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APPLICATi4�1 FOR CONSTRUC?.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />I I DEMOLITION f I COMBINATION hd BUILDING i 1 M�CHANICAI '' PLUMBING I! SIC,N <br />PROJECT AODRESS <br />Ili ll��.�� �i_il��ni?�c_<c ,- ---- <br />�N++Fn u�n eno�rs5 cn - tm r��cr.r <br />N.�J.la�a,�-D IIsz�I SC-�E2r.e�g..:IJr �✓�rr 9'bza4 z�o-oBGs <br />iFN�NT 4�11 �DfMC55 f,11Y )IP f11pNF <br />D�S�G� L���s �a �5 n,.�.oa <br />encr�irCcron neSianNrn M�II ADOfIF55 CIfY rm rrroaF <br />7�317 171t'1/� i���N� <br />arr+cneirnv�necron u�n�amcss r.nv -� - vm r�roHe surri�cFasF. <br />MFCHIINIGI CONiMf.iOR M�IL �DMF55 CITV TP p110NF SfetF LiCFNSF • <br />❑IIIMPINGCONIRAf,ip{I M�I111DORE55 <br />ST�iF I ICI NSE • <br />^,ONIMCI�MCEO�YKMk q � � <br />�% / Z� HEATING SYSTEM: J1'i GAS � I ELECTRIC f i_____ <br />DESCRIBF WJRN �I� SqIMF FOOT�fiF. INV01 VF.D I:ONiNf.l n� q50N �NP OIu1N! Np <br />� 1�i� Sro2y %�an3cd.e w�C;.+�en ,t d �-�+R�c�NS ------ -- — <br />Eist,v/Jow�cz_Cu•.a; Lor'"/3 <br />iea�� oescmrnar� a rno�nn �sNnww ne�ow rn �r ucH rwo covies� <br />�or aix► or <br />S;7S-ocb-o/3 <br />PMCEL f11N I D MIM9ER <br />Na <br />CONSTRIICTI(NIIO�NIFNL'P M8NIE55. TFIEP11diENUMRFR <br />TYPE OF FlI(TUAE OR ITEM <br />WATER CIOSET (TOILET) / <br />BATHTUB _J� <br />SHOWER / <br />KI?CHEN SINH 8 <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASH <br />PREVENTERS <br />CE -�BAR,EI <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOF1 OrF►CE IiSE OML%: <br />rn�rsFTa�r.w _ � ar�n�Frn'�� � <br />�� L.1v _ <br />usr! F �or�nre O <br />� _ �all_ <br />IIEINI111MII�11ONw,� J� NO M I�WFIIIP�� <br />yy\ IIN�Iti <br />Y <br />fIPFFPf1�NMIFfIf1FOp— RF�f(N1 <br />IYPFOfCPNG• PI4NS• <br />�� /�/_.. ._ n.��� < <br />FEE <br />SIf1E SFfP�(J{/ <br />S __ <br />v�c�Ni sirf <br />��vrs n�� <br />IUNI pnsfMfNl � � <br />�� /Q ' �1 C 'Y�4�1 <br />I HEREBV CER7IFV THAT I HAVE READ AND EXAMINED THIS <br />APPL�CATION ANU KMOW THE SAME TO BE iRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND qRDINANCES GOVERNINIi THIS TVPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF <br />NOT. T11E �3FIINTING OF A PFf1M1T DOES NO7 PRESUME i0 OIVE <br />AUTHORITV 70 VIOLA7E pR CANCEL THE PROVISION OF ANY <br />OTHER STATE 09 LOCAL lAW REOULATIAp CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAf I AM AUTHOF12EU BV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPUCATION IS MADE AND 1 COMPLV WITH THE STATE <br />CONTPACTORS LAW 1827 RCW AND 296200 WAC. <br />x l �• �• - � G-zo-g� _ <br />SI �NATURF � p�fF <br />fIIV pU51qFS511f.fNSf NO <br />_ _ . _— __ _ ______ "_—' �_ . <br />MECMANICAL <br />NO. TYPE OP EOUIPMENT FEE <br />A/C - AMNDLG UMITS - H.P. � <br />FORCFD AIFl SVSTEMfi -- B TU M E.A. ' <br />HEA? PUMP--� � - ��� � -- -� �- � � -- <br />UNIT HEATERS --- BS.U. M ; <br />_ CLOTHESDRVERS�_ i <br />T <br />VENTILATION FAN � <br />RAN6[HOOD � <br />WATER HEATER <br />y <br />WO'1D STOVE <br />METAL FIREPLACF (WOOD BURNING) i <br />T' <br />FIREPLACE INSERT (WOOD BURNING) � <br />GAS FIREPLACE ' <br />�— <br />GAS RANCE <br />GAS PIPING <br />EXHAUSTFAN / � <br />SU� TOTAI E <br />PERMIT S <br />TOTALFEE S <br />r�evuirr�� If'F_ ,7� PFCFlPtNO <br />Yl� C �i.i� �. <br />FEES VALUATION_ __ _ FEE <br />�nni i iur -- - - _. _ � -�- , <br />----- $Z,11 ]-- --- �'��/�lj �O,_ - <br />+ rinunw—_—___ .._ _—__-�<1 i�^� <br />_ /� -�/- <br />MFIII�ANIfq ._ - . . .. _.__'_ _ ___ I�� , t'' �) <br />� - 1 <br />- �OfN�I11N�11`I�NCII(f�.M � <br />-� <br />_.-_____ . _ . _-__- .__ __�.._. <br />MnF� <br />� <br />i <br />._.___ -_. ..-_ . _ __— __- ___ __ _. <br />. i ni I N ul I��Y�1 SI IIIf,11Mfi� i/� i J <br />. _--_ -- .-- .- -_ __ ..- _U._. <br />..".-. __. - __ <br />CITV OF EVERETT �-��n��� w����.. � ^� <br />LOCAL SALES - ------- --- --------- �-----.-__c�.��C <br />TAx CODE IS �105 TOTAI _ . � 7� �;' <br />