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APPLICATIA FOR CONSTRUCI%N PERMIT <br /> CITY OF EVERETT A BUILD114G DIVISION <br /> 1200 CEDAR STREET EVERETT.TVA 49201.2570'10 <br /> DEMOLITION COMBINATION I✓SUILDING ❑ MECHANICAL PLUMBING SIGN <br /> I PROJECT ADDRESS A7 ,9 L <br /> ORNER M.I ADDPE66 CIrT fP P9T4 <br /> Pnt M� DoyOA 17411 IJ5/^AyC SLC gLotnlfd 94)91 Y?S ;331 3119'9 _ <br /> rfN•Nr [uA•OplEHB Gn t0 PTOT•E <br /> Arc{,co'.1 NDrlhyes} IA ,Kv lle 9f(b7a A/l5 1185 A/9Gb _ <br /> •N[prtICT OR OE69«R T.MA WpR 99 COY Ie' RpYE <br /> TdtiLel DevtlonMLn1 sAnL ?111fTAdt/n/cS <br /> pMP4COprPW rpl r TT•E•DdTF88 Gh !v P10T4 SMTS L9FMl• <br /> �tstl �/a PD/tb'771 K/1 Al A4 A7E tK SkueA> 99'.759 Yzs 7711 Y/// <br /> u[c 9utprpWr wi•DDRE99 crtr rP nTDNE rt.TE[9Xx9EE <br /> Btnr NEtEsshi 172"ds4 of Ar l yl60 E492i4 st2r 750T-P 1/3 <br /> RIMBIHD COM[R•C'Ipl Y4.Oprt99 CI« Z. RPbE IITAM MASS <br /> f%WTRKrMCEp MVpA <br /> 5 HEATING SYSTEM: V,GAS ❑ELECTRIC f7 <br /> 941 Al' Z)OIIAIJ x9cpe[Raw•ro 9w.R(,9Dr.DE 9n9[v(O cwrW T v[Rsnl Aw1EKwE w <br /> 4s 2317 ? <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> Proros[DDSE M eu.090 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 /> [FULL pfCPnTKwd MOPF.pn r8wrM 8[IOW OR nWp Mc (, NOT THE GRANTING OF A PZRMIT DOES NOT PRESUME TO GIVE <br /> LOT�_9[0c. a 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 FERFORM THE WORK FOR WHICH <br /> ODrolzl95006 3935Cra�oot/dctr APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> r ELTAT ID pUU(ER CONTRACTORS LAW 18.27 PCW AND 296200 WAC. <br /> tvTd«t BAM� Evert+� 1195 .'758- 6 X� ^ �/D/ <br /> GM19TRIX:tit IO"IIuk 'Car R[FRKVA MNBER `! <br /> UWAIUM E <br /> COr WPT488lKETKEw <br /> PLUMBING MECHANICAL <br /> 40. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A'C—AHNDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASINI HEAT PUMP <br /> SHOWEn UNIT HEATERS <br /> KITCHEN SINK f DISP CLOTHES DRYERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> / CLOTHES WASHFR WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING <br /> DRINKING FOUNTAIN FIREPLACE INSERT WOOD BURNING) <br /> FLOOR DRAIN OAS FIREPLACE <br /> BACKFLOW PREVENTERS GAS RANGE <br /> SINK(SERVICE—BAR.ETC I OAS PIPING <br /> Li EXHAUST FAN <br /> SUBTOTAL f 1 SUBTOTAL f <br /> PERMIT f PERMIT f <br /> TOTAL FEE $1 TOTAL FEE f <br /> FOR OFFICE USE ONLY: A7 <br /> ,BORT Ulm. «AAMImK SOF UnAcA GtGI MIWFR ,[E RFCEPTw <br /> 20 Zo 5, p�• /p <br /> MZOTTE IOr•RE. V• TS,N FEES VALUATION FEE <br /> rf r(( Ow s <br /> I<nNTlulr.r� Iwn Pw[upu i�s 'T <br /> / RINMlO <br /> T pop 99pE{ OCCUMpI IOW SARMW K0, 1rtbYI11f:K <br /> I/•I Z ❑r(8 NO <br /> ,ft spp"R Koo «A. Wp191TMLP4N GRCp <br /> '1110 OM[R <br /> rrN•[ATAT rrtaP «•60p <br /> STAU 91A[pu(wcpu9( <br /> rrrt orcwsl n•ps•rcP1.v[D e. CITYOFEVERETT nB[9 wOP.S <br /> LOCALSALES <br /> •J DATE3/P._7 1 TAX CODE IS 3103 TOTAL <br />