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APPLICATA FOR CONSTRUCIOIN PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 • "7-8010 <br />DEMOLITION X COMBINATION fl BUILDING ' MECHANICAL PLUMBING SIGN <br />N1,11DO t55TT/ WA ]✓/V lily li <br />vzr yl e <br />`IPV EctoltmsowP N4 ADORES Ol• <br />n.UIbMO Cd11111CTO14 WRAIpMSS CITY IR ArM 6TAIM LCENSFr <br />{%RrIP1LT RILE lM MpYI <br />HEATING SYSTEM: I OAS Cl ELECTRIC ❑ <br />47P NYYM1:Yq sOUM[iOOibF MVolus�p/ <br />U <br />CON( M Ielp p(� <br />IACTC <br />ur ysz srpl <br />e era's' �; �„ fr <br />�+ ^ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL <br />PROVISN)s'S OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WI4 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 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 IS MADE AND I COMPLY WITH THE STATE <br />CONT CTORSLAAy1Iy(.`J1827AGWAND296200WAC <br />K 'K� �/Ql�rj/ <br />MI <br />LEON MA T" RIDRRTY(S rr Mta MAIM" TVI CCPElt <br />to, o' <br />') <br />SIP OQ^ % <br />FNiil tM to INNIER <br />Cox6TM1CTXMlDW MT«R.ADRREM.HMI19rA NU![R <br />61oNeI1Mf oRF/ <br />.nTY RUSHeS BENS( W <br />PLUMBING <br />IMICHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />J <br />WATER CLOSET (TOILET) <br />AC —III UNITS <br />L. <br />BATHTUB <br />! <br />I <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />! <br />HEAT PUMP <br />I <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />I <br />CLOTHES DRYERS <br />DISHWASHFR <br />RANGE MOOD <br />LAUNDRY TRAY <br />i <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />_ <br />BACKFLOW PREVENTERS <br />I <br />GAS RANGE <br />_ <br />i <br />SINK (SERVICE —BAR. ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />SUBTOTAL S <br />SUBTOTAL f <br />PERMIT $ <br />PERMIT 9 <br />TOTAL FEE $ <br />TOTAL FEE i <br />FOR OFFICE USE ONLY: Pa ) I D./- oc)& <br />l.1UI ICK E <br />/!1�^/� <br />.\GP 611IRLIT <br />W <br />&OE eEIeeCEll <br />nM�CNFCIt _x � <br />FEE30 <br />PFCERNp <br />ost la <br />ml <br />a 3� <br />IR <br />N"`,T VIE <br />ns #¢a- <br />FEESS/el'+j <br />VALUATION <br />FEE <br />611lI1i10 <br />2C1% <br />NEblilMlT1\(X1 <br />NJ or CFKIEIN.I <br />SI([oF el 1 <br />1603 412 S.f. <br />RUYeMO <br />O(a'CIIIYNC• <br />1: •� <br />N]PrFFIOIE6 <br />CCLIAWIIOW <br />0e514EN\ / <br />fl vE9 MW <br />KCrYJrIC4 <br />N11N\ION4 RNI CNECIt <br />r Pf eVP'MPLP ROD <br />PEASCN <br />ODRR <br />FNEMMNMoo <br />"U'" <br />SIAM V Epq FUMTMROE <br />TYM OF Cotrsl <br />nANSAMRMFD e. <br />oelE 1 <br />CITY OF EVERETT <br />LOCAL BALER <br />TAX CODE 18 3105 <br />rwcwaws <br />TOTAL <br />