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APPLICATIONFOR CONSTRUCT& PERMIT <br />CITY OF EVERETT P BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 A258-6810 <br />( 1 DEMOLITION 11 COMBINATION X BUILDING rl MECHANICAL : 1 PLUMBING I I SIGN <br />PROJECT ADDRESS <br />Ce. <br />/7/9 . <br />n _.�i�MEP M.R MRmss cnr nr R,(YF <br />Au[!M [w1RKiw YAKOODRESS tilt liR --- ,r t aTME IXEM[[I <br />CwIR+C\ IYS[ q W01Y1 <br />HEATINGSYSTEM: 1 1 GAS ' I ELECTRIC ( l <br />Cf Sf:MF NpMI.M15QMRi rnnl NVJ'Hn <br />Me � .+ Th.Irf✓cd Cev62.s <br />lwMtl gPapN+MI RNM xJ <br />7'e fr/Pons us-��A- LonD <br />�^/ r�-rBaLfk./ ZGi�JsG� <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 LAYS 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 WI1H THE STATE <br />CONTRACTORS LAW IB 27 RCW AND 29E200 WAG. <br />vRRvnunw nrwoxR <br />XXVt,,A4 rU/LIA( <br />IERAl ofsuwruxa nortRn lSrpMl e[LowwarlAcx lYq cwEn <br />lo\ RICCR _ a <br />MIILFI M+I D M WYR <br />C(}19\RVCIICNIOW I[MtFR MIIMIf 55 \fl[RrnHF MI+lFR <br />soxAlvlc < w1r <br />an NlaxEss lcwsr xo <br />/LUmem <br />1AECHA CAL _ <br />NO. 1 FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—MINDLOUNTTS—H.P. <br />BATHTUB <br />FORCEDAIR SYSTEMS—B.T.U. M EA._ <br />LAVATORY GVASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNITHEATERS—DT.U. M <br />y <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHEP <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />T <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />— <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE —BAR. ETC.) <br />OAS RANGE <br />OAS PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTALFEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />(Mwl dlPvx <br />PIu15f IR4x <br />S�Cf aF1E+CR <br />Ilweidl M111[ER <br />!rl <br />_ <br />M[fIPIM <br />uPl nwr <br />mI ARFA <br />YAOx\M\E <br />FEEE <br />VALUATION <br />_ FEE <br />EUAp <br />I'YES 11 w <br />mmf L.""m <br />waOAallae <br />ENFOr InnNl <br />Aoq- <br />T FRRHR+I[ <br />nCCIIRAMTtn <br />EAMMFNT <br />WCx k <br />A/^ <br />IIYEE <br />- -- <br />Rm11nlYlaw urECK <br />r.cAlxwREon <br />IlfAaw <br />Nq <br />OTHER <br />FIRE fPIMMIfn Won <br />REA" <br />- <br />--- <br />IYPF Or fAMfl <br />nwa <br />[:ITYOFEVERETTLOCAL <br />nwr. rrpwa <br />SALES <br />A <br />aT[ - 0 <br />TAX CODE I05 <br />TOTAL <br />