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APPLICATA FOR CONSTRUCON PERMIT <br />CITY OF EVERETT / BUILDING DIVISION <br />3200 CEDAR STREET / EVERETT, WA 98201 A (425) 257-8810 <br />I I DEMOLITION ❑ COMBINATIOH ❑ BUILDING MECHANICAL ❑ PLUMBING ' SIGN <br />PROJECT ADDRESS: 107-S NIF'"% Si Y. <br />I_iL T ,.g1t . k Co [3elL \-+..offs 6VAfA jv?vC -zeev C4T.s -Zqo 9eig <br />tww/ MAN Nt1AA of, <br />/Ile1l1[/d1MLWRn um ss CIR M M1RIx1 — <br />wr.,Zakcml..Clm WI YtMIf S! on ---- - m MIKR IFAN LKFNR • <br />IypCMIRuaOn MMA1tA115! OM1 M NIDR fNle ICfw <br />�IR 1Z5 <br />l3 R SFI1ttom- ZA .... ti..� <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />pelLl, {1y.�.Ql <br />pµM•,0., ANI LAN 1 N.\ /IMIVl1 Zu5 rrr <br />i f <br />CRIIACI NIININAM nI1M M1 <br />.� �..��. C-L6oi69S•99o� <br />I HEREDY CERTIFY 711AT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 111E SAME 10 BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1111S TYPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TIIE 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 REGIAAIINO CONSTRUCTION OR TIIE <br />PERFORMANCE Of CONSTRUCTION 114AI I AM AUTHORIZED BY TIIE <br />OWNER OF THIS PROPERTY TO PF iFORM 111E WORK FOR WHICH <br />APPLICATION 15 MADE AND I COMPLY WITH 111E STATE <br />C04TRACTORRSS IA�W 1021 RCW ANSP62M WAC <br />*�Q/ a�/•G� <br />LMWA1 R111 <br />HtIfOV mrL A MwOFa <br />IeMI AlCINItMd AKKTRM1 ILIdN1 NlONN1AttA[N IWDCOML <br />lot Nall IY __ <br />"— <br />--- <br />M1kA Nno NAAsn <br />COMltNC11I1NItMN11 NtKR. MINKlf ItilmA N111Mn <br />CITY ARAM Al IRHMf W <br />PLOMaINO <br />MECHANICAL <br />NO. <br />TYt1E OF FIXTURE TIR ITEM <br />FEE <br />NO. <br />TV" OF EOUPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC—MINOLO UNITS_ <br />FORCEDAIRSSI YEMS <br />_ <br />-- <br />BATHTUD <br />' <br />i <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PIMP <br />_ <br />SHOWER <br />IMIT TREATERS <br />KITCHEN SINK 5 DISP <br />CLOTHES UOYERS <br />_ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT(WOODBURNINII <br />_ <br />FLOOR DRAIN <br />OAS FIREPLACE <br />' <br />BACKFLOW PREVENTERS <br />i <br />OAS RANGE--T- <br />6INK (SERVICE — BM, ETC.) <br />OA9 PIPING _ <br />EXHAUSTFAN <br />I <br />SUBTOTAL f <br />' <br />SUBTOTAL f <br />PERMIT IT <br />PERMIT f <br />io D <br />TOTAL FEE ! <br />TOTALFEE IT <br />FOR OFFICE USE ONLY: <br />InIN11gIFRF RAP R1FACt lIOt IIlI6l1 NMCIK F-111 77111 —�rAf/AIM <br />MF FUA <br />Hn AAF <br />_ <br />a"ll D w <br />MRIMIn <br />IRMNIIIMIA.eN <br />mum <br />we R 11,013,11 <br />1Ag1F0 <br />WI NAw'M <br />lIL1.IIMM:e Nlf'I SHw! <br />Uf11MM111N11 <br />IAMwMI <br />MIFF <br />till! O M <br />. <br />ACN 1,0 NI R AM CIYM <br />Iq AIMTHOU AAL1,1 <br />MMINNILMCMMN <br />lin Aftwll M1Axa CITY OF EVERETT nit f. YAKNF <br />LOCAL SALEB -- <br /><_ TAX CODE IS 3105 TOTAL <br />