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APPLICATIA FOR CONSTRUCAN PERMIT <br /> CITY OF E A EVE IF BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERE7T,WA 98201 •(425)257-881G <br /> 13 DEMOLITION (] COMBINATION O BUILDING MECHANICAL (3 PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: S <br /> ..1 ff�-'�'!3 L�s�.�ro��✓ ao 3 f(>75rs�.?•ssf5�- <br /> IIY.NI YM 41pYSl Gry <br /> NCMfIG1pP nFSlnr1{n 1��II�4/1Mi15 ,�'��j'�/(. Cliv 9A/��JS ,rIM/t <br /> YICn4IC4 ffw1a4.lUa WR 4irIM51 frM1 )If - - - ---ronl SNIF ICFMx• <br /> ruWnrifp11R4:ICa W(411M(St pr1 M' IxM SNIi1C[Mx1 <br /> itwm¢i lax!of IM)11• --- <br /> HEATING SYSTEM: AAS ❑ELECTRIC ❑ <br /> eF M1sDYeM rnor$p v[D caar rl n11nM ao - <br /> "11 �?eWc�esecliNls✓SCAN " <br /> I HEREBY CERTIFY THAI I HAVE READ AND EXAMINED THIS <br /> D Ily�nlq^1 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> d/RI`f PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> Imo xMnrpYp f11o1Tarvlsrrpw NlO4wfn¢NrnD Cpa1N WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tol Roae p AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION MADE A 1 COMPLY WITHHX THE STATE <br /> NMCi11M ID Maaan� CO��If i7 ' AND ZOO WAt7 ' AND 70D WA�� / <br /> GYItIMR:MM 10Sa HMia Allpafa ITIIISEME MANn <br /> lu <br /> GIS$URMSS)SIMV M <br /> PLUMBING I MECNAMCAL <br /> NO. TV"OF FIXTURE OR ITEM FEE NO. TYPE DF[OLIIPMflFF FEE <br /> WATER CLOSET(TOILET) AID-MMgIG UNITS <br /> BATHTUB I I FORCED MR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNITHEATERS <br /> KITCHEN SINK A DISP CLOTHES DRYERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) , <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) �— <br /> FLOOR DRAIN OAS FIREPLACE <br /> BACKFLOW PREVENTERS J GASRANGE ) <br /> 5WK(SERVICE-BAR,ETC) OAS PIPING _ <br /> EXHAUSTFAN <br /> SUBTOTAL f SUBTOTAL f <br /> ---- <br /> PERMIT IT PERMIT f <br /> TOTAL FEE f ITOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> I p1Nt V11Mft q.a<I M.f. WIx1YCl1 H.MfI CI1 MNMa�,_ I!I aifllPllq <br /> FR/A1 -v <br /> ItN)oat lor•M• Y4:Aa1 w! EE _ VALUAT _ FEE <br /> Ori$ D M AIS,MMi <br /> IfIDMI la•IArlpry MO pIMtlIMO 4R 0" <br /> S awn,l - <br /> WI <br /> nlaM•m <br /> IMM}IY• an•IMf p.flgallGW e1MMN1 MlN1Mf11 <br /> DHS Dan <br /> IUM 1NMNI114RnD�- p•alw IpGll(WI MAN CI•fa <br /> _ OIMa <br /> IMµMY a1DU q.arw <br /> SMIf eINGWR Y111CWIMi! <br /> Irnpfpnr neat MlalGvm e• CITY OF EVERETT nMr.RpMa I <br /> LOCAL SALES -- - — --�--• <br /> D.q TAX CODE 15 3105 TOTAL I <br />