNING( PNLF Of M1det <br />HEATING SYSTEM: ❑GAS DIELECTRIC El <br />oEscPleE waPe ANo sow'If foo,Ax Anaw:o <br />ru G 1 <br />co(IAc'rrllsoN AlA] NO <br />JE <br />-z 47- <br />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 REC•IAATING 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 15 MADE AND I OMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW D TOO WAC. <br />ZIACOYSI11110IIOlIIOAM <br />X <br />maDs(o us(a s1AlMNO <br />tfOAl Ms TKNW nalcA"( q KLM CIA -RAC- two Lv Sl <br />LOT w(KX or <br />TT tpLl LS JAIr JnIL!_ --,IN s Alp Z 57 <br />F.1✓�[ <br />MRCFI TAAIO.MARA <br />lFNOER.AgeK55 Rlf'NCNE ASAAefR <br />PC r r( T T- <br />sInIAI nAR <br />ii6 i 3 <br />O U <br />alr elSAEss IKENY AO <br />PLUMNM <br />MECHANICAL <br />TYPE OF EOIlIPMEWT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />A/C—AMNOLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />PFEENO. <br />UNIT HEATERS <br />KITCHEN SINK A OISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE IIDOD <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 (W --OD BURNING) <br />FLOOR DRAIN <br />CIA5 FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUB TOTAL f <br />_ <br />PERMIT S <br />PERMIT f <br />TOTAL FEE S <br />TOTALFEE f <br />FOR OFFICE USF ONLV- <br />IRCAII u'RAEA <br />NA <br />REAR SFIRACK <br />JA <br />SIDE SETWk <br />NA <br />r1ANucc LF�3 <br />d <br />«I �_ <br />PErsnl No <br />usErwElJ -C <br />AnEA <br />S,r SSA <br />vA ANI VIE <br />Orfs ANC <br />FEES <br />VALUATION <br />FEE <br />ne1MN <br />(J� <br />NEroln u+N'AnoN <br />'f L,EfC <br />NO aOwtwxn <br />Irons N^ <br />SIZE OF eloonl <br />— <br />rl,n PVO <br />mANcr <br />Non slFw(s <br />accurAN'lo+o <br />BASEMENT <br />❑YES ❑Mn <br />wcN.mcAl <br />AMSIMAl MY(CIeCe <br />PPE SMUNRIEA REO'D <br />nTAVC <br />OLRn <br />FIPEA1MMnE00 <br />AT Ac, <br />SIAI( Plnl �A7 SIInC11AM[ <br />Irn[a CONS' <br />I'IANSAP ytner <br />oAlt y - B_C <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE 15 3105 <br />nnl N:wms <br />TOTAL <br />