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APPLICATIO FOR CONSTRI110*01N PERMIT <br /> CITY OF EVERETT A BUILDING DIVISION <br /> 3200 CEDAR STREET A EVERETT,WA 98201•257.8810 <br /> I- DEMOLITION ❑ COMBINATION " BUILDING I? MECHANICAL fl PLUMBING SIGN <br /> PROJECT ADDRESS 21 S 79S'� FL— SW <br /> 4q"CWtl Si Ut♦ IV Rq4 <br /> R SIPVEn Kr,f.#xTr 7'WK V �( EL,�..LI 4Yza3 Y1 r 7 -r---713 y _ <br /> EWWr�•� YYl1p°tR69 Q CITY lP Rp/r( <br /> •RCIaTEcr°R asprER wa•°°IlFsf CY O S cm 7r 1 rvgryf <br /> Gnr4 La/ScAa ✓I lg fr ? ppz9 <br /> UFTIFR4 CS.y ^Y NM�E9B III, !o Rpr{ 6r•ri llclnSE• <br /> tsr7 lira 5;;As.4/ ✓aeesf/ Yrl7Yf9.t7s <br /> YEd•YC.4cd rOR YUWTESS ti MqE STATE LIcf1HEA <br /> ft.n cdrwcroP YAa AUUPESS cn. tP RIOrt STATE LCENLEA <br /> Cd1P"Cr AICF Of <br /> HEATING SYSTEM: OAS 0 ELECTRIC FI <br /> GE9CnOF waPA ANO60UYIE rootAOF RNnuEo � CONTACT MRsd Aw RlOrrt No <br /> w l Y t!-JAY7Y77 <br /> c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> RKNOEEOu aE euaoRn APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> E PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEaAL°r ROTKWRPRORRTY I61UWM eELPYd•nM}I MOCCPteI WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT MUCIC AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIOS OR THE <br /> v jrnik PERFORMANCE OF CONSTRUCTION THAT 1 AM AUTHORIZE i BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK F R WHICH <br /> q/4J-000-0 LL -00-01 APPLICATION IS MADE AND 1 COMPLY WITH TILL. STATE <br /> PYrCEuw ID a 11 CONTRACTORS LAW 18.27 RCW AND 296 200 WAC. <br /> 4 <br /> fifAl,eAv A'h�tal /MA .� ./I z116/ <br /> /ZLEf+/ <br /> CONST ICNL 1E10ln•[MKSS iFIF tAIM[� A, <br /> 28' z3 -Z 7f/P1Q7 <br /> CM.'0.•�` Anit"wc,III ;ilg,6w DATE <br /> Hie TWO CA".UENESS LCEN9E rq <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> 7 WATER CLOSET(TOILET) AC-A-HNDLG UNITS <br /> BATHTUB FORCED AIR SYSTEMS I <br /> mq <br /> UVATORY(WASH BASIN) I IIEAT PUMP <br /> SHOWERUNIT HEATERS <br /> KITCHEN SINK A DISP CLOTHES DRYERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER I <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE IY/GOD BURNING) j <br /> DRINKING FOUNTAIN FIIIEPLACE INSERT ryY00D BURNING) <br /> FLOOR DRAIN OAS FIREPUCE <br /> BACKFLOW PREVENTERS GAS RANGE <br /> SINK'SERVICE-RAP.ETC.) OAS PIPING , <br /> EXHAUSTFAN <br /> SUBTOTAL f SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE SV, TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> I"TSE� 7 MARSETBKRi BOF S[TeACN RANLM[CR EYYB[R iF RECfeK IO <br /> S' 1 / /0A-a 73 q+, <br /> usE toNE Lot uKA vRc•nr t}W FEES VALUATION FEI <br /> Kfs n rq S <br /> wrs z <br /> 1EpNT lBNr•T NUS IuM Ia OEeLmTI <br /> RIMM <br /> YJ S EMl6 UCSIFIJII LUW e• umt --�Yf — <br /> . / CN•YL4 <br /> • Z nYEe Yfp <br /> i11e Ruw Mao M.9UN Ad9TYJwl RAn dEa <br /> O MfR <br /> r Pf AVPYMUU M•XM <br /> BtYF eNUAAVI SURCNAPU( <br /> t.M ar cdsr R•Ns.PProHOe. CITY OF EVERETT RAILKROIMe <br /> f"T• LOCAL SALES <br /> -� <br /> _.l E. "+tZ�z�4) TAX CODE IS 3105 TOTAL <br />