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APPLICAT N FOR CONSTRU ION PERMIT <br />CITY OF EVERETT B BUILDING DM� <br />3200 CEDAR STREET A EVERETT, WA 98201 A259-BB10 <br />�MOLITION ❑ COMBINATION ❑BUILDING � MECHANICAL ❑PLUMBING ❑ SIG <br />ECTADDRESS: �A-4 9 l ,CTMOPE <br />It, /> i A+O /L, $Ciip EvF.�FTT 987pE 4iS-317-9079 <br />AIYL a 1— rIn NPI1Nf <br />iENWi <br />Ywl Pamess <br />CITY <br />Pl <br />rNOM <br />�I ➢r�I-�SIAN GLiwy <br />CAL,%A/r/,A <br />ST.EyrprTT <br />1A7ni <br />AI-2L-2Sl•9a <br />66 <br />nrwrECrMDEfgNER <br />YnR MOaffb <br />CLIP <br />PrYJNF <br />t:/d TLu,. end <br />ST.�37/I <br />/2ZN0 EEL <br />SIC EVfRL•Z-T <br />9ez0B <br />4IIA-337.9679 <br />DEI(MI COxiMCipl <br />YN MdIFEf <br />CITY <br />rlr <br />MIONE <br />FinIE CKINIA <br />Nglp C7 , I/[ <br />2707 7C7'Il <br />AUL •E I7-A <br />GHA 7B}29- <br />263.924•12-90 <br />PAT /fPGyCF <br />ETEry1YTSN MATACrp1 <br />YMAdY1FEe <br />.I. <br />rT <br />FINONE <br />ATAIFLA:E., <br />P <br />LUM" <br />" <br />COMTK'i0R WM1AWREbb CIry VP PHONE $10TUCENBEF <br />CMIMCT TEI OF NOITIt <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />DEBCHBBF xPJrINAMO fDUAA[ iCOTADE PrvOlvFO <br />l.. �,Lc a r, r:/Na 3,7r -T <br />cOMACr PFRbON AM rHONE NO <br />'^nR oo e <br />^ IA l <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT Al <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE C <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN 0 <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO DIV <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF AN <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TIN <br />PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY TH <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIC <br />APPLICATION IS MADE AND I COMPLY WITH THE STAT <br />CONTRACTORS LAW 1S.27 RCW AND 295.200 WAC. <br />XC 07P EL 6-/7-99 <br />"gnOEED USf Or BIMDINO <br />. oEfcaPTpNd P,,p,RF, WiG1+N EEI On ATTKHTNO COPIES) <br />'or BLOCK a <br />PNICEL Ira LG. MIENER <br />CONSTUCTCN LOAN LEHRR. AODrIEff. THEMONE NUI <br />SIGNATURE It DATE <br />02 G� 7- <br />CITY BUSINESS LICENSE NO <br />PLUMBBIG <br />MECHANICAL <br />NO. <br />TYPE OF RIUTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EWAPMflIT <br />FEE <br />WATER CLOSET (TOILET) <br />VC—NHNDLG UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLA :E OVOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSI RT (WOOD BURNING) <br />_ <br />FLOOR DRAIN <br />GAS FIREPLACE.__ <br />BACKFLOW PREVENTERS <br />GASRANGE <br />SINK(SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL S <br />SUBTOTAL S <br />„IT S <br />TOTALFEE S <br />PERMIT S <br />TOTAL FEE S <br />FOR OEFICF USE ONLY! <br />FPWT SETPALM <br />PEAr15FTBACN <br />SIM SFTPKx <br />E, NCVCCe NUVR[P <br />FFF �. <br />RF CHIT NJ <br />USE 70Nf <br />LOT An[A <br />v.GANI SnF <br />FEES <br />VALUATION <br />FEE <br />_ <br />,uT Llun.nOY <br />NO aGWfluxc <br />SI7f OF OLM71 <br />l101r/ <br />rvrvvc <br />bccwANcr N Slcwls <br />occwwTLo.O <br />B.4F NEI <br />YEw.,nc,L <br />DnOUP <br />.00RION.L M1Ax CNFCN <br />nE SnTMGER PEG <br />PEA<04 <br />/ <br />O1HFn <br />�VI <br />I <br />rnF nIANAl AEG <br />PEATON <br />I <br />SigE PVM1OmR E1111CN.aGE <br />LI'I'1YNMIEq <br />rrrE or cowl <br />nnvs rrrr, Dm <br />CITYOFEVERETT <br />I lG <br />LOCAL SALES <br />i <br />TA% CODE IS 3105 <br />TOTAL <br />i <br />