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APPLICATIO0 FOR CONSTRUCTION PERMIT <br />CITY OF STREET <br />A E • BUILRETT, INGWA DIVISION <br />3200 CEDAR STREET • EVERETT, WA 88201 •259-8810 <br />❑ DEMOLITION It COMBINATION RLBUILDING Ar-MECHANICAL 5rPLUMBING ❑ SIGN <br />PROJECT ADDRESS: SN/iA S 7 nd <br />"I C, F' 11"1 In YM /JfM[54 ..• - �" - . <br />Sa [Y CflCQbsf <br />.nAsL <br />WVue•Ie: ,,,�II 0R uenAMMii c,Rv !�r MqN[ <br />.v L1.l.Ylh N•. /Y]'] Ari i� r_ l aoN.. 5rgr11cl4s[• <br />EONIRACI MEE a LIMA I <br />F N <br />i ".0_•±7v 3el"IAlZ AKIS U l73 dl) <br />OO Po <br />HEATING SYSTEM: ❑ ELECTRIC ❑ <br />OEspbeE YgnR e4115q).M rOOr/{E nvaKr <br />dlo �y <br />n�a�w <br />,{GAS <br />1:(W refs rI R50N.M M.JRF Iq <br />�n <br />k[ Lrsth 7733 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Mlaosrouss a Rulo-Nn <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />r/y <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />IEGM Ms,:MmgN ar I4grEpry lsr.ow Miav oq greclr ivq CMAS)1 <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />for MOnR � Vfr& 4 <br />N07. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />or— <br />_ <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 />IwICEEiu IO IAArerR <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS 27 RCW AND 200 WAG. <br />wl.srrurNr.loeNiEwrtn uxelrss rrlEM,dENvwlrn <br />X_1-/%LvJ <br />G�' I'�' <br />RY IIV4M Ss l I V SI rq <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. TYPE OF EOUKAEMT FEE <br />WATER CLOSET(TOILET) <br />A/C—M/NDLG UNITSBATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />_ <br />HEAT PUMP <br />F <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEALER <br />CLOTHES WASHER <br />—WOOD STOVE <br />URINAL <br />MC TAL FIREIRACE (WOOD BURNING) <br />DRINKING <br />FIREPLACE <br />FIREPLACE INSEAT(WOOD BURNING) <br />FLOOR URAIN <br />__ <br />OAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — GAR, ETC.) <br />GASPIPING <br />*-- <br />EXHAUSTFAN <br />SUBTOTAL S <br />SUBTOTAL S <br />PERMIT f <br />PERMIT f <br />e <br />TOTAL FEE f <br />TOTALFEE f <br />OR OFFICE USE ONLY: <br />F RWi KIReC4 <br />userw: <br />RU-0SFTR/A4 <br />wrAMA <br />SOE SEIRRCR <br />v4cANT RIF <br />OVES Owl <br />AlmowcRM n 11(� <br />__;S1o522 <br />FEES <br />L '' <br />VALUATION <br />Mf.CMl 1p <br />FEE <br />MMIINIS <br />��J✓t7 <br />l ) /L <br />pE13p1 uwwllOp <br />GCCIF14Cl IgryiT(gf <br />MO a0NHu4G <br />UATR <br />CC <br />OIR•14U 11U. <br />SIZE CIE MMYII <br />J 1 <br />fl/.S[YErtHr <br />Af ONO <br />ryI1MR 40 <br />W CII.Acm <br />AM I EAA.j MAN CNrC4 <br />J <br />I <br />`)—�-- <br />nRE $RUM.IEp pE09 11f NSpN <br />0111En <br />rWEAURM pEOD RFA." <br />Ir1E or tars, <br />MANSArMrlv[nnr <br />onE (Zv 97 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />SwIC RIRIlMrt 51rIKT1Al1(1F <br />MAN r. wrKlxs <br />�T <br />TOTAL <br />i1 <br />