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APPLICATION FOR CONSTRUCSON PERMI4jlr <br />CITY OF EVERETT A BUILDING DIVISION <br />/ 3200 CEDAR STREET A EVERETT, WA 08201 • 257-8810 <br />ff DEMOLI110N F) COMBINATION (/BUILDING VMECHANICAL I,/PLUMBING LI SIGN <br />PROJECT ADDRESS <br />O TC 77 C'W, t vPer i It,A <br />pvnKP _ 4I.4 CCp1f 59— CITY r/GTQa/J[ IYgY4 <br />7.p 6 <br />PEUMPO DDAIIMCTEP YALADDRfU CT TP PIpNf STATE =14H9 <br />EMIN OT MCI cr 11�%ry <br />Il CP 00 •O/ <br />HEATING SYSTEM: ❑ GAS F LECTRIC J <br />fRICME wpP IOU OOTAOF KD <br />KIP[RKXIAMI W <br />- <br />o 0 <br />` 7fJ 7f7 <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW T14E SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 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 />OTHER STATE OR LOCAL LAW 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 15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />/'FJ _7 <br />PnOPO;D ulE M OSAI oll <br />LEGAL DESCRPTMEF MEFFATV IFwwn ULM Dn AUA Two EMfl, <br />LOT __Km Df <br />r'T Q <br />PAMLLEAE I D rAAREn <br />y <br />C�rglCTgn LO W LFNDE0. M]Ilf !. TE' EPM]NE NDAlER <br />7-/zsJ' NFRiT.E ice. �h PU, Roy �i <br />E f/ — <br />t / <br />1^ J 4/4R 5, Q <br />LRr oUISASt CEMEW <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC- AHNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />UVATOgY (WASH BASIN) <br />SHOWER <br />I <br />HEAT PUMP <br />UNIT HEATERS <br />r <br />KITCHEN SINK 6 D15P <br />CLOTHES DRYERS <br />ER <br />HOOD <br />TRA <br />WATER TER <br />WASHER <br />WOOD S <br />ja <br />FOUNTAIN <br />METAL FIREP E D BURNING) <br />FIREPLACE INSE (WOOD OURNINO) <br />AIN <br />GA9 FIREPLACE <br />PREVENTERS <br />OAS RANGE <br />VICE -BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT S. <br />PERMIT E <br />TOTAL FEE E <br />TOTALFEE S <br />run UrFlCE USE ONLY: <br />fRDM IEl4LR <br />REM SEIWN <br />n <br />SOf SFnAp <br />s- <br />PIµ CMECKMMER <br />EEE <br />da. 9 <br />RECIPTW <br />ulE mrAT <br />LDT AREA <br />(In.l <br />41CAnrom <br />aK11 w <br />FEES <br />VALUATION <br />FEE <br />(eS16 <br />ngnr LomMTpn <br />1 <br />wre Dw[uoy <br />M7E a Pmt I <br />^°MON° <br />� <br />Li r no � I <br />aDcuwnT Ep.D <br />s+sEu[Rr <br />ores ra <br />F. SR0.RPlFR RFOD <br />65 <br />REA" <br />O;?o <br />AXXTSASALPUNCUECK <br />own <br />'ME E�ROD <br />STATE ltxb WRCRMpE <br />TYPE Ext Sr <br />V / lI p <br />f7 El <br />PI SA nor <br />o. , a <br />CITY OF EVERETT <br />LOCAL BALES <br />TAX CODE IS 3/03 <br />F91LO waxil <br />TOTAL <br />