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APPLICATIORFOR CONSTRUCT& PERMIT <br />CITY OF EVERETT ( BUILDING DIVISION <br />32DO CEDAR STREET It EVERETT, WA OB201 ( (425) 257-8810 OL <br />❑ DEMOLITION ❑ COMBINATION Ild BUILDING //❑ MECHAIMCAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS:..3G� Cv• CA5,wo XZ vD-23 <br />WCN•wlcdrpu SM un •LMrss nry 1(' %DIN( ar•.r ISFN4. <br />%IIIpM CO,ip•(,ICP Yw Y1D+!(t C,ry jI %p.( fl•N I,C(N]FI <br />[drMl:l PIYCI a pD,V <br />�� <br />SYSTEM.. ❑ OAS ❑ ELECTRIC ❑ <br />77S 12t1�IC UYC� <br />JHEATING <br />IDI aocA a <br />HEREBY CERTIFY THAT 1 HAVE READ ANO EXAMINED THIS <br />PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />ROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />ORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />OT 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 AUTHORREO BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IB 27 RCW ANDM 2W WAC q p <br />��^�^-F-�//� /D <br />� D•1( <br />izu, w, D Nunn <br />wlsrnucruliowlr,nfn ArorS[sE RI[wor<NIApFp <br />nl(fO "tow rA <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF RETURN OR ITEM <br />FEE <br />NO. <br />TYFE OF EOUMBNMT <br />FEE <br />WATER CLOSET (TOILET) <br />AC -ARNOLO lNMTB <br />' <br />BATHTUB <br />FORCED AR SYSTEMS <br />LAVATORY RVASH BASIN) <br />HEAT PULP <br />�— <br />SHE • I!R <br />UNIT HEATERS <br />KITCHEN SM A DISP <br />CLOTHES DRYERS <br />DISHWAS44ER <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 KISERT BVOOD BURNING) <br />FLOOR CRAW <br />OAS FIREPLACE <br />BACKFLLW( PREVENTERS <br />OAS RANGE - <br />- <br />_ <br />SMK(SERVICE - BAR. ETC.) <br />M4PIPINO <br />EXHAUST FAN <br />SUBTOTAL S <br />SUBTOTAL f <br />PERMIT $1 <br />PERMIT f <br />_ TOTAL FEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />raWS VIpY.N <br />a•p 5(5(•CN <br />(Ia MIFK. <br />AwnACA P <br />� n <br />rfl <br />afrPI NO <br />ua idr <br />murN. <br />vcwr Nr[ <br />OrtI Ow <br />FEES <br />VALUATION <br />FEE <br />Mn pMD <br />J <br />.-.etY_U_L_YJL <br />aKd,1.�W1•IpY <br />M; INIFIIPID <br />NINE IM Rpyil <br />�— <br />II— <br />OCI:1lIM.S Mn51,v15 <br />Q(IWMI ID.p <br />(•MWNI <br />D5n P'MS <br />W'...4 <br />--- - <br />•Dnlsrw rwnYn <br />r .LLPKOD-- <br />NA <br />MA" <br />OuI•Wnn <br />-_ <br />IINr%f NrcAND4 qPl�0 _ <br />M.td <br />(i%upn wnc,uaN <br />11WIl <br />o•r[ 5 - / Y,3TAX <br />CITY OF EVERETT <br />LOCAL SALES <br />CODE 15 3105 <br />--- <br />— <br />TOTAL <br />- <br />---}— <br />