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APPLICATIC& FOR CONSTRUCTfbIN PERMIT <br />CITY OF EVERETT P BUILDING DIVISION <br />3200 CEDAR STREET P EVERETT. WA NMI A 259-NIO <br />El OF_MOLRION • ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING J°L BIGN <br />FROJECT ADDRESS: NEC - JW /OD,4 157 SIF <br />%7L� �i/Av.✓G �c AP/I� o. C�O�ri•Fy5> +^s. S'FY A r -/a A., J <br />oNMtR MM ADaEss ary tr nEDIE <br />T uML un ra vlva <br />!ahau5al IZ AnaEss 77.Nd &en 5. !li / % 98432 (Zg*? 25/ -6 Z2-Z, <br />d1 DEYY}ER MU ADORE ss Cm nP "'CAE <br />11ECNAMC cmTRACFCN MAIL ACdSSS GTV ZIP PIAYIE STATE LICENSEE <br />PIUWIG CONINM:TOR MAIL ADgQSS CITY ZIP PHDNE STATE LICENSEE <br />carer <br />iPIRCE of INarW <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />CEROERF WOrIMAM Sg1ARE FOOTAGE WVOLVED SF _ <br />/58E <br />Ca11ACT PERSCIAl" P1U11EW <br />Wpm <br />-/earl ON pzyt 7 - 4!2 `5 <br />_ <br />" Zq <br />Ue- -5d6A6 ON FWP , Zy 5r4!5 N <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 TATE OR LOCAL LAW REGULATING CONSTRUCTINDN OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT II AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />M., RRACCTOR/S LAW 18.2277 RCW AND 296200 WAC. <br />° usE a WALDPfD <br />i7/nn' /�✓1K� <br />LEGAL DEscrw"Ot PfEOPERry ISNOWN RELOW ORARACII TVIO Wnfsl <br />Lot RIOCA a� p <br />04ii1 crf 177 fir -3- 032 -0000 <br />F'AF iM 10 NIIElER <br />CdRTRIGl1pN <br />ldW MNOER. AOa1E55. IEIEPNONE NIAERER <br />SIGNATURE WE <br />Gry RIISINE55lICENY NO <br />PLIAIBINO <br />MECHANICAL <br />NO. <br />TYPE OF RXTUHE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUr%lENT <br />FEE <br />WATER CLOSET (TOILET) <br />_ <br />AAC—AA/RNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK f DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />T <br />URINAL <br />METAL FIREPLACE (WOOD BURNING)_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSEFIT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />En <br />-EXHAUST <br />SUB TOTAL S <br />SUB TOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE f <br />F091 OFFICE USE ONLY: <br />FRWtSFtRKN <br />MM SFFRACK <br />SIDEmlT <br />PL.WCI[CN <br />FFf/ <br />RFf.FIP1 N0 <br />r 7 <br />/^ <br />�. U <br />LS 2Z <br />LOTAREA <br />,A r&IF <br />FEES <br />VALUATION <br />FEE <br />WIND <br />❑1ES ❑ ND <br />W'G,VT LIMTATRW <br />wOF DWELLING <br />SIZE Ci lKDYTI <br />IW Is <br />vLNN61NG <br />T <br />OCCIAMCY IQ asIMfE <br />6 gA <br />OCCINANr I°AO <br />RASEMFNI <br />MFCNNMC.4 <br />❑YFs ❑ 1q <br />AMTMALRANCrIf CE <br />FWESgCMtLERWQD <br />Nf ASON <br />OTNER <br />FIREµAAMREQD <br />RFASCM <br />STATE Run DIMauRCNARG[ <br />a2L <br />TYPE arorls <br />PI ANSAr°A�vFDRr <br />CRY OF EVERETT <br />PDMeVAx+Ks <br />;I Ire <br />LCCAL SALES <br />TOTAL <br />-- <br />"S <br />TAX CODE IS D105 <br />WTE )$ <br />