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APPMCATIO* FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />32DO CEDAR STREET • EVERETT, INA E6201 A259-NIO <br />❑ DEMOLITION ❑ COMBINATK% lo'BUILDING ❑ MECHANICALv ❑ PLUMBING ❑ SIGN <br />TENMR YNEIOLFIEss all )w II <br />PAl.WWII DC MACTOIR MM ALAKESs dM !In <br />LONFMCT Pl,DFT <br />1 <br />HEATING SYSTEM: ❑OAS ❑ELECTRIC ❑ <br />DFECMf FDOI <br />D� � F� <br />U / <br />t'i M115GNAM Ff�If —� _ O�� <br />~ ' Ste— <br />I HERESY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIM THIS TYPE OF <br />_t42 <br />Of, JAM/O a n <br />W µIT" L2SLil1[, <br />rJL 1 n UTn' <br />R n W J <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />U"M NRTU OF P/q KV ILIOEAF SEEM LN ATIKN TYIO COPKSI <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT KA <br />a <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 WORT( FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW MID 2ff.200 WAC. <br />• ICE' 9 —/Q <br />/ r/ ; <br />Bd6El TM M NIAMER <br />CONs1A TIOWI LOM lFWER. AOOWIESS. RIEPIgK <br />MUWKR <br />URF MIE <br />dlY AUSYKSs ItFNSE MO <br />PLUMPING <br />MECHANICAL <br />NO. <br />TYPE OF FlXTl111E OR REM <br />FEE <br />NO. <br />TYPE OF EOIIIPSUNT <br />FEE <br />WATER CLOSET (TOILET) <br />ANC—AAEIDLO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />_UNIT HEATERS <br />KITCHEN SINK A OISP <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 (WO/�O/�D� 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 />SUB TOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE f <br />FETR EIFFICF IISF ONI V. r jellLj <br />FRONTSETWK <br />KMSETIACK <br />SOE SITRUCK <br />MANCIIECRMMfn <br />If <br />PFCiwF ND <br />USE loaf <br />IOW AREA <br />l•CMI LIE <br />FEES <br />I VALUATION <br />FEE <br />OWES G ND <br />ommc.. <br />O <br />NEIONF LNITATION <br />NO OFDLUhIJ <br />SIIE OfhWnl <br />UNITS <br />MIIYIIM <br />I <br />ANLI NO asl(w(S <br />CCCUFANT LOAD EASEWNI <br />MECIMNILN <br />GC�LIU <br />OWES GNO <br />ADDII"AI MMCIRCn <br />fIflE SMLMRI£P PEO'0 <br />Rf A[a1 <br />ooKn <br />FIRCN MPE09 <br />RFASfN <br />sull PInIIMNn SIIIY.IIA11(1[ <br />�� <br />TmEaroNsl <br />MANS Arranvfn Al <br />CRY OF EVERETT <br />nfur.wduK <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />DATE I <br />