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APPLICATION FOR CONSTRUCTAIN PERMIT <br />CITY OF EVERETT r BUILDING DIVISION <br />3200 CEDAR STREET r EVERETT, WA 98201 r (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ($-MECHANICAL (11 PLUMBING ❑ SIGN <br />PROJECT ADDRESS: S-zI 'A ,SC-' <br />pMl[w YN MS+YSS OIY If h91A <br />lleovav <br />1[MWI YM 111pf {s an n w1018 <br />MCIrRtl M0119Mw YM ADOA!{S Clh )f nCM <br />D[w(wNC lwfm UK All ph )M M1IOVf SIVIt 11CYYY• <br />Yfd{MC4 t(MIw1C101 YYl {001411 ph )f PI[Yt [IIIF ICI Ml1 <br />Fy �`�/ As,2•.ZiFY ELG`X'L_s_s0/>�7 <br />p 11yNL l:PI1RY:lOw Y4 YIpRN Gh )f POw {MIF IF:fMIf• <br />CP1rIYC1 DI YIOIR Aw <br />HEATING SYSTEM: .CI.OAS ❑ELECTRIC (3-- <br />WK �f ISAND1g1y� rOO1WE FwIXV[O <br />(//l�= Rh nic <br />A <br />cwtt l"w rlW wO ' — <br />ZIP /.,[lax jrx <br />-- <br />I 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 GOVERN -LNG THIS TYPE OF <br />WORK WILL 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 />001ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEF,FORM THE WORK FOR WHICH <br />APPLICATa IS MADE AND I COMPLY WITH THE STATE <br />CONT TO LAW 1827 �RCWW &NDND M 200 WAeG 7 � <br />✓` -^� �� <br />rlloroR �� r�T <br />l[6M0[xwTrpla wvawM1 RwpAII RIOII p1 ArlAU11Yq CLKR{I <br />LOI [foal p <br />PAlfCp w to MMFw <br />COMIMCId IOW IlMKP. AOpC 1S RltPCM MAAFA <br />XO�✓\L/ <br />SKiM1MIA MIF <br />Gir MI7A45lCEMM MO <br />--- <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EOUPMENT <br />_FEE <br />WATER CLOSET (TOILET) <br />NC—MMDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />I HEAT PUMP — <br />SHOWER <br />IUNIT HEATERS <br />KITCHEN SINK A DISP <br />I -LOTHES DRYER_! <br />_ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE DwV�O�OD�BURNING) <br />DRINKING FOUNTAIN <br />(NIGUO <br />FIREPLACE INSERT BUR' INGI <br />FLOOR DRAIN <br />OAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE — <br />SINK (SERVICE — W. ETC.) <br />"L <br />6AS PIPING <br />-- <br />EXHAUST FAN <br />R7 <br />SUBTOTAL <br />E <br />SUBTOTAL E <br />PERMIT <br />E <br />PERMIT ! <br />TOTAL FEE <br />E <br />TOTALFEE E <br />FOR OFMCE USE ONLY: <br />I IIfMI VIwY.II_--IYvwRlMfv <br />Lpf l[IFfL1 <br />f <br />mcfflVOlolm <br />VM,'MI RR <br />VALUATION <br />Gn[ DwmPKILM.[vMMMIGrt{iw1gY1 <br />MFIEs <br />OIMw <br />fPt I3NW MOD <br />MICOv <br />{IMF 11IKlw10 RIRMIMd <br />I'm IN <br />nA•s uI n.rvr n{. <br />CRY OF EV[RETT— <br />-- <br />LOCALBALER <br />•----- <br />— <br />MR _ <br />TAX CODE IS 7105 <br />TOTAL — _ <br />_ <br />