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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT x BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT. VIA 98201 x 259-5810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL jr PLUMBIND ❑ sN3N <br />PROJECT ADDRESS:_/ <br />AIXAAESS AA wdEBS Pv� - - MARNF <br />riff_ mr T,rR,f /raw— aF-C'yxr/ f.li 9'0l7oL 7f2!-6A5 V <br />AAK..rtcIdDESIONER uu AlKwE$5 c"' im MIPAF <br />OENERµ CORInnCId YYl AOFNESS nn rp1E STATE 1FCEX5E•_ <br />YFCXANICAICdtRACid YA4 App11Ef5 fllY )m MgNE S1AlE lSFNy• <br />MUIIFIGCdIRAf.Id PAIL HgFIESS CITY lln - MADAME STATE tKXASt• <br />Cd11YC1 AYAICf p NVIAIt un <br />U � <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />p SLFMEWMMAMD SpLRE fOOtAOF FAVOLKn <br />.�.vs TitcC FG oo,� i'7,vKS <br />fpnACl MnS, AMI MAp4 NO <br />=+S- s -Iz 52 -64.3 <br />L <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME 70 BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER O' THIS PROPERTY TO PERFORM THE WORK FOR WN1FCU <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X <br />rFKXosrDYSE Dr RnnlNo <br />IFGµ OfSCRP11pI IX 1AAC)"E Y (9A00N I[tOM OR ATTACH INO co"WS) <br />LOT Roca or _ <br />PNICFt ru UD MIIIOFR <br />coHSTRLICIKM tOw tENOEn APpIAESS. TELEMg14 MMllfn <br />SM.HAIMIF DATE <br />CIIT BVSM45$ ICINSE Hp <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />I NO. <br />TYPE OF EOIIIPMIW <br />FEE <br />WATER CLOSET (TOILET) <br />NC—A/HNDLO UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />--T <br />HEAT PLUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK f DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />Cl OTHES 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 />EXHAUST FAN <br />SUB TOTAL f <br />-9 <br />SUB TOTAL f <br />' <br />PERMIT f <br />ZO ; <br />PERMIT f <br />TOTAL FEE fqj <br />I <br />TOTAL FEE S <br />A-nn nalre 11"c nuI V. <br />t MNr SETRACK <br />RFAR VrTMCK <br />SIRE SITBACN <br />MwCnrCx MllpFn <br />rill <br />nrr:Mrr Nn <br />USE ZONE <br />IouREA <br />VACANT VIE <br />DIES ONO <br />FEES <br />VALUATION <br />FEET <br />IIIKRRMR <br />NRGFNUNIubN <br />NO pOM4lUNG <br />Lwns <br />V)EpROOn1 <br />PLIRARINr. <br />— -- <br />---- <br />- <br />r6mAWI <br />I Mp LfPoFS <br />OCCUPANILOAO <br />BAYYLNI <br />all" ❑ r.R <br />uFfIIANT.Y <br />._ <br />AnryrNMA1 MANCIIICN <br />FIRE SMINKLENRF00 <br />RFASp <br />_ <br />nurtn <br />_ <br />FIXEAIARMREO'D <br />RnSm <br />SIAI[ RLKI fInlf. 4lM:uA11[tt <br />�— <br />ITM nr CORSI <br />PIANBArMrovrnnv <br />nnt <br />CITY OF ' ERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nmie wp'"R <br />---- — <br />-- <br />TOTAL <br />--— <br />