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APPUCATIIA FOR CONSTRUCT&N PERMIT <br />CITY OF EVERETT• BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 . 259-8810 <br />❑ DEMOLITION L7 COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: n . <br />UAAr 9 E,- <br />TVUKD N.IL AxXXIESS CRr <br />rro noK <br />4G.RCT On aSCiMn WII ApgIE55 CIT' !In hpxr <br />D PNrnmiFn) c4HsC rp I+c Bt[ 73`lc TwPtK{f �wA- OL'W D PSa72 �taGZNS <br />axrn4 coxln.cron uK [mr<ss cnr rm near sl.rc lKrw:t. <br />MFCw.MCK COriRKlpl UAl ADCRESS CATY IT, NK MATE UCIE.K. <br />n IIMRNry Ca11RKTPi UK ADDUESS DIV rW I`IgIR STATE LCFNY. <br />Cd1MC11MEa Y.011R <br />9I cj 47 3y le 771 <br />HEATING SYSTEM: ❑ GAS O ELECTRIC ❑ _ <br />asaBeE wow AwD souAK [oDTAo wvar<D <br />��� c�NAAGYi <br />caDKl rcnsow AxD nawE .a I <br />i 4AUIO Lt!25FdF+/ 2S9-7Z5Tr <br />S7L� <br />1p.KINCr 1[ <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 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 I AM AUTHORIZED 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 18 27 RCAW AND 296.20D WAG. <br />K_ <br />FnoroRD uSE or. <br />Hc4asc Txlwa ITOP[Rrv//ySN�O�wN� KIOw w ATTKN IM C SI <br />LOIµDLR Kea_ <br />IOi C I <br />PMICELTAXI D WAAKA <br />COwST I[NL(n, AD nE55.1 LE OA KFUREA <br />SKI1.r111K DATE <br />cln BusIKsS Lc[Ns[ ra <br />PLUMBING <br />MECHANICAL <br />_NO. <br />TYPE OF FIXTURE ON ITEM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIG-AMNOLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />I <br />UNIT HEATERS <br />KITCHEN SINK A DISID <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />I WATER THEATER <br />CLOTHES WASHERI <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />_ <br />FLOORDRAIN <br />GAS FIREPLACE <br />13ACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE - BAR. ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT S <br />PERMIT f <br />TOTAL FEE f <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />r`ADUI% K:. / <br />WARSFIBKY <br />Sla srKKN <br />Jr /O/ <br />ft"DTCMMMrA <br />. . <br />rrr /r ZS <br />Y <br />NO Drum, <br />USE rDAE <br />- <br />LorAKA <br />MA xr IE <br />.ES O ND <br />FEES <br />VALUATION <br />FEE <br />ywDAKI <br />0_ <br />�Klnn uwnlpN <br />Z / <br />ND aDnTLLAa <br />unTs <br />iNEa MaNll <br />S7LA S,F <br />nDNewD <br />I <br />I �AK'Y wn"DATA <br />CCLIAMxr TOAD eISEK xr <br />❑rrS 0«D <br />WASp1 <br />KCNAMC4 <br />+ <br />nrC SRIMItIInKOD <br />ABDIrpN4 r1 AN �KCA <br />On4R <br />rR NMRPIDU <br />IYlt ocwST <br />KASaN <br />nAxs Awncvrnar CITY OF EVERETT <br />LOCAL SALES <br />n4t TA% CODE IS 3105 <br />s1ATF BUAWKIAAlAA1X1E <br />nrelr.waw5 <br />_ <br />�/r�f� <br />�/ <br />TOTAL <br />- <br />-L— <br />