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APPLICATAN FOR CONSTRUCAON PERMIT <br />CITY OF EVERE-TT K BUILDING DIVISION <br />3200 CEDAR STREET P EVERETT, WA 98201 •257.8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL n PLUMRINCI n emu <br />PIUMWO CdrML WItGaNtf LPY IV 81"ELICENSEE <br />Ga1rMCr Mlp pf WaM <br />I& (,].% <br />HEATING SYSTEM: O GAS ELECTRIC ❑ <br />OESCPEE IVOIY1 AIO fAOARE f00IADE YfD <br />Gall rPfP60NND <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 ONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER TI PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLiCATIO IS MADE AND I COMPLY WITH THE STATE <br />NTRACTOR W I8.2I ROW AND 296.200 WAD. <br />% 1 <br />PRDIDSE <br />LEDN RSL IDrl o< RTY IKIDWFI DFIOW OR ATTACK IWO CDRER <br />for xow a <br />RARCELIAIIDNMEER <br />CONErRUCTKIRLa41uNYP. MORFu tEIfROE MMtlEP <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB ✓ <br />- LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />MTE <br />c" SOSfESS LICENEL KO <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />AIC—AMNDLG UNITS <br />FORCED AIR SYSTEMS <br />- MEAT PUMP <br />UNIT HEATERS <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 />FLOOR DRAIN <br />FIREPLACE INSERT BURNING) <br />OAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR, ETC.) <br />GAS PIPING <br />- <br />EXHAUSTFAN I/ <br />SUBTOTAL f <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />_ <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />F"t EETIACK <br />7o <br />FEAR tErEtCK <br />2 O <br />SIDE SEISACI( <br />CI�Of If�Iy_R t.) <br />fE�[y� ;(n <br />PfCfwT NO <br />VSE 2l NE <br />{OTAIEA f <br />v!lART SIR <br />FEES <br />I VALUATION <br />FEE <br />NEioIIr LEKrAT <br />IMri P.Eu+a <br />suta Euurtl <br />163 s •AivAinuww <br />-uuufxr <br />12 <br />wcr xDaslaRss <br />Z <br />cl:arAw wAO <br />./ <br />om— <br />REcRAFCFa <br />rwE 6PAMlER RFCO <br />IEA(IOM <br />ACarIJINL %ANCNECK <br />OWR <br />fwE A1NW PE00 <br />IEA9CM <br />ErArE WEDND EUICKNgf <br />RELC RaEs <br />T+PE acoNn <br />ruw91rwKRsnfr <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />