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F-1 <br />0 <br />APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET• EVERETT• WA 96201 •250-SG10 <br />❑ DEL..tLITiON COMBINATIs1N ❑ BUILDING Cl MECHANICAL C' PLUMBIHA ❑ SIGN <br />MHOJECT ADDRE38: 2 *0��-00Z z P/ sW <br />� S e� 'rw r`£nu-�' �_v_7_<aL, .C,•c1�Fdny_Fl S�1r1[C--- rAir�� Ns.L,E� - <br />It1 l <br />cnv <br />aNAY cwIIUClg1 <br />Y4lLWK{f <br />nn --_ <br />lfr---_--0_-o;--- <br />-.mmNY. <br />MU'Nt \I"IF IK[NN. <br />YtdY.U;CwINK10N <br />YM NPrf{f <br />aT' <br />!T - <br />n V1Mgl;wllYGla <br />VLL IDIMI{S <br />clM1 <br />- nlDrl STAIEO[FNN. <br />COrT11KlPI¢lawar <br />--__ <br />HEATING OYSTEM: [I OAS ❑ ELECTRIC ❑ <br />cwucl•...:• nw .n---_ _ <br />9s�— —_ <br />I9- 37gI7 <br />I HEREBY CERTIFY THAN 1 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 />V ORK W U. 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 REOULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FDA WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW Ie 7 W AND 2/e 200 WAC <br />2z <br />K.�zA99 <br />alnr rawAro {ouAiromnr mnvto �. <br />5 <br />- <br />GRr 46G / v2o 0429- <br />Q tra. _ <br />1 ` <br />- <br />rsoteour U IlKoro <br />SI�pl Alf <br />�. <br />M wrtaiicl ix%v ..Arr NKFI KIM pIAl1A[r1 IMCMII{I <br />Ppp„�.J • /I /C A'A, <br />39 Ss a00 0Z_�24 7 <br />AVIm MID KA.iA <br />CW DIIlC1O1IO LFI PADMIll RItIM KUKA <br />w t,At wI <br />an IusMY Tct4u ro <br />MECHANICAL <br />PLIROBIG <br />N0. <br />TYPE OF FIETURE OR ITEM <br />FEE <br />NO. <br />TY170F EONPYMIT <br />FEE <br />_ <br />WATER CLOSET (TOILET) <br />AC - A404OLO UNITS <br />4BATHTUB <br />_ _ <br />LAVATORY (WASH BASIN) <br />F <br />FORCED AIR SYSTEMS _ <br />HEAT PUMP <br />U NIT HEATEPS <br />SHOWER <br />RRCHRN SINK A DISP <br />CLOTHEB OF IERS _ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />UREEAL <br />METAL FIREN AGE EMOOD BURNING) <br />DREADING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />I_ <br />FLOOR GRAIN ----_--- <br />-- <br />( <br />_9JFIREPLACE <br />GAS RANGE -- <br />BACKFLOW PREVENTERS <br />SNK (SERVICE - MR. ETC) <br />2 <br />OAS PIPING - <br />EXHAUST FAN <br />Su.. OTA It <br />PER{{IT <br />SUBTOTAL / <br />PERMIT 1 <br />TOTAL FEE i <br />TOTALFEE I <br />FCNi OFFICE USE ONLY: <br />ImIN1 wo-V <br />_ <br />WARNT�r <br />{a ltll ,• <br />n.NC1K(ILNYL��Ar <br />frf�(1V <br />IKrrlPlro <br />55//77FEES <br />w toR <br />IUI.AFA <br />vACAxI Rrt <br />VALUATION <br />I <br />Ov{{ Oro <br />Im^NWI <br />NYNT IlYll.11DY r <br />w' a D01llMD <br />Vri a MDO•11 <br />- <br />SSS SF� <br />nlwNo___ <br />VILNUK4 <br />aK��//NN'' IDO{Ifn11 <br />MIDI <br />QAIMNIID.0 EAF(VI4I � <br />CrA AA{Y➢ <br />a.SIN <br />.Cb INYrM nw[KC. <br />OIN(N <br />_ <br />rH[/wNYll09 <br />AI Atw <br />f1Alf yRPM14MCrYM1 <br />T^taro.sl <br />n"N1 AM11DVIDEr <br />CRY OF EVERETT <br />ns N. wonc <br />TT <br />LOCAL SALES <br />TAX CODE NI 305 <br />TOTAL <br />