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APPLICATIO, FOR CONSTRUCTON <br />CITY OF EVERETT a RUI DING DIVISION <br />9200 CEDAR STREET a EVERETT V A 98201 a (425) 257-8810 <br />❑ DEMOLITION <br />PROJECT ADDR <br />❑ BUILDING ❑ MECHANICAL <br />11.1W YM Y Fls <br />GrY 10 hgNf <br />fI1LNRCi Oa (ISLGxSx YM K4x SS <br />PERMIT <br />O PLUMBING ❑ SIGN <br />1,nAJ• �Ye.t.�. <br />OfM W [ 1N[Ipl YN KdYSS CA, )x' n4yK SNrl 1iCINV I <br />J( oo-G,� o09 A 051s ��1Lt�-9�6� �2Y�-t'TA 6CnS733x� <br />YfCxlY1,11 CbIIx1C'lla Y44 YAr1s SS GM1 )r nlpl( WpN IK[xSS• <br />"WM Twlm mft. ICSS blY Im nVf fMIf lKCN5S1 <br />[WraKr TKE IY wdY �� 7SL?r_ t% <br />HEATING SYSTEM: ❑ OAS ❑ ELECTRIC ❑ <br />trfcaff woT,Taa fow oar.m rnal o <br />d+Inionq imil 4 J He 100 <br />cwucrnaew aulnnM .q <br />1 HEREBY CERTIFY THAT I 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 />WORK WIIL BE COMPLIED WITH 'WHETHER SPECIFIFO HEREIN OR <br />NOT. THE ORANTINn 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 TI/AT I AM AUTHORIZE0 BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION 15 MADF AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW IA 77 RCW AND 2%200 W/A�C <br />XT�/FI�p�..o G7/�JfA S � 6-�� <br />° yP Uy,E,(� mYonn <br />/�C�1 Tmeh•� <br />I(OY xp'l MN mnlSl KLO Ml"WII OCd Sl <br />rot AIOb Ix <br />f 11 IAI ID raAMla <br />cOM{rmlLrdrDIH 1:4Ilia Mln(Ss rnSpgVF MVMFn <br />eaaMM! DEIII, <br />_ <br />Gi. WSNA SS IKSNSC HG <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE Of FIXTURE OR REM <br />_ <br />FEE <br />WATER CLOSET (TOILET) <br />;W AVHNDLO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN( <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYERS <br />�— <br />SHOWER <br />KITCHEN SINK { DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />RANGF I1000 <br />HATER NEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />' <br />URINAL <br />I <br />METAL FIREPLACE MOOD BURNIN01 <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT BURNING) <br />—+— <br />FLJOR DRAIN <br />GAS FIREPLACE <br />i <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC I <br />OAS PIPING <br />EXHAUST FAN <br />r <br />I <br />r <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT { <br />PERMIT f <br />TOTAL FEE i <br />TOTAI FEE III <br />t <br />FOR OFFICE USE ONLY: <br />I"TVIaV.a <br />RSR MrfKY <br />Pp(M14Ca <br />q(xGIFCIt MIMrfa <br />I(f <br />MFfrr NO <br />UN fOM <br />r01AM• <br />rKSr1I "IF <br />FEE <br />VALUATION <br />FEE <br />Ortt IT ND <br />fln nn <br />_ <br />�— <br />ND v Dx(LIaAS sY[ p KOMI <br />IMIt <br />Nd1i IMIsrgN <br />.— <br />n Ia111111D <br />CIF —1 V pO�All <br />pCIMNI IOW S.14 YfNl <br />Nf1'NI m <br />---_ <br />DYEf DM <br />WpIXMY RW MCs <br />IXKWMIfAa[O'p <br />IrASON <br />�� <br />011aa <br />iR AIA1M al0O <br />MAYn <br />.INI MAOMI LIIIGUpN <br />.R rr rxmr <br />naxA APvno.rneT <br />.:ITY OF EVEREtt <br />mar.wpN. <br />LOCAL SALES <br />-- <br />TOTAL <br />D.iE <br />TAX CODE IS 0105 <br />m <br />