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APPLICATIOR FOR CONSTRUCTION <br />PERMIT <br />CITY OF EVERETT At BUILDING DIVISION <br />32DO CEDAR STREET • EVERETT, WA 98201 A (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING SIGN <br />PROJECTADDRESS: 162o W MDAINE (IEW DA <br />Mr-Etra MGI TA.IN KL IDsnF IT ?9fl Y &6UI] A'%E <br />bNNERSS' Gtt Tn FNJ[< <br />7s3 <br />LiMAAAQDI�S !C-LO I I AnnCf % VIFSIJ f)(z 9,$201 ANr <br />rA.n AA.+r mGC <br />RNANi u.n AOacss ran n TNAINC <br />7✓IA <br />•RLNRCI OR OEYf.Irtn Y•x Ml)r1ESS CITY !In nNy,F <br />4t.7rf r o . Oa haX 337y5 � 9 ) -37�/3 a„c LV •hslx <br />ME L-x-1 V'f P _ <br />NEmt ca+ln.clrn u•R ss am Ar MAs f <br />STATE t¢r,VSf r <br />E` <br />MCCNANCANKAl fO41RAClw1 M11UfJw1f 55 GIY Iln MKNr <br />SiATi IKFNSEr <br />N/4 <br />M 11YlMG CONIR41pT YYt .CORF55 CITY TIP rMONF <br />Si•TF IgENSf• <br />if �,C GM U-f <br />c-wm a w wau <br />HEATING SYSTEM: El GAS ❑ELECTRIC ❑ <br />OESC"^MB'F MOn'M�A40 SSWAn[ r-I—NVJIVFD <br />CONTACT TTTLSW AM Np PM <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 GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESLILIE TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW AEGULATING CONSTRUCTION OR THE <br />PERFORMM CE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF *.HIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION !S MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW ANDZ96.200 WAC(/ / <br />X / ✓JAA 0 � I �- % 6/1d" <br />rRwgsf OOSE M nvItO1NG <br />t[GAL D[SCRIrnwI w TNIw(ATN ISNOWN HtO M ATTIKH IYO COMESI <br />LOT nt0cx w - - TT <br />_A . In Gu_L- qA 4';r' C• <br />wx7r'Im Y19 <br />CONSTMCO IVtOANtCNMR AdnESS. TE1CA10YEMIN1En <br />Dc-MT-t T- M af-� CO. T!:9I' Pllc <br />"D"•^ 0•' <br />��I� Iva ��O q ;z <br />uO <br />G11�II INESS IKFNS[M'J <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EOIIlAum <br />FEE <br />WATER CLOSET (TOILET) <br />AC-AMNOLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE - BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT S <br />PERMIT f <br />TOTALFEE S <br />I <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />IMINI[r InACK <br />nr.R Snn•Cx <br />SIM SF[IACx <br />Pt AN C11f[R NU rR <br />550/3 77 <br />rrr ( /I ^O <br />r OFIIINO <br />USE ZOW <br />101 AnrA <br />vACAVI SIM <br />FEES <br />ViLUATITION <br />FEE <br />_�— <br />PM pNG <br />— <br />❑vf5 ❑ NU <br />HEIGHT IIVIIAIIUV <br />NO(YV Ll LING <br />sltEw MnGNI <br />wns <br />101.�NO <br />IxconAvrr <br />mrour <br />MIN SI,w IS <br />MLIWAN11UAn <br />fiASF4NT <br />DI[s DNO <br />WI'I,YOCAI <br />ADp11GNAI ryAN GN[x <br />_ <br />FIRL SMIINKLLR PEGD <br />MASON <br />OUTER <br />FIIIE ALARM PLOD <br />nFAiOv <br />[TAIL fl11n UMG SIIIIGYnI:E <br />---- <br />—�-1� L <br />' <br />IvrE w r.ONSt <br />PlnvS •I'MOVFO Pr <br />CITY OF EVERETT <br />rMnl, VAxrxc <br />UAI <br />LID CAL SALES <br />TAX CODE IS 3105 <br />---- <br />TOTAL <br />- <br />oz <br />