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APPLICATI& FOR CONSTRUAON PERMIT <br />CITY EVERETT •BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA98201 • (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING �GN <br />PROJECT ADDRESS: 3 IZ F_Vc=1 —"f7 4,0e <br />'l12SK I�f 2-1C�*�it G1aJIL 1417 Gij-nI 'f-rA-ter SLT2-ns2 <br />prV <br />CID Ac nulc won+ <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC Cl <br />OESCneF MVn4.10 SQUAM iYe NVOl44O <br />two <br />COnrlCr xn ND r,pnf Np <br />i <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 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 70 PERFORM THE WORK FOR WHICH <br />APPLICATION 15 MADE AND I COMPLY WITH THE STATE <br />CONTRA LAW 1B 27 RCW AND 296 2DO WAC. <br />x�. <br />nnor05fo OSE Or emmwD <br />Imo DESCNmnCII arlpnEnTY lSrgwN 6Et0w Cn.Ila:N two CDnESI <br />IQ' SIMS or <br />r.ncD r • I D 11 <br />�3Lt/ lra7 0,99 ro('J <br />Cb1SlAtcT NtO.N1[Ad n.lpOnE55 f[l[AHWF NVYIIFR <br />CITY eUSIWSS tICENSE NO <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 />A/C—AfHNDLG UNRS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />—`— <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 />_ <br />SINK (SERVICE —BAR. ETC I <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL S <br />SUB TOTAL S <br />_ <br />PERMIT S <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />i nnnl Snn•C. <br />KIII SF 1e•G <br />SIM sfte•cI <br />n.n CIIEC+NU rn <br />rfr r <br />WIF."10 <br />u5E rONE <br />�.2 <br />Iol Im. <br />v.c ANT snt <br />OrFz D I.o <br />FEES <br />VALUATION <br />FEE <br />— <br />- <br />-� <br />If IGul Omul'ON <br />NO O/ DwI IMl <br />unns � <br />SIx! a elWv <br />ru,unso <br />vF(n.wfa <br />CCCurac• NJrv511u1f <br />Gn Wr <br />aCur.�lu.D <br />❑•lS On0 <br />•Dp11pNFl hw prtl+ <br />r InE SPnPalE. nmO <br />nr.5f1N <br />Donn SI�nn1 <br />(PGUO �' <br />-- _ <br />I nn.uuu"IQ D <br />11A1t MIbIDPM $INKIVIy,E <br />Sb <br />It1R mrQNll <br />rl Ans Arrnovm e• <br />oat ( S <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />roenr won+S <br />TOTAL <br />E�L'i <br />