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APPLICATI& FOR CONSTRUC&N PERMIT <br />CRY OF EVERETT • BUILDING DIVISION <br />32DO CEDAR STREET • EVERETT. WAe9182'0"1 • (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION _ gBUILDING Y�ECHANICAL ❑ PLUMBING ❑ SIGN <br />.RLMT(C10^mL wm 4N• ss c1l. <br />GFNIN.IcwnI,Llp1 4•rl •PNnrss CV• Irl' rvM;4t sl•tl lrff N51. <br />co4mwl rmcr a vNiP" <br />HEATING SYSTEM: WCAS CJ ELECTRIC G _ <br />Mscranr w.wNinp sw.Pr rool.pt .IvavTo <br />caNl.cr n Pvw.N^ rri.n No <br />1 HEREBY CERTIFY fNA; I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE TAME 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 DOLS 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 TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON RACT )RS U 9 ' RCW NO 2%2GG WAC <br />/ <br />ri <br />14rorouP u<I or m v <br />ITGAI MSLPm116-M r^a'E^ry ISNONI. MtO o^ 111K. lWocol+(sl <br />IGl nloc. a <br />- <br />CdsRKILiKM I .N 1 rr+ryF^ YKM ss iFIFAK1Nt 4rM1{n <br />•i.,qt <br />IrAll <br />L11. nV4Nf S5l. NV NO <br />MECHANICAL ._..__.. _.— <br />NO. TYPE OF E6l11PM[NT FEE <br />PLlRMMO <br />Np, <br />TYPE OF FIXTURE OR REM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — ARINDLG UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />— <br />SHOWER <br />i <br />(MIT HEAT ERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />PANGE MDOD <br />LALNDRY TRAY <br />IWATER <br />HEATER <br />_T <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAINFIREPLACE <br />INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />GAS PIPING <br />"'— <br />EXHAUST FAN <br />SUB TOTAL f <br />SUB TOTAL S <br />PERMIT f <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE f <br />n... Ar <br />rpflNl YTn.r. <br />MAP srlal k <br />!;RX X1lKt <br />I.. Ln[L"41M(P <br />r(( <br />PlfrPrlM <br />use lo4r <br />lol•M• <br />v.c.m vlEFEES <br />VALUAT1011 <br />_ FEE <br />-- —r <br />nlnl PrN� <br />O.rs ❑ xl <br />NErpP11IN1•lgY <br />+p UPWIl11N6 <br />SITE R wmq <br />NLN.4M'.1 <br />I <br />OCIIT•4L. M`n1 �Itbl] <br />U'. 11in.W 10.9 <br />n•SrN YI <br />RAIN <br />❑.[5 ❑M <br />_ <br />rIM nN11 U"PLrID <br />MAc[N <br />O1N(P <br />NRE •UPM PIp'0 <br />PI AaVv <br />alai BartIMMi 41NCPAMd <br />nn Mca+a <br />nANs •rrnGvtnn. <br />CITY OF EVERETT <br />v.�r, •�""'"S <br />— <br />LOCAL SALES <br />-- <br />___ <br />— <br />oat <br />TAX CODE IS 3105 <br />TOTAL <br />