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APPLICATION FOR CONSTRUCTAN PERMIT <br />CITY OF EVERETT - BUILDING DIVISION <br />3200 CEDAR STREET r EVERE T WA 98201 A (425) 257-8L 0 <br />❑ DEMOLITION ❑ COMBINATION 04 BUILDING ❑ �MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJEC�TT ADDRESS: �,/22 cT S/_ J4,wj, / <br />1 (.V MAIIIX %J2 Zy S> e,6ry %f c�3/C3 1S��G23i <br />AIAIIA . dA <br />IIMtYI Am AMAwss dl. H nqq <br />Aw,.Iftl0AmIIc,w. Wq YKYII SS do /m NqN <br />�tlsdrlee, 7y 'i3r��E�+�r�2t,�os 3 03 I�ySA1QG�y6Li3 <br />MARRA r1millAclan RAR Aa tl an fm nrYR GMI! llClww. �� <br />IRCII.WA rMHAI..Im VM AMX1155 an im n10N t1Al/ICFRE!• <br />AI WIINfi IONIRAr:IP VIA Adlll[99 an RR PIKOW 6lAlf llC[N9r. <br />COwllu[I1'IIN:I a <br />a <br />HEATING SYSTEM: ❑ OAS ❑ ELECTRIC ❑ <br />Msrwer wM.Awn 9aww aolAa rtvavre <br />aalAClrtmwAwn PIAYi MO <br />4 <br />iti.M Relo uu OF swan <br />^,! <br />uWl s Rmllona PRaIRn IRorlll slaws AnACR crxsl <br />'I nY J^P <br />IPI -__ raw 0 a A910 <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW DIE 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 1 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 />WNTRACTORS LAW 19�277 RCW AND 200 WAC <br />n✓�rt� <br />X�,���� <br />Pulcn In In *Y p <br />COMIwICIRW10Aw1(NIFR IV111R61 nI N44 N11111[R <br />{KYYI allwn <br />dl. /OgN[591ClNSlM <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC _ AASIDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK S DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />I <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />( <br />GAS RANGE <br />_SINK (SENVICE -BAR. EYCJ <br />i <br />GAS PIPING <br />EXHAUST FAN <br />1 <br />I <br />SUBTOTAL f I <br />SUBTOTAL t <br />_ <br />PERMIT f <br />PERMIT t <br />1 <br />TOTAL FEE f 1 <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />IMMI VIbfI. <br />--- <br />axI PIFAfw <br />LOf X14Cw <br />M1AMCAr11 MRMR <br />!!f <br />WWI An, <br />nN 7nwr <br />q vY111 NOlwh -- <br />♦ Yv•i,al <br />77577 <br />IM 1A1Pg1[NMan - <br />I wR 4MV MVU <br />pA M Im" <br />__ <br />iai ANA wwI AIR <br />Ong a., <br />M11Y Iww 11M 9ltlarr,nl <br />xH� <br />FEES <br />VALUATION <br />iE <br />- <br />_ <br />xxnARl <br />_ <br />nIW11wR <br />V_ <br />MIIA'ANIIWp <br />FAprMMI <br />ORs (I A, <br />al'MAN'AI <br />AM}IInNAI AAw(MI'A <br />. <br />IN AN'M <br />MAYM <br />MAY%AWINNlrinn. CITY OF EVERETT <br />LOCAL SALES <br />PAVE TAX CODE IS 7105 <br />MAII Mx1MN1 SIKIYRM <br />nRllc wlq.. <br />y <br />-- <br />TOTAL <br />- <br />_ _ _ <br />