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APPLICATION FOR CONSTRUCTibN PERMIT <br />CITY OF EVERETT N BUILDING DMSION <br />3200 CEDAR STREET R EVERETT. WA 9B201. 2594610 <br />❑ DEMOLTTION ❑ COMBINATION ❑ BUILDING ❑ MECMHANICAL ❑ PLUMBING <br />1 <br />PROJECTADDRESS:7on 1A/ �ffj& lft &A/ .R <br />Q A ALA A l m <br />GM1 <br />!M <br />hO4 <br />//ARP N1aim6leftil <br />Ziff a <br />uFwlrr <br />w <br />uhg14 <br />7-sr, <br />93" <br />iERARI 11�i IENpRE$T <br />flit <br />K <br />RAIN @ Pd&,j e A&Dw6R <br />17ao w AM <br />z&e_-- <br />mea-y /m <br />er.iraErr <br />JT2" / <br />rmDEy R WUEA ss <br />Gn <br />M <br />WqR <br />7r,,; <br />N/A <br />fIERERAI CONfNCiM MITI ADdEss <br />crtr <br />tM <br />nfy4 <br />SrRIF IKLIt)Er <br />A461.62 5(6" C.o fNc- <br />/'n /2D.Y 33743 <br />LAIA <br />9 (33:s <br />MEkR.742(W <br />AK'CMAARCA�C MACTM AfuEADEAEss <br />CITY <br />TV <br />ACNE <br />STATE ICENSEF <br />N//T <br />RDIlA6 LONTRAC}DP MAA ADgiESf <br />Glr <br />Ilr <br />ACNE <br />SIAN ICfAIM• <br />h/fin <br />coN r RnKE a rATlsl <br />HEATING SYSTEM: ❑ 6AS DIELECTRIC ❑ <br />DESLTNIE Yg1Yt ANO SD EFDO A YFD , <br />3 S <br />aMIALrrfn50N/JO N <br />^� <br />_ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT Al., <br />PROVISIONS OF LAWS AND ORDINANCES GOVE WING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPEU!FIED 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 REGULATMq CONSTRICTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AR AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I C MPLY WITH THE STATE <br />CONTRACTORS LAW 1E.27 RCW AND 2110 WAC. <br />X _ <br />FFCgSfE usE a eulEvq <br />uDAL IAXW lalMA JWTY ISHDEfrf KIOW a A1TACR TM CWKSI <br />LOT K= ar <br />:,9 <br />`— <br />rwcEt rulo RD1ER <br />Cd6IR11CICNlOAN IEAIpfR.ADDIIESS.IFI[ACIE NIIAlER <br />SS <br />sKw oA <br />�Ll OT I ^'- � <br />an wnHIss lKE NO <br />PLIIMEIMG <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE 011 ITEM <br />FEE <br />NO. <br />TYPE OF NQUMffIIT <br />FEE <br />WATER CLOSET (TOILET) <br />MC—MMIDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNITTEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <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 />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL f <br />AL f <br />PERMII f <br />IT f <br />_ <br />TOTAL FEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />rnCyi SFIRALA <br />REARSFTRALN <br />SIDE SFIRACN <br />AAN CIIFf.RMMyJ <br />ffF <br />IIF"N'Tw <br />Nfi <br />AA <br />�R <br />/<7 (O <br />_ �O <br />usf ZO <br />IOLAWA <br />rACANI WE <br />FEES <br />VALUATION <br />FEE <br />�•C— <br />DIES <br />Ny , <br />RGCN1lIY11ATX]R <br />N <br />517E Cf H'ARI <br />-I�l_It4E <br />jCMEUE <br />uRns <br />AIINIRq <br />1 <br />CC�CUTANCY <br />MJ p51M15 <br />OLCITARIIOAD 'iAY1RR1 <br />yffRARIFM <br />❑YfF ❑Nn <br />AMIIINWAI MAR 6Mfl <br />— <br />f NIE5I1 ERREDD <br />nr Aspl <br />Durtn <br />IIREAIARMREOD <br />Rf A5CW <br />SIAIF RIypND SIRCIMRLF <br />�f <br />— <br />lxr[orfDRsr <br />Rr <br />r1ARS Ar vfnT <br />CRY OF EVEREVERETT3105 <br />nlRl¢vRnrt <br />(M <br />LOCAL SALES <br />— <br />TOTAL <br />I j <br />TAX CODE IS <br />"TE -S <br />