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APPLICATIN FOR CONSTRUC&N PERMIT <br />CITY OF EVERETT R BUILDING DIVISION <br />3200 CEDAR STREET T EVERETT. WA 98201 A (425) 257.8810 <br />❑ DEMOLITION ❑ COMBINATION Q'BUP-DING Cl MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: —4 <br />1FN.X1 YM YMT55 �a.� ^ <br />•ngx11C1 GP pF4GX1 �� N.fMAf 55 CIIF )�r <br />qq NNl MMS (�S-_-A'�'PP2� 51.II IKrX4r <br />MfU�ArACAI ClYI1n.C11M 4.rL .lf%YNtS Cln hr AgNr S1.If IKFNSE• <br />nlhghG CONIP.f,1M NF4 FgM55 1,11 llr nYY.F $FAIF I KFXSE♦ <br />CG 111wy r F W YXKIII l / <br />HEATING SYSTEM: ❑ GAS (7 ELECTRIC ❑ <br />MumM w-�m um sw.nr f oo1wF INva Nn <br />I I /� X 14" r Dcr�AA ADD I.Izcfj#Nwrx <br />nwl c. n nsaX.Nn r�«rf Sq <br />A! NAY S ud*y <br />F srtaw C'pvaP <br />4Zf— 7-r- `752-- <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 WII L 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 1HE <br />OWNER Or THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW tF,27I/RRCVV �AAN�D2962M W//A��C O9 9 <br />- ��" /.��""� �,Ft•----r — <br />M1151xE L <br />iiTKrosFP vse q nuxgw <br />N <br />lFGh DESCRlr LAgr TTTY r. RI Iow Gn AnwNlWGcorns <br />To, IS NocA Cal. A-D(o. NNFIEG4 4H7 S <br />Y <br />! 0o op� J o- o�OlO <br />r XL qnD MKANn <br />C(TISIn.ICINh IDW IFN(KP AfMxlr Si lllfl'M(Y1k MMPfn <br />— <br />oIT Wa 'slwl Na Xo <br />MECHANICAL <br />PLUYBINO <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUWMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AEG—MMDLG UNITS <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK L DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY MAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE BVOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFI OW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUBTOTAL f <br />7ERMIT f <br />PERMT f <br />T01ALFEE S <br />TOTAL EE f <br />i_ <br />FCR neelre "Cc MMl V, i /l 14oi <br />IMM1 ViRAfx <br />MPR SFIRACR <br />� <br />SIq S(1lAC._ <br />S <br />IYAN [Irt x� r�� Ir( D <br />ITT ml Yp <br />uSF roX <br />Nor AMA <br />vAcwluq <br />FEES <br />VALUATION <br />PIPIMXf. <br />nseOv6 <br />( <br />_EE <br />R'Ri <br />ITIMII IINIR IJY <br />M q lIWf111RG <br />ill IX Nall <br />_. <br />IMIP / <br />b o0+— <br />rIIMIMi <br />TAXCNI 41ry511RN5 <br />I <br />q:flx'AR110111 A51N\I � <br />DVIS V» <br />MIT HANK AI <br />1 <br />—3 <br />rXw $nN MI[R RFO'0 <br />PF Pqi <br />.gMll(MAI 11 14 FMf. <br />/D <br />GDTR <br />- <br />IIM PUNM PInD <br />MAfr <br />51.11 RIx11NHG 51RlCl,.nIf <br />nMMraXa <br />nANs.rrmwl�Rv <br />CRY OF EVERETT <br />—" <br />ox1F 79 <br />LOCAL SALES <br />TAX CODE IS 3105 <br />— <br />TOTAL <br />