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APPLICATII1 FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT R OUNDING DIVISION <br />3200 CEDAR STREET w EVERER WA 9S201 A (425) 257-8810 <br />❑ DEMOLITION ❑ CDAESIIIATNDN ;@ SUS"w ❑ MECMANM ICAL ❑ PLUING ❑ SNSN <br />P�IOJECT ADDRESS: Lilt (r�� �Lr, )U f I At?� <br />4�co, "h ! I I I\ Ul do7, 'an hi l vu 11v t n i rc W 17JR7b23 42r7 - 2r, 2 --Yi = <br />117N.Nl AXM Alm"I rlY 1M PrOM <br />wCN.MCAl C0XmACTUR MN MJOFEss on M PNM Frm LKERRF <br />NIMMG CP1tRK.tOP MAX ADDESS CITY Irp "W", _ SMRLCFRf♦. <br />- M I HEATING SYSTEM: 19 GAS ;SA EIfmm ❑ <br />M wyrw ANO SOO.M rpprADE .IVU D <br />c .cl rt . .rn rARIE ND <br />ca; k- �rauV <br />Lr11C �� <br />r <br />3uo-l�lyx-zcx�c� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND OORINECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WXL BE COMPUED WITH WHETHER SPECIFIED HEREM 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 REGULATNQ CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORRED BY THE <br />OWNER OF THIS PROPERTY TO PERFOMA THE WORK MR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON/TRRAAACC/TjORS I AW I9 AND M 20D WAC <br />/,l ��_:%; <br />oRmoFE064 CA RRrTra <br />IFGAIRXPm-ri7cw or PROWIIII' IROWNSELOW a ADACrI Two C s1 <br />Im ROCA w <br />\ 1 1lL) L l 1'1 ] hJl Jl S LJI , <br />pT— <br />p�jlR <br />PAMCfI TAX I D NRIR A <br />COYGTNFTNM IOAN IFMIFI ELP4FS 1FlFM3rt M11ARR <br />SIX DATE <br />CITY I.IWE%s lcf MF NG <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE ON REM <br />FEE <br />NO. <br />TW 10F RONAPM/T <br />FEE <br />WATER CLOSET (TOILET) <br />MC -NH DLG UNITS <br />BATHTUB <br />FOOCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />NITC N SIM({ DISP <br />CLIQTCES DRYERS <br />DISH SHER <br />RAN E HOOD <br />LAUNOR TRAY <br />WATE HEATER <br />_ <br />CLOTHES SHER <br />WOOD OVE <br />_ <br />URINAL <br />METAL FI PLACE(WOOD BURNING) <br />DRINKING FOURRAIN <br />FIREPLACE SEPT(WOOD BURNING) <br />FLOOR DRAIN <br />GASFIREPLAtkE <br />BACKFLOW PREVEI RS <br />GAS RANGE <br />SINK (SERVICE - PM, TCJ <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL <br />f <br />SUB TOTAL Si <br />PERMIT <br />f <br />PERMIT f <br />r <br />TOTAL FEE <br />$1 <br />TOTAL FEE f <br />FOR OFFICE USE ONI.Y: <br />I nl1N1 YrNCn <br />WNSf1IK.n <br />SrOf SFtF.CR <br />ryANCIK� <br />r[F <br />Rrirr'l xp <br />✓✓✓((((��//FEEB <br />IISE 10`0 <br />101 AMA <br />VACAxi S1L <br />VALUATION <br />FEE <br />FUIMNf: <br />2- <br />CITES OAT <br />NEaxl lrwlTMpN <br />W a PAT IlMG <br />Gr1E or Rm" <br />wns <br />rrnera <br />MURANCY <br />NC (•. SlM l <br />EX.rImAM lu.0 <br />S.H MNI <br />wCrr.A1:.I <br />_.- <br />OYES O C <br />.DD1GMu 1Y.x uwc. <br />— <br />FF SPPAIAIFRMQT <br />M.Gw <br />OTNER <br />FM ALARM RE00 <br />M Aapv <br />G1ATf FxRCM.Mw <br />RInIDIxIi <br />__ <br />'`l/. <br />YYYIITCCC <br />Trrt ar rover, <br />MANF.rrPovrn D. <br />CITY OF EVERETT <br />rnnl x: vwRwG <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />7� <br />DAIf <br />