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APPLICATIA FOR CONSTRUC*N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT.WA 982' •257-8810 <br /> DEMOLITION COMBINATION X BUILDING MECHANICAL PLUMBING SIGN <br /> PROJECT ADDRESS <br /> 4R-p (DISE SY Sr; <br /> OWIILP 4141ppP[55 C1♦ $P 11g11L <br /> CHAOS 1' DONNA CROA•aM S–JuA.iT 9$701 VL\ Sti$ y/ <br /> tE14W uA4 ApaESE 427 (,o- Sr SE OI. IP R,LNE <br /> 4CRIi[Li pI OEISRtR 4.4ACOP[6! GIY !P RKM{ <br /> OENFMLDa1IPKTM YK•RN1FE! oil IF PI,aA STAM LICENSE• <br /> EHIL (ALr1d.�4► (ayneJ� BdAditttl lQtA7w ( 4ityb➢U.LU.t <br /> RCN•MC4CONIPKIOR 4.4•pLY1fE! city IP RO( lIAIlILN� <br /> 0.114pM]CON114Lip1 44•WR[!! City tP AyY(, SI•TELKENlE• <br /> CPITRKt MCF Lr MJ1T4 <br /> HEATING SYSTEM: ❑OAS O ELECTRIC I-]— <br /> DE YAIrDI UO sauUR rooT•OF HIaVEp CMWT PM P14Y2 No <br /> ZNfLt &A,mii ALRO ALA1Zj0Itjjc <br /> y.1 Lw z4a CAr a5� N2JC TO'a &1153 <br /> C.r NL A! 1r70nla L AI,J HEREBY CERTIFY THAT I HAVE READ AND EXAMI'IED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> Tworos[D usE or BORONS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> L[MIpESCPPIKrvaPNIY[PT.Is.Dwrl aflQY on•nu:N MocaAR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> Lor 177 IS 19 UM.7_a AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> _ SA.!•,LAAD C- S 14' PEs Pe. PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED PY THE <br /> (}L'.AnONV OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> P/JK[L TAXI D M11EHR CONTRACTORS LAW 118 27(ACCW AND 2S8 708 WAC. <br /> Cg19}Rlll.'iCN lO4I lEKFR•DpIEIE IELERg1EN EA A. 1'" �, •��-r'�,� ��a•4J <br /> 65lCFMH r10 <br /> PLUMBING I MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) <br /> AIC–AHNDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS ! <br /> —�— <br /> LAVATORY(WASH BASIN) I NEAT PUMP ! <br /> SHOWER i UNITHEATERS <br /> KITCHEN SINK 8 DOSP 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 GAS FIREPLACE ! <br /> BACKFLOW PREVENTERS ! GAS RANGE <br /> SINK(SERVICE–BAR.ETC.1 I GAS PIPING <br /> EXHAUSTFAN <br /> i <br /> I <br /> I 1 <br /> I <br /> SUBTOTAL S ! SUB TOTAL 3 <br /> PERMIT f PERMIT S <br /> TOTAL FEE f I TOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> rPDNE'A`CR P[.P SE IpKR 64 H1!•C�R R.N Cr RMMEEn•DII rE[ 77 // P[CFRI NO <br /> IIH1 yV/ IOLnT. <br /> "'i <br /> Ft` / FEES VALUATION FEE <br /> n <br /> n ! IS'SEo S <br /> MfgNilWnn . I15 DA[4140 PZFa RDOl1 <br /> QGH S.F• RDYEp6 <br /> 2CIM•1Cy M1p5PlS UCGNANT LOW !•H4[Ni 4FCN•NC4 <br /> MA / <br /> Uy nnE Ivry <br /> r RFbMMIER PEOD Pf.soN WDITKINK IlJJI LHFa <br /> OINEP <br /> rIPEu.moD RE•!ON <br /> BIATE EAIIDEKI SI1rICE4P0E <br /> rrPfa LDNST RM14APPTgV[D Ay CITYOFEVERETT REKK waw! <br /> I' LOCALBALEB <br /> TAX`CODE 19 3105 TOTAL <br />