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APPLICATION FOR CONSTRUCTINN PERMIT <br />CITY OF EVERETT e BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 99201 a (425) 257-8810 <br />❑ DEMOLITION ❑ COMOMAT10N EMRLDMO _ ❑ MECHANICAL ❑ PLUMBMO ❑ saN <br />lEwNl <br />IEAA [oaress <br />un <br />n PNONE <br />,7w-WCT oP IIELGNFP <br />YNA Ess <br />CITY <br />ZIP rMYF <br />541 .c'm <br />NMI LOd1E55 <br />CIl• <br />tlr IVgYF 541E IICFNY• <br />WCHAW4 CONTFIACTOP NAp"DOnF55 MIN 71r PHONE STATF LCENSEF <br />PLIHEBMGC0N1A.1301 NAILApOnFss 0" 71P PN S14F LCENSE• <br />CONIWI OT WOPR ,�L <br />P� HEATINGSYSTEM: IO MAS ❑ELECTRIC ❑ <br />cweE worn ANn APEE +ApE maVT¢o WT T15p1 Are PIA}) � <br />I HEREBY CERTIFY THAT I HAVE REA AND EXAMINED THI <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONSOF 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 ONE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REOIILATOO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THEi..V.Goc.Wi-u.c1'L!7 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WINCH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1e 27 RCW AND M 20D WAG. <br />L1/ <br />PPOPosE ,,//zF IIF lml ^_ <br />(=R /LL�r%�GLC4LOL-F' <br />LE ALRSCPIPIICNRPTeFEInI e[LMMA" cN lwO caul <br />LP+ _._ uaN p <br />( II <br />PAlcn Tulu p p <br />% <br />111E R <br />CONSiRIC11CM lCAN IF OEP 4'41ESS 1ElFPIg1F MILMFP <br />X <br />s wl[ / �p <br />/ <br />�/ '� � <br />7i /A <br />cnwMcss Ls:fNuw <br />PLUMBING <br />MECKAMCAL <br />NO. <br />TYPE OF FIXTURE 311 REM <br />FEE <br />NO, <br />TYM OF EBIIIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AA:-AMNDLO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK It 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 />PACKFLOW PREVENTERS <br />GAS RANGE <br />—�— <br />SINK (SERVICE -BAR, ETC.) <br />GAS PIPING <br />. <br />EXHAUSTFAN <br />r— <br />SUB TOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTALFEE f <br />TOTAL FEE f <br />I nON+v+n v.�-_--nrm <br />Gne+d <br />SIR SF+eACN <br />nu C11"N1 P <br />S771 <br />r[r <br />/ <br />Prcrml No <br />.off' <br />us[ ronr <br />� � <br />IGI AIN A <br />VACANT 911: <br />OrEs O <br />FEES <br />VALUATION <br />FED <br />_ <br />e1E11MNf. <br />MIGII111WIAlI A <br />NO P"WE..ING <br />SIT[M44i91 <br />OCI:I mAYf.Y w SIIw{5 <br />(:POUT ^ <br />L <br />IX:CIIrAN11 UA11 eAVN NI <br />_ <br />WI:IIAW.l <br />Anp+MINA)RAM O11C11 <br />IIIIE S.111LERPE09 <br />PMSM <br />oINEn <br />— <br />rIPEAUPM P[OL <br />MAsov <br />c1A11110IUMf SIT(:IIAPC.[ <br />__ <br />��»LLCC <br />+Yrr lx"MM, <br />RnvP Arrnov[n er <br />CRY OF EVERETT <br />Rrour. wnnAs <br />_� <br />PA+L <br />LOCAL SALES <br />TAX CODE IS 0f05 <br />- <br />TOTAL <br />a 5 <br />