Laserfiche WebLink
APPLICAT19N FOR CONSTRUCAON PERMIT <br />CITY OF EVERETT •BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 IT (425)257.8810 <br />(3 DEMOLITION lF COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SM <br />11100AMADDRESS: "31 _S-cc iluro� �VC/. <br />' '!IL-W ch.— P Yn R nsa 7/L &r j .rpi,ir uA r- zSl-3c o• <br />lErw, uul uwllss Cn. )w ng4f <br />IVAr� So+$+J d.�/.«,z A._ 2_ z4G- K7-//)-C <br />.PCM,fCt Un MSIGrRn .N Yfn�rE�ss cnr /�r rrrn.l <br />sic �utrca 1 A,Na i? 3 02- <br />GFMn4[DNinnCipl CfMrLM T�ir Pr p[ "A" <br />A lKf N51• <br />u1CrI.MCN (.UN.In.C1Un ul .flUrF $s !rM1 !N' liMhl sl.f{lK[M$F• <br />A4-d.erro$-. <br />PIUMMG CUn111.C,M 441."IS$ Clir llr rrNnl SIAIF LIC"M• <br />'/Jnnvo i07 <br />CO41nK, PPICE M Mlla <br />Nt SF/j'3 7 <br />HEATING SYSTEM: GAS ❑ ELECTRIC ClR.NIIk <br />Of SCnpF NV11 SWAn1 In01.GF MYIXVFn <br />CONIAC, TPSON.M rMNI NO <br />GYYs Zs,L-sc9y' <br />-- <br />/,� <br />J <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />OV <br />PRISIONS OF LAWS AND ORDINANCES GOVERNING TIIIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOCS,JpT 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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18277RRCWWAA 2962MWAC <br />X <br />i'GN.lii67DA11� <br />rnm$FP 4a nr eux nM: <br />LEGAL OEscn 11oN o1 INIOPEn" I$uowll KlI Cn ATTACH Ino CDIYIs <br />of eltKp—_o, S/ -�G <br />F� <br />�(oa i 0�3 0o S FX-7CtIOO ] F 7Ch <br />PUKELIAAIDM� <br />l.ic,�r�fy +t�.-� 3sG-166 LJ <br />CONSINIKfILN L(MM LMIFR AAIVKSS 1EIf1MUNF MMfn <br />cllY wws$ LKf NSL ND <br />PLUMBING <br />MECHANIOAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />J <br />WATER CLOSET (TOILET) <br />_ <br />__ <br />NM A/C UNITS <br />FORCED AIR SYSTEMS <br />7 <br />BATHTUB <br />PC <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />_ / <br />KITCHEN SINK 6 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 (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 PIPING <br />EXHAUSTFAN <br />SUBTOTAL f <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />_ <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE -USE ONLY: <br />FRMR V 1p.Fr <br />IIE.P $FIpAf.. <br />LO — <br />— <br />� <br />20 <br />ipLl,l. <br />n{L IDNI <br />HFIGIII IIUI1AlIVY <br />VV d nMIIINO <br />IIVIIs t <br />DiCICpI mANrr .� I <br />pnnM4nmD <br />A.'1 ✓'I 2 <br />ILIP[SrNlllµ(N RL']D <br />41.\IVY <br />lNE.4PM PEOD <br />IIf.cI1V <br />,mF-n�F-c/p•4s1 <br />71A11A IFr wnnI <br />I <br />5 O. <br />FEES <br />nl Al nr.: <br />K eLW�I <br />393 S-- <br />e.. IKNI <br />D", <br />AD[YINnAIM1WIIYI• <br />OUNn <br />tuiL PULINX: 51XKwM'.F <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />M1INI rC nlKLR-_ <br />- <br />TOTAL <br />0 <br />Ni %J/F3faly 7(0 <br />