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APPLICATIN FOR CONSTRUCAN PERMIT <br />�* <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 A (425) 257.8810 <br />❑ DEMOLITION L] COMBINATION 9 BUILDING ❑ MECHANICAL RI PLUMBING ❑ SIGN <br />PROJECT ADDRESS: g720 SERIIUr,S-TAVE E455ETT ra`��ql <br />_sJ.kLQhcLL Q_al,w�il[ 992o St[.6v;a Alm .EVPtftj 98904 {yj•g� 7e�09 bo _ <br />OMYFn /uuIYO,ESS OOn <br />1[WNf <br />VM V1dif65 <br />OTT <br />!o <br />xnnl <br />ewucc <br />•IOf1ICItTllF4.mw <br />4u14MIm5[ <br />GlY <br />!M <br />r1N+v <br />cxm wx CP11R1flpn <br />4q Wnm[5 <br />CITY <br />Ar <br />xRM <br />[I\1111CINw <br />Ou Ta <br />-- <br />— <br />4FCV\MC4 fOYtmrlo" <br />V\R M%wR55 <br />ON <br />-- <br />M1GYf <br />[ nlf lKiNt[• <br />U LVW Lr <br />w1114nM1C CClnW'm <br />4\n \PITS$ <br />CItY <br />tir <br />rM!TI <br />$1\lV ISG.51 <br />`°Ntnat mKl `" xM[ <br />HEATING SYSTEM: ❑ GAS ® ELECTRIC ❑ <br />nl[Cant YrM1(.wtSWtgt tOOibT xvglto <br />ronr\ct rlw50Y tV1 n,(M V <br />AA 4e3 Se Ft f0 trDhK lE C1T� AM 592,— <br />ft h 2.1 (log nwt er <:. 24 R—_ <br />— <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />11 <br />Msa C N 8t C II MC T4 rSOt rot.[ n e M G. <br />APPLICATION AND KNOW THE SAME 10 BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />wrorosiDlLnIAdNn <br />Q[61p[MCI <br />WORK INK L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />Irc.1"[scmrtlwarNdtnrr l4.bwr1lROW OI aIAGN lxd cans <br />1 qa F EVE 4 It02' <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />1pI &0cA ean•pO <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />3I SCnJ CRAB Of AF NO <br />FORMANCE Of CONSTRUCTION THAT I AM ( ZED B Y THE <br />4-91 h'Li Af NA 57I <br />MY ER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />`jF07230113 E [31" A PT! Or Lt. g3if S4 ETS1 pt <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS IAW 1027 RCW AND 296200 WAC <br />PM rl'AFID M";;n <br />57'ppP-O5'3 0403 De eG <br />jO <br />/d •/•99 <br />cOt[ImIL1RxINN1tNIlFw AntNN •.: 1t1tPN0NfNWMn <br />y <br />�_ <br />vtt� ra-I-S9 <br />GIY W5IM[S ICUFTv0 <br />PLUMBING <br />MECHANICAL _ <br />TYPE OF FIXTURE OR RF_ FEE <br />NO. TYPE OF EQUIPMENTFEE <br />_ <br />CLOSET (TOILET)AAC-AMNDLG <br />UNITS <br />B <br />FORCED AIR SYSTEMSRY <br />(WASH BASIN)HEAT <br />PUMP <br />ER <br />UNIT HEATERSN <br />__ <br />SINK A DISPASHER <br />W--ft <br />RANGE HOOD <br />RY TRAY <br />WATER HEATER <br />ES WASHERL <br />FIREPLACE IHSERf AVOOD BURNING( <br />ING FOUNTAIN <br />FLOOR DRAIN <br />GAS FIREPLACE <br />_ <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE - BAR, ETC) <br />GAS PIPING <br />_ <br />( <br />EXHAUSTFAN <br />SUBTOTAL f <br />SUBTOTAL S <br />PERMIT f <br />PERMIT f <br />TOTAL FEE S <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />I rinNl [t IPA(. <br />nf.P NiN1f.4 <br />SNI SF�11.�'i[ <br />- <br />6«royL <br />iGl.mA �rj$7e <br />o\no f01 <br />_' <br />,N,w if.,lr 1"t42 /, <br />M, OIWtIHMO <br />•k-75 <br />14 •\ F .11aW <br />Y..f1iAY:• N"'�•'i�[,1 <br />IIN LIT\NIIO.n <br />P.GNnI <br />---- rnY[4lmYtnn•/LII CITY OF EVERETT <br />V LOCAL SALES <br />TAX CODE IS 310s <br />FEES VALUATION <br />—_ <br />mxrwr. <br />vn n.•.v . <br />vn n.•.v . <br />rmm� <br />TOTAL_ <br />