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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 A267-8810 <br />DEMOLITION COMBINATION A BUILDING ❑ MECHANICAL 11 PLUMBING SIGN <br />PROJECT ADDRESS <br />Iszp 72, Sr <br />5e. L-'veltel7 41F. yP2�S <br />TYMP uA-AUl>aEss cu. !n RNb[ <br />Ache M kaAwtL.ke'd IIAII. 7a1te sY Se. &LagV A%a fj`43 y1i-3SJ-9130 <br />TENANT MAX ADDRESS Crtr In MOTE <br />MCIIRECIDR DESOMIT MSEALDRSS CITY to RP}E <br />OfNFR4CDIIPACIW MAX AtOMRS co, In R4E STAR ICENSEA <br />— (9W NYR <br />4ECNANKALONIPAC10R 4AR ACDIf58 co, In Rlp( SINE IK[M[• <br />PIWP^q CONIPALION MAXADDMIS C01 !n APPE STATE LICENSE. <br />CONIRKI W CE Cf YAM <br />HEATING SYSTEM: ❑OAS Cl ELECTRIC rl <br />OESCR WOM AE 6OU1PEEMtAM NN4V[O <br />Pa o �ilw1RP IS sBA <br />CONIKII'FPSW Nq NO <br />T7r1v��.Tmoate d lieu/` <br />U2s- Si S- 9l3J <br />1 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 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 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18 27 RCW AND 2" 200 WAC. <br />P/O/ <br />PnaPOEE^ D IMALDM 1 F ,p <br />R <br />UGAL OEMArtm OF MOPEPTY ISM'" SEIM DR Al1.1CN M UJAIESI <br />Apr SIOCP w <br />PARQL TA I D MPAKP <br />Q7GY� <br />CON6IPIICipN IOAPIFWEP. AODPE48 1[IFRIDE NM1BFP <br />AC <br />oT7 <br />6 IVPf D <br />CITY WSMESS tct NSN TO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOILETI <br />NC—ANNDLG UNITS <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS <br />LAVATORY(WASH BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK a OISP <br />CLOTHES DRYERS <br />DISHWASHER <br />i <br />RANGE HOOD <br />LAUNDRYTRAY <br />! <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BIIRNINGI <br />FLOOR GRAIN <br />GAS FIREPLACE <br />BACKFLCW PREVENTERS <br />! <br />GAS RANGE <br />SINK (SERVICE —BAR ETC) <br />I <br />OAS PIPING <br />EXHAUSI FAN <br />I <br />SUBTOTAL f <br />SUBTOTAL S <br />I <br />PERMIT $I <br />PERMIT f <br />I <br />TOTALFEE f <br />1 <br />TOTAL FEE S <br />II <br />FETES FIFFICF IISF FTNLV- 'p— rn e _ ..n I <br />,"ItUlm. <br />1,10,111MA, <br />SOESEHICN <br />MANCMCNNWPEP <br />IFF <br />MCEYINO <br />USE tart <br />tom wt. <br />VACANI SIM <br />'I TES n IA <br />FEES <br />VALUATION <br />FEE <br />SUXDMO <br />MOW LMiIXI N <br />M D DAT"m <br />Inks <br />sat Or `%ml I <br />RMUSTO <br />OCO�CIpANLY I Ma EMIEE <br />oc,; A TAm <br />N:EutrO <br />E'lES r O <br />MECNAWAX <br />ADp1ON4PLNICMCN <br />EPf EPPPwI[P PEOO <br />MASGN <br />EMIT <br />IPEAIMIMMOO <br />MASON <br />61AIF SNLd1Q SURCNAOE <br />M1M 4I C4trs* <br />MANSAPYIK)ADPY <br />ONE <br />CITY OF EVER ETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />—IK—IT <br />TOTAL <br />