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APPLICATIOV FOR CONSTRUCTAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 A 257-8810 <br />DEMOLITION ,j(COMBINATION BUILUINU I_, AXI:..nwmm.l I; rwmv TAG <br />PROJECT ADDRESS 1 . ,041 --V1 <br />`NW,Qre- tT <br />Te Pfe-A+ <br />hxNtn 4.0 1(XM[55 CITY IT, N1CN[ <br />Z�L'.N 1G.r7F-c,p % 7,. 1 <br />TENANT 4,...nOP[SS 2tl(p -.l�t T .I, l'�• Ii A,p4 <br />cCVTPACT PRCE Or Wn1R <br />HEATING SYSTEM: ,(GAS r E.LECTRIC F- <br />Ja a <br />�I In[vroPltuu BO�ARF r001ARE KO <br />LOUI,ET rEpsoN. Vr++lNE No <br />IK"C{�r.1 <br />KQC[�P(1•i-Gt � f �?�<X <br />LZT♦ l <br />L&,'h�Av-e Sfn-L <br />l oHERES1 StS-�I3fin' <br />CERTIFY THAT I E READ N D ZXAMINED HIS <br />APPLICATION <br />S 37^ <br />AND KNOW THE SAMY TO BE TRUAND CO RECTTALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />nl NSF a B lL— <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />([w(OFScawTKm orraor[arOSPiKrl en. � <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />L.+.��.uc�-*. �CoLwsi <br />�elocN 4 1 <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />m�� r or <br />I <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />.E� <br />1 kl V h a Qe Y'T <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MA <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW , RC AND 29162W WAC !` <br />�,- o1�UI <br />I <br />J <br />P.PC[(•,B IU M1V4REP <br />X <br />cC�;nOclroALOAN ([Na(P uron(ss. tru ,O,A tuue[R <br />�� <br />59N.1Va( I,TL <br />�1�\ �+4„�Y� ����\ � '•O <br />CIIV BVSttM.55 LC(NS[M <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 />NC - AHNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT -UMP <br />Q <br />SHOWER <br />0 <br />IT HEATERS <br />KITCHEN SINK A DISP <br />CLU ES DRYERS <br />DISHWASHER <br />RANGE 0 <br />O <br />L DRY TRAY <br />1YATER HEA <br />CLOT WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 1 D BURNING) <br />DRINKING FOUNTAN <br />IREPLACE INSERT (W BURNING) <br />FLOOR DRAIN <br />Q <br />GAS FIREPLACE <br />13ACKFLOW PREVENTERS <br />GAS PANGE <br />SINK (SERVICE -BAR. ETC.) <br />GAS PIPING <br />! <br />EXHAUSTFAN <br />! <br />�— <br />I <br />I <br />SUBTOTAL f <br />SUBTOTAL S <br />PERMIT S <br />PERMIT s <br />TOTALFEE $ <br />I <br />TOTAL FEE 5 <br />1 U..l nE nE_ - M A / //.9d.6W- <br />rRBNivNEAR <br />Al <br />NEE ZONE <br />SETB.CX <br />�, <br />wt .rK+ , <br />&OF BETB.GR <br />5 ' <br />v.c.x* <br />FE <br />S 5 -77 <br />VALUATgN <br />RFCFA NO <br />FEE <br />EM1IR.TION <br />- <br />ATO 9 UM <br />�38WONT <br />SIEEP ✓ -I'i1to <br />MFEESVALUATION <br />OCCVPANty KVE PRES <br />,� 3 <br />OOELWA I.0.0 <br />oc <br />B.SFu[M <br />EnNB <br />r <br />E SrPfLlll0 <br />f <br />u � <br />RE AS/O/ N''RR// /E <br />VOC 060 <br />OPWR <br />rlaF.( F <br />11 ono <br />SI.rE BIAIdNO BUPCNUtlE <br />TM Or COAST <br />TUN.a.w ovEoar <br />/f1T <br />-- <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />we(cwrn.s <br />TOTAL <br />o <br />i <br />