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APPLICATION FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 • (425) 257-8810 <br />❑ DEMOLITION R COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:_ 17A WAINUr <br />Gelly5co coast SAk hli8 ye" 3T s w-4rrrN- 98.m3 <br />gwrn 4utuwxss art rin rrroNt <br />Ancl.rtc, onavrrrtn u•a •DnnEst cnv nr rwcwr <br />GELL�w�J Cast /ac. /Ze qs-*15}.3.0. EdtV7T `$ 3 3a-317� 66-4ecIG49m6 <br />aNtnAI CCNIPACIM u•A ACa1ES5 car Im nxrvt SI•n II Mtr <br />4EC`uwK4C M.CIW mAn MlESS Qn rir ll M1l "OF l4[N5t• <br />n1114flMGCW1n+C,Qn WIl.0MESS CITY pp PIg'f $l+IF 110ENSr• <br />cOw,n.cl rINCF a WO" <br />7LL S (Vr,5jruc4FM <br />HEATINGSYSTEM: [IGAS ❑ELECTRIC ❑ <br />a SCROF wM.+wn Sd1+nL IMIAGI wIMWD <br />CMIAC I n RSON AW rlg tip <br />M44 308 31-7 <br />3ASIC * [Z - <br />11 <br />Sln k $'E C <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 CF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS 27 RCW AND 295 200 WAD. <br />X 3 ;)3- N <br />orgrosen us[ 0r pt.Dw <br />UGAL MKMPTIM an EA"JSI1 Show <br />to, 19 SIMI p ' 4 <br />5�&3 95I'IG D J 00 <br />ru1c0 w 1 D uantn <br />CDwi, K,M1N tOAN HMer N1t S..,FHnlpwF wn4DFn <br />s..IU L uut <br />cnrwNwEsstKtwsEn <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC—AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOVER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE OVOOO BURNING) <br />DRINXING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />_ <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />v <br />SUBTOTAL S I <br />SUBTOTAL f <br />_ <br />PERMIT f I <br />PERMIT f <br />TOTALFEE Sl <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />1"TV9 <br />(N'r <br />M"'116C+OF <br />l <br />SIM srleK <br />n•Nc.K" r `� <br />rrF �O <br />nrcrlrrw <br />Im rDYF <br />11• . <br />51c <br />vGwl5n <br />xf rs o No <br />FEES <br />VALUATION <br />FEE <br />A11A DnIR <br />- <br />�— <br />NF1Mn uMwgN <br />a <br />•,ng1Na <br />�_L <br />strati 91 <br />249 <br />j <br />OCCtINK.r ND nS1nR'IS <br />J-( ^-- <br />(�3 <br />wl lu+u <br />SAU"ty, <br />OA,ts - <br />4rf.N•Mfn <br />•DdIIDwa.nANawc,: <br />-- <br />— — <br />Dnpn <br />[I•If A1MUwG 51111CN+�[ i[ iG /' <br />CRY OF EVERETT nmlr vmnss <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />