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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT •BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425) 257-8810 <br />(1 DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN <br />gRO <br />,,1 ECI'T ADDRESS: <br />xY .. _,a1011 S�LGt•+• E' <br />ICk_N NN'iGr .S}SIc oye i 9fl,1as 7io-4J75 <br />ITNNT YM APIMff <br />rn. ro R•f1t _.-- <br />MCNWC4 fwlpff.IP1 Y1l A°PYSf PM1 )s• F¢,( <br />llATf lC[IIN • <br />N INMMCwIRffl ///LYy lypl[f! LIR• !q <br />9,75 M1 STAR ICfM11 <br />cwrllAr.T 1'IACI P FRKY <br />— 1 HEATING SYSTEM: XGAS ❑ ELECTRIC ❑ _ <br />I HEREBY CERTIFY THAT I HAVF READ AND EXAMINED THIS <br />APPLICATION AND KNOW TIIF SAME TO DE TRUE AND CORRECT ALL <br />lib <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7141S TYPE OF <br />PnPYprY lflgpp /Fl°p°p.RA[ll tppt'pnL4 <br />WORK YAKL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />wmI <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />P <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />7D" <br />OTHER STATE OR LOCµ LAW REGULATINU CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICHAPPLICATION <br />15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTO 7 W /27RCW D:5/2 ACMIp <br />K AIU1L ' 9 <br />Dnl r <br />Y1PYf6 RLLIMONF M11AFp <br />P_wrelNa <br />o.3o7a� <br />GT1 p1yASS lC1Nt( Np <br />YEON/MN!AI <br />—IRI.I nPE OF FIXTURE OR REM FEE NO. <br />TYPE pi EgllPyp(F <br />FEE <br />WATER CLOSET (TOILET( <br />BATHTUB <br />bY:—AAOIDLG LNRB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A OISP <br />CLOTHE60RYER4 <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOOSTSTOVE <br />URINAL <br />METAL FIREPUCE DW'700 BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT DVODD EURNINO) <br />FLOOR (TRAIN <br />OAS FIREPLACE <br />BACKTLOW PREVENTERS <br />OA9 RANGE <br />SINK (SERVICE — BAR, ETC <br />OAS PIPING <br />—��— <br />EXHAU57 FAN <br />SUBTOTAL S <br />SUB TOTAL S <br />PFRIA7 E I <br />PERMIT S <br />TOTAL FEE E <br />TOTAL FEE / <br />IRf lPR IOI Apn YACIN1 YIf FEE! <br />❑rtE O. <br />I MTATIw Aq P PIIYIIb EY[ P l°Upl <br />)MIS <br />O•I6 On <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />nIMM11 <br />M(xIM Y <br />ApPlllyy n W CxTn <br />Ulxfp <br />ARq Mp P1Y IIAp'w11P <br />nYl Ir. M(pYt <br />TOTAL <br />