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APPLICATION FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT r BUILDING DIVISION <br />3200 CEDAR STREET F EVERETT, LVA 98201 r (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING If9 MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:_�+iS._— <br />AIKwlrclwnfYaAF YU AIKKxas an fII rvgNf <br />mmm CONIPAc'm Y4 MpRSf prr m %RM F1.17IKfN9• <br />KCN1MC4fbIMACib1 4Yl ACPiSS a" 1M' %Ipl FrF1f IKfYSIr <br />%1 Cp11P1f.1p1 YY Ad}laF arY � fNOhf �/ 61A1r ICF4511 <br />�f/YI/f/r.f /1b1� <br />cwlwcr nacf a wrn. <br />HEATING SYSTEM: GAS Cl ELECTRIC ❑ <br />ax+nF KVAII ANo abIAAV, rO0rA4f .rvIKYEo <br />flKnAcr rylyplAAOfNOIII W <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORN 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 />OT14ER STATE OR LOCAL LAW REGULATING CONSTRUCTON 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 I COMPLY WITH T14E STATE <br />CONTRACTORS LAW 48 27 RCW AND 296 200 WAG <br />JL. /�__3-� l 9 qs <br />Ql <br />XtaGNf1UP! <br />IroopOlne Pt lllXONq <br />/ <br />Ifw MW—TKX4 OF rYprEKIr IKIOINI KIOMgA AOACN TAO COIEL <br />LOT NO[X a <br />IM[f11" 10 MITI <br />C0191MKrY'MIWNIfMfA NRPff6 iflfHdiMMfK <br />I <br />brY fI19Hf6! lC[N6L NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C— A44NDLO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HE AT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />LACE <br />DRINKWG FOUNTAIN <br />FIREPLACE B'fooD BURNING) <br />FLOOR DRAIN <br />OAS FIREPLACE <br />BACKFLOW PREVENTERS <br />IGAB RANGE <br />SINK (SERVICE — BAR. ETC) <br />I OAS PIPING <br />E%HAUSTFAN <br />I <br />SUBTOTAL S <br />SUB TOTAL i <br />PERMIT F <br />PERMIT F <br />TOTAL FEE E <br />' <br />TOTAL FEE E <br />Cna nttlne ufee v nw . <br />I.tv1FAr+-____rcwureACF <br />Fa ulsAn <br />%W p4d • <br />rrf <br />wfrmNo <br />IMF fOIK <br />Im AKIA <br />v¢ANI Hrf <br />FEE6 <br />VALUATION <br />E <br />_ <br />Ovfs 0 N0 <br />NFg4r INArA1KM <br />No aOWfHM <br />IIMIF <br />FIR m Kaw <br />ryUK111p <br />I <br />CCINAK♦ IFI M1 IItr11I <br />O(IIMNr ICAO <br />11YYFNr <br />4FCNA4[N <br />D Its Dwf <br />A IIAN%ANwaI <br />rvK smIIKIFPAFoo-- <br />IIf AF(M <br />OINLN <br />row NA mov <br />ITT <br />FIArf WA1 VW-" <br />— •. <br />Ir%(II C", <br />%ANFY%Ib?OAY <br />CRY OF EVERETT <br />nAYKKtwF <br />LOCAL SALES <br />---- <br />__� <br />-- <br />Wlt <br />TAX CODE IS 3105 <br />