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APPLICAT19FOR CONSTRUCT WN PERMIT <br />ITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 A257-MO <br />DEMOLITION X COMBINATION • BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS <br />>Wrta uAa A.l GTl ri NA14 <br />AL, kw OW&S W40J7- 3907 SFCTL4 AV �- r WA- 987D3 (42 ) 513 ZS I! <br />lE.T UAn A• IS Cnl S. RUrE <br />• CESG•Qn 4•q ALOnl51 NSrt! <br />r�+rzCtCa IraT. Lbl IA22-b 1411H A-v 5PrrrLS 9 812E 2 (o ocav 219* 1 <br />rwr -rVv M C LK s L: L - Q5- la- SL SE Z u 9Cdo3 <br />UECHANCt Cp Mr TC MAt ACMESS Cnl SP IKME STATE LKENSEA <br />4��5 3S 3 G�(/Sc7 <br />roNTRKT PacE a <br />G.xvcas2B <br />HEATING SYSTEM: ❑ OAS ELECTRIC ❑ <br />CESLa.E YrCaA •NO SOU E \ <br />DF �-• UNIT <br />C TM l PEP"ITT F4 N W <br />EYZ DPK B Z <br />'tDfal. 40(60 S <br />iU" <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 WILL 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. TI/AT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTR . ORS LAW IBT RCW AND 296.200 WAC <br />1/ A <br />Ir 'h golu o <br />PoowsEO vsE v nvnOw; <br />LEGAL CESCPVTT"a WTJPEMV (SNOAN EELOW GR ATTKH ➢W COPIES) <br />LO*.� 0 mac•�.tol c.PuxT Ix E%%l <br />PUKu TAr is wrvmn <br />q - l -02.9-aGpj <br />CP4TN t"IOw IENCfa. IpanESS IELEPg AAAAAFR <br />SiGNAf�I RFT� rE <br />Lrtv euSKSS LKEHSE 1q <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />0.'C - 0.NNDLG UNIT 5 <br />i <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />MEAT PUMP <br />j <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK f DISP <br />I <br />'CLOTHES DRYERS <br />i <br />DISHWASHER <br />RARGE HOOD <br />LAUNDRY TRAY <br />WATER HSATER <br />I <br />CLOTHES WASHER <br />WOOD STOV— <br />URINAL <br />METAL FIREPLACtWOOD BURNING) <br />j <br />_ <br />DRINKING FOUNTAIN <br />- <br />FIREPLACE INSERT (nQO BURNING) <br />i <br />- <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />- <br />SINK(SERVICE - BAR, ETC.) <br />GAS PIPING <br />�- <br />12- <br />EXHAUSTFAN <br />i <br />I <br />I <br />i <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT S <br />PERMIT S <br />i <br />TOTAL FEE f <br />TOTALFEE f <br />FOR OFFICE USE ONLY: //i. 1 rn :, - O/li /r -o 9/r <br />1T 1SEIMC. <br />to f <br />AEM SEISKx <br />SAE SETBKx <br />- ' A'di • (of <br />eFn <br />p3 - 03 g <br />F <br />FEE <br />�3. ti <br />nEC t.l TAT <br />USE TPA <br />rC-S o <br />LOI ASTI <br />vKWISnE <br />❑ns NO <br />FEES <br />VALUATION <br />FEE <br />BUAmIg0,e i/(r. L.; <br />2-1 Z cLj <br />KGl <br />LrD <br />OWELLFq <br />uns <br />SNEOFIRDGnI <br />140(,o <br />ItG49iNG <br />— <br />DCCUn•ITCI <br />OnOyP <br />b I <br />nOQ:NN(F <br />3 <br />OGCTpANI LDD <br />ASEME., <br />M <br />ans <br />M[Lr1ulKAl <br />""le SAINLL[a TYDD <br />RFAWN <br />ApgipTuIRNI CHECK <br />Grrrtn <br />rnE ALAnu KDO <br />R[ASON <br />STATE MMW SIMLNAnGE <br />TIIt TY Oagr <br />�M <br />III A" r <br />GATE -14 • <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />NTILK woaxs <br />TOTAI <br />1J�, <br />3 <br />