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APPIJCATIIS FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT R BUILDING DIVISION <br />3200 CEDAR STREET R EVERETT, WA 98201 R (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />urcP.uc.l coNm.rloP <br />Nuuf.DPL ss <br />nry <br />Tm <br />rvaNr <br />s.. 0-trN . <br />PpiNPmG CONIP.4M <br />N.R.C[Rr55 <br />nlr <br />nr <br />— .•roNr <br />swncrNN. --- <br />co.rn.a rncr a wmR <br />HEATING SYSTEM: ❑ GAS 0 ELECTRIC 0 <br />oExwRr wonw:NP sou.. r r.ornw - <br />rwl.crnnscN.Nn r,.dNr uo <br />(Jul o r� ircor <br />I HEREBY CERTIFY THAT I HAVE READ AND EKAMINED THIS <br />i I <br />APPLICATION AND KNOW THE SAME BE TRUE CORRECT ALL <br />TNgrosfoux a elnmNr. <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WII L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />IVIOvO. RUdw OII An.CN IYro CMUSI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEMEMSCRm1IONorT+R)T4Pn <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />EOI OLMK or <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />-- <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT TORS UWIP Z)RCW A. 296 200 WAG <br />/I <br />TM.KEL u.In,-Y`t'�7.C11[�jp�//,}LY�/��/.�, <br />_ ��r�'/` <br />J!% <br />, l �w/�-,.'• <br />cm%Tr111GPCN1o.NH n.IK,rrsi lHEngNE NUMHI <br />% iL.1 <br />r.N.lua <br />1Pr11SVESS IIru,N No <br />MECHANICAL---- �� ___ <br />FEE <br />PLUMBING <br />NO. TYPE OF FULTURE OR ITEM FEE <br />EN <br />NO. TYPE OF EOUIPMT <br />WATER CLOSET (TOILET) <br />AI —AMNDLG UNITS <br />FORCED AIR SYSTEMS <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />MEAT PUMP <br />UNIT HEATERS <br />SHOWER <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />-- <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />\PATER HEATER <br />CLOTHES WASHER <br />WOOD --- <br />METAL FIREPLACE WOOD BURNING) <br />URINAL <br />FIREPLACE INSERT (WOOD BURNING) <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />�� <br />SINK (SERVICE — BAR, ETC) <br />GAS PIPING <br />EKHAUSTFAN <br />SUBTOTAL S <br />SUB TOTAL S <br />S <br />I <br />PERLIIT S <br />PERMIT <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />r7a.y r"A" <br />PI SE IRK[ <br />SIa.E1R.CR <br />n.NO1ES. M111Rf P^ J rN <br />/ <br />FEES <br />VALUATION_ <br />FEE _ <br />IISE im, <br />ICI .Pr. <br />vK.N141r <br />— <br />❑YES 0.fYNf. <br />ryINRR' 1 <br />p1:MLM'.4 <br />2D, _ <br />IRMNI IIvn111pV <br />Nd a PMrIEM] <br />SIR W -mq. <br />()( .NCY N{1n.IIpS <br />UfcVrRN110.0 <br />B.N'A". <br />❑Y[s O o <br />.CdlKwu nwLVKP <br />rIPE SrPmwIFP REOD <br />Pr.Nvl <br />OLHP <br />cl.11 RVIUm651RtIAMr <br />nwi K. vxrLs <br />— <br />._ <br />__ _ <br />_--- <br />ME AIM. PLOD <br />Pr.adv <br />Tmrrx rwsl <br />n.NRArmorrne• <br />CRY OF EVERETT <br />LOCALSALES <br />— — <br />-- <br />TAX CODE IS 3T0S <br />TOTAL <br />oKL <br />