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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 A 259-0810 <br />I l DEMOLITION I COMBINATION I I BUILDING MECHANICAL I I PLUMBING SIGN <br />PROJECT ADDRESS <br />OVINFp MAIL All 55 Gtv )1r rower <br />�.� �05 ��lh.� _ � (;I <br />it N6A11T MAIL Anonr Ss CITY ip TILA <br />�r"Y <br />ATTfIRiCCTLT On LIESIGNrn MAXI ADIN1F 55 f,11V 711, rNONF <br />Gr NrIIAt r-OIIIIMCILIII MAIL AWtORs p1Y 71P TY InNT p1ATF IIC(NSF r <br />MFCIIAMCAI CONIOAr,TOn MML ATM1nFS5 CITY 711, 1,1101,11, SUtF IIff NSF r <br />PLUMBMIG CONTRACTOR M.MI Anort"If CI" )IP PIIONF STATr tICFNSFA <br />C0NIRACT rPICE or wnnM <br />�j�,�4 • � <br />HEATING SYSTI ECTRIC I I <br />OF f,01pF WORK ANDSo11ARr r0OTA0F. INVIXVF.n <br />C0NIAC1 PrnSONANDNIONF NO <br />P �n)V,su------ <br />--__—_— <br />Igo� <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />DU - <br />— <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />rnorvsFoucE or nMI IMNnv <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING. THIS TYPE OF <br />— <br />WORK WILL BE COMPLIED WITI4 W14ETIAER SPECIFIED HEREIN OR <br />IrGAL DESCRIPTION OF PnovrnrY v;no" prtow MAT TACIT Two fort") <br />NOT. THE GRANiING OF A PERMIT DOES NOT PRESUME TO GIVE <br />tot RIocif or <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAZY REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I 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 />PATICEL TAX 10 MIMRFn <br />CONTRA ORS LAW 18 2� RCW AND 290.200 WAC. <br />�7auoS • y) - n3� Q <br />CONSIIIUCTION IOAN TENDNN ER. ALIFSS, TFIEAYIFIE MIMPFR <br />X r,..F�-i'� - 4.6' <br />7 <br />S10N 7tinr C DAIF <br />CITY BUSINESS LICEW, NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WAfEH CLOSET (TOILET) <br />I _ <br />A/C—AMNDLO UNR9—H.P. <br />—A— <br />BATHTUB <br />_ <br />—T <br />FORCED AIR SYSTEMS — B.T,U. M EA <br />-i <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />�_ <br />UNIT HEATERS — B.T,U. M <br />KITCHEN SINK 8 DISP <br />i <br />DRYERS_ <br />i <br />DISHWASHER <br />.— <br />_CLOTHES <br />VENTILATION FAN <br />�— <br />' <br />` <br />LAUNDRY TRAY <br />) <br />RANGE HOOD <br />_ <br />CLOTHES WASHER <br />i—�- <br />WATER HEATER <br />1 <br />URINAL <br />' <br />WOOD STOVE <br />) _ <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE (WOOD BURNING) <br />—i— <br />FLOOR DRAIN <br />_ �— <br />_METAL <br />FIREPLACE INSERT (WOOD BURNING)_ <br />—~— <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS RANGE <br />GAS PIPING <br />' <br />I <br />_ <br />EXHAUST FAN <br />T— <br />i <br />I <br />� <br />I <br />1 <br />1 <br />1 <br />SI113 TOTAL f <br />SUB TOTAL S <br />' <br />i <br />PERMIT f <br />PERMIT f <br />I <br />_ <br />TOTAL FEE f <br />' <br />TOTAL FEE f I <br />FOR OFFICE USE ONLY: <br />r Ront SFIRACK <br />PTArt sr TIIAPIt <br />51nr SFTRAC,M <br />PIANCIIFCN NIIMIIm <br />rrr <br />nFCFIPt No <br />-5-r3 -73 ,;11 <br />- <br />Uir 70141, <br />TOT AnrA <br />VACANT SIIF <br />_ <br />FI ES <br />VALUATION <br />FEE <br />I IYFA I' NO <br />---- --- <br />_ <br />still DING --- --- <br />IIEtOnT I IMNATNIN <br />--- - <br />1F0 or DwrILING <br />wr or ntm,i I <br />-- - -- <br />---- <br />IINItp <br />I'DIMRINO <br />17CCIMANCY M fM SITMA[s <br />GROAT`////L <br />GCCIMANI LOAD <br />nASFMFNT <br />MrC1MNIC.A1 <br />AYES II NO <br />1 <br />-- -- <br />— — <br />----'- ` <br />1InE ALARM pro (I <br />ADIMTIONAI I'I AN CINCX— <br />------= <br />nFA50N <br />-- <br />olllER <br />Titig RI innnron <br />nrASMT <br />---- <br />----- <br />STAIE n1111NN0 mmci IAnnr <br />IYrFOr fONST <br />) <br />PIANSArrnnvrOnY <br />CITY OF EVERETT <br />rumlL wnnMc <br />LOCAL SALES <br />-- — <br />--- <br />-- <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />