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APPLICATA FOR CONSTRUC&N PERMIT <br />CITY OF EVERETT r BUILDING DIVISION <br />3200 CEDAR STREET r EVERETT, WA 90201 r259-9810 <br />DEMOLMON I I COMBINATION I I BUILDING Id MECHANICAL I 1 PLUMBING (1 WN <br />PROJECT ADDRESS. <br />3 lA/�sT wo i3Lp6 -f qJ - 7 aI73 <br />" <br />pylNf9 Y/YINICrIr!! Gry IN' nOt <br />" s✓A 76 <br />KocwC o Nw PAS w i nr, a -3l� <br />tiN.Nt MYl R1Uli ! Glr br nrx! <br />� ��//,� AA <br />C1UL/VL CD ;WS V✓. C_N1M D#.IUO T+I.1CKRrtfil W/+ <br />MILYIf C10111rtlRVrtN Y6I,CO1E!! OIY lir AR1NE <br />ITT M Nµ 1:G111M11.,, AT. NXVIF 9! Glr ttr r,glf 111TE ICFNSF •• <br />l'MIICI.+C1V11 MN NNNIr59 GTY !�r r11ONr 11.1F I.ENSF <br />YFCIIIY[.!l r <br />I?4 "` PL SbEnu WA N)69 dW-91LIC' NoLAFrl S77A,7:' <br />_ <br />fiwWr- IA+KS wA yta,' S, <br />CITYnr rrlpNf slu[ICFNSrr <br />rt,,ww f,ONN¢TM uw .ln•M1 fl <br />C. 'PPAC'l`TXEa.. <br />HEATING SYSTEM: I I GAS I I ELECTRIC I I <br />M K.SENYY l.PA11F fOOTM1E—MWII <br />CIMTACI nnsIw AMI nR fW <br />4�u,r.43E- A/a1 P V /'1c. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO SE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />rTlUlost"USE Of EAST GNP <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />GIR9 <br />trPAE lxscFNR11G1 Ur INotPTr IYIITMI IIfIGN IT AITAGI IREfs1 <br />AUTHORITY TO VIOLATE 09 CANCEL THE PROVISION OF ANY <br />IGT wccw of <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />j30g'W (, L U e�7/�3 <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1S.27 RCW AND 296Y00 WAC. <br />rM:ft. TAXI IT MIYIIE" <br />CONSIlXCTNMIOAN PEWS" A111NIF95. 1HfNXM PA In <br />UATE <br />INW.TNIE 1653 <br />- <br />CITY eUWSSTCENS( I(P <br />PLUMMMO <br />MECHANICAL <br />NO. TYPE OF FlIITURE OR ITEM FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />1 <br />A/C —ANNDLG UNITS —H.P <br />BATHTUB <br />1 <br />FORGED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />1 <br />HEAT PUMP <br />SHOWER <br />UNITHEATERS—BTU. M <br />KITCHEN SINK E DISP <br />1 <br />CLOTHES DRYERS <br />DISHWASHER <br />1 <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />1 <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />r <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVEMERS <br />OAS FIREPLACE <br />SIN( (SERVICE — BAR, ETC.) <br />OAS RANGE <br />aAS PIPING _ <br />1 <br />EXHAUSTFAN <br />1 <br />T <br />1 <br />SUBTOTAL E <br />I <br />SUBTOTAL S <br />I <br />PERMIt SI <br />PERMIT L <br />TOTRLFEE *1 <br />TOTAL FEE L <br />FOR OFFICE USE ONLY: <br />rININt BFroACX <br />REAP SETBACe <br />DOi EEIFAfIt <br />RANLTIEGI wIDFR <br />rFE <br />MCEwIw <br />USF lOIr <br />t0TAAFA <br />VACANT DIE <br />maVALUA110H <br />FEE <br />ylpq <br />nns nw. <br />I9MIt1MTATg1I <br />wOr W,Fww <br />!Ta Or eIWI <br />IMITS <br />RIIHIYR <br />(){:TApANCr MIarIPEfr <br />OW <br />GCGX'ANT LCAtl <br />eAlEIENI <br />Y[L•IlyEf/y <br />nree nw <br />AOOITIONALNATI UIECIt <br />rxE.W+A REao <br />RFAlOI <br />OTHER <br />TEXT YIYINIERIIEOR <br />REAl01 <br />eTMI e11AMA! DNIdMROe <br />nXRcrArtNT! <br />tvn a CGTleI <br />INAA% 00 <br />CRY OF EVERETT <br />LOCAL SALES <br />DAlE11• . 9 <br />TAX CODE IS 3105 <br />TOTAL <br />