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A <br />APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 A (425) 257-8810 OL <br />❑ DEMOLITION ❑ COUSIN <br />PROJECT ADDRESS: 3 ZZ <br />.a�li"L�n`MY"CM'n � Y.p 4MxILSS <br />cFNrnAI clwrnAnw All AOomss <br />BUILDING ❑ MECHANICAL <br />an <br />FJ PLUMBING O SIGN <br />MFCNAWAL EEATEACrp1 MAIL MMlSS Ory tlL' RIONf tLll tCr MSCI <br />El IIMIMG CGNIRACip: MAIL AEI SS an <br />!Ir r.qN! S1An IS[MS1r <br />CMLMCI"' WOE <br />�.11 <br />m Sc.SF ANO SOLMAK IEKTAUF NYEA O <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC <br />cCNuci FM1 rrNM <br />/?n74fnye�}' <br />tX"f <br />1 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 SEUULAT140 CONSTRUCTION OR THE <br />PERFORMANCE Or CONSTRUCTION THAT 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 />CONI RACTORS LAW 1827 RC W ANO M 200 WAC <br />IT <br />WLOrO5fUU51 Ix FARUNW <br />IFGu lxulgrrlwal+rorFnry lslawx n[lawwAnACN iN9cdSr51 <br />LOT MUCK Or <br />n <br />FL T.47 I 7 O/ 000 <br />CONSLRIALlIp1lOANICM1Fn ALIpIL55 rCl[1KIONF NIIyIFn <br />SKN <br />DIV SM'SMAS51C1NSC NO <br />MECHANICAL <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />N-0 <br />TYPE OF EOUBMAENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC—NHNDLG UNITS <br />_ <br />BATHTUB <br />rORCC DD AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HGOD <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 />GAB PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUBTOTAL f <br />_ <br />PERMIT f <br />PERMIT f <br />TOTAL FEE FEE f <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />I prlNi ViggK `C <br />10 W <br />.jl.V <br />STF SCIl4P <br />rlW blFp NU411C11 <br />mr"E'AO <br />LIu 7ONFP _ <br />T� o <br />Io1 <br />"ALM"511E <br />OYrS W <br />FEES <br />_ <br />FEE <br />TM TAW <br />-- <br />A�VALUATION <br />IGa. PO <br />IICIGNl 111NlAIIO <br />4U <br />MIl <br />SIZE Or KDWq _ <br />r� <br />I O J <br />r1114RM <br />OCC111•AVLY <br />I- <br />M)M51(1AS <br />r <br />1 <br />p'.0 <br />BA MINI <br />f5 ❑NO <br />C NIMRj PEOD <br />IIlASd1 <br />> GQid �l> Ci�OOKn <br />AOpIKWY.RAN LNCCN <br />-- <br />FWF uIp?Y \arOo <br />pruov ��jj /�-{ <br />CI I> ll/I <br />" A,. 1011OWC 51WIMpUr <br />`]✓ <br />rvrc lx c04cl <br />v vN <br />AANi Trill <br />7L <br />Ont 'oL 11 S <br />CRY OF EVERETT- <br />LOCAL SALES <br />TA%CODE IS 7105 <br />-� <br />TOTAL <br />