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APIMICATIC0 FOR CONSTRUCTSN PERMIT <br />�* <br />CITY OF EVERETT * BUILDING DIVISION <br />3200 CEDAR STREET * EVERETT. WA 99201 N (425) 257-SB10 <br />❑ DEMOLITION ❑ COMSEIATION <br />PRWECTADORESS:,y23/ Rug <br />❑ /IIILDNIG ❑ MECHANICAI ❑ MESSING ❑ SIDN <br />ES��/J I/23/~ /ZucKENC E� <br />itwN1 4r u d1+ )v P'gNF <br />I.PCM1fCt OP 11ESIP4P YM •0°PE55 <br />mr- <br />INI CWiPKID° 4Yl WDESS aw 71 I+PIx! Y!•.tCP,-- <br />%IM1IM CON1RKta1 Y4 NUPESS vt'. ZIP 1'IKYR STAIRIICENSt- <br />`mTPKI PNCta YKXw '7z (� o <br />HEATSIG SY3TEM: ❑GAS ❑ELECTRIC ❑ <br />CPIIKI rtnSd Ml PIgIE ND <br />nfSPMF PPM PNII SDUAR rOplKt MVD12Eo � S <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATKXN AND KNOW THE SAME TO BE TRUE AID CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TINS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE SAWING 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 WINCH <br />AIMICATION 15 MADE AND I COMPLY WITH THE STATE <br />IUCTORS LA11127 R W ANO 2" 200 WAC <br />mpgsrD O5t P mNto-n <br />liN, `- Tf�l 37r1�L- <br />tEDAt nEK%PTIwPPnarEPM1 ISNOMtNEtoP Pt mAcll tNOCOrxs <br />tot etacA a <br />-- - <br />wPo t 1.1 R MIANIFP <br />a <br />SQa a Oa. Oo3 — 6) <br />COYS1mIClIM 10•N IEMfEP POPESS tEIEiNP1E N11tEYP <br />X <br />DAR <br />b C[NS[NO <br />PLLIAIBI/D <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />ILO. <br />TV" OF EOIIIMR <br />FEE <br />WATER CLOSET (TOILET) <br />ANC—AlH DLO LINTS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK S DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATERHEAICq <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METH. FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR. ETC.) <br />GAS p1° ' <br />EXHAUST FAN <br />✓ y/G <br />SVB TOTAL f <br />SUB TOTAL f <br />PERMIT S <br />PERMIT f <br />TOTAL FEE 5 <br />TOTALFEE f <br />I nUNl viNt+ <br />m•P •Pt NCM <br />SIDE MINK. <br />PI PN CIPCP NINEP <br />S9o33 <br />fFI. <br />RRP't ND <br />OSf Tort _-- <br />_ <br />IDI•m• <br />vK•r yiE <br />D vtS D NU <br />FEES <br />VALUATION <br />FED <br />PpIM4G <br />_ <br />IIFIP1111VI1•IgN <br />YO1P IMll11NG <br />SIIFPNa'll <br />%IPwMf <br />i <br />_ <br />(J al„•YC.. 4lrvcli �9l1 <br />IIm SPPIIAI[P R(7'D <br />pCf11P•MI :U•n P•V EE 41 <br />G.IS ❑M <br />I.4(N <br />4f1'MAYN'.4 <br />/ <br />_ _ <br />— <br />— <br />•D(MIg411 %W CIVCP <br />Ot1EP <br />c�D <br />nP[KAR4 NlDD <br />m.50, <br />[u11 PM.SIRKNPMf <br />nllu r. rAr�.c <br />I'm PCM51 <br />Wore+rrwovrnm <br />oat fS <br />CRY OF EVERETT <br />LOLL *ALES <br />TAX CODE IS 3105 <br />TOTAL <br />