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APPLICATI& FOR CONSTRUC*ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •257-8810 <br />DEMOLITION ❑ COMBINATION "A BUILDING I-1 MECHANICAL ❑ PLUMBING fl SIGN <br />ADDRESS <br />Lair Sd7— <br />MEGIAIK.LL CCNTRALTgi LU0.AOOPE55 GlY ZIP P,K:NE STAIELCENSE- <br />PLUy9Pp CONTpACryJq MA AWnESs G1Y ZIP NIVIE STATE LICENSE• <br />ccNrwcr PPafawaa <br />HEATING SYSTEM: i )GAS FIELECTRiC ❑ <br />DESCnIBE w➢PK AW SW.0 fCGIAGE IWMAD <br />�YF_tpor <br />CONTACT PFPSON Aura Nq IE W <br />yyw pne7/tlo`^ � <br />I HEREBY CERTIFY THAT I 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 RCW AND 286.200 WAC, <br />M �-- <br />P SED USE ITI'EM <br />LEcuCESCPglIGsa PPG'E SY SH SELOw oR Al"C" 1W000PICsl <br />mr eLocK v <br />PAPCEL TO ID FP _ d/ f9 T l <br />CONsiPVCigNIOINLENCFP. AL➢RCss. iElf1YKWETN49[P <br />X <br />sq PC <br />LATE <br />CITY BUSINLss LKENSE NO <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />MECHANICAL <br />NO.T TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />I <br />A'D—AHNDLG UNITS <br />BATHTUB <br />I <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />I <br />SHOWER <br />UNIT HEATERS <br />I <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />i <br />URINAL <br />METAL FIREPLACE(WOOD BURNING) <br />i <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />I <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />I <br />GAS RANGE <br />i <br />SINK (SERVICE — BAR, ETC.1 <br />GAS PIPING <br />i <br />EXHAUSTFAN <br />i <br />I <br />i <br />SUBTOTAL S <br />I <br />SUBTOTAL S <br />I <br />PERMIT S <br />PERMIT S <br />TOTAL FEE S <br />TOTAL FEE S <br />_ <br />FRd1T MIBALK ` <br />PW SETB4K <br />SIRE SETBACK <br />PIAN CNCC,, NV -TER <br />FCE <br />RFCCMt NG <br />OSE Za.E <br />LOT APCA <br />vAcar SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />OYES ❑ NB <br />N HTMTTATM <br />Nu of uhEUBq <br />mTs <br />sIZEa&Wrl <br />Et fY4. 1 I SO <br />ftwmW <br />0CqtA,CY <br />I WM STEISS <br />CCCUPANi IDAG <br />BASEMENT <br />MCCNANIC4 <br />' <br />S` <br />❑YES �W <br />7FqE <br />AppRUNIi PLA11 LNECK <br />6PP4RL[R REO➢ <br />NEASON <br />'vo <br />➢lHEn <br />FPE ALARM AEO➢ <br />REASON <br />/ V <br />STATE WU W SUBLHATkM <br />TYPE a/c�Lo+sr <br />FUNSAPP <br />vfoar <br />CITY OF EVERETT <br />PVBL[wrnKs <br />LOCAL SALES <br />V " <br />TAX CODE IS 3105 <br />TOTAL <br />oaiF <br />