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K <br />APPLICATIA FOR CONSTRUCLI%N PERMIT <br />CITY OF ERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •257-8810 <br />ADDRESS <br />!-' COMBINATION AW BUILDING P MECHANICAL W PLUMBING ❑ SIGN <br />ClT. <br />Crtr <br />coNTRAcr PRA:E DF wwRx <br />3 O <br />HEATING SYSTEM: ❑ GAS aIELECTRIC ❑ <br />DESCRIBE VIOPM AMD 50UARE FOOTAGE IWOLItO <br />CCNI i CR%. AND¢NJ <br />S <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 TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />AW 10 27 RC W AND 296.200 V.'AC. <br />CONT-Mm� <br />X <br />PNOPD usE F B uLgrp <br />«mLIiEjCRmTwv OF P,wPERrr Islwwe EL woR Ari nrnD COPIESI <br />LOT/9, AQ BLOCK 9,1 IA) <br />.Pa[iGa TAK 1 D NU448LIAA <br />CONS UCTwn LOAN LEM R.A ICSS. IELEM KNU`.1BER <br />SGNAiU ��TEE <br />EITr BUS„IESILIC NNIL14 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />i <br />A'C-A'HNDLG UNITS <br />i <br />BATHTUB <br />FORCED AIR SYSTEMS <br />1 <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />HEATERS <br />j <br />KITCHEN SINK A DISP <br />THES DRYERS <br />DISHWASHER <br />I <br />E HOOD <br />?RA <br />AUNDRY TRAY <br />E EATERHES <br />WASHER <br />D S VE <br />URINA <br />METAL FI LACE (WOOD BURNING) <br />DRINKING UNTAIN <br />FIREPLACE INSERT (WOOD BURNINGI <br />j <br />FLOOR BRAT <br />G "FIREPLACE <br />1 <br />BACK OW PRE NTERS <br />AS RANGE <br />SINE-ISERVICE -!ISM, ETC I <br />GAS PIPING - <br />) <br />EXHAUSTFAN <br />I <br />I <br />t <br />I <br />, <br />SUBTOTAL 5 <br />j <br />SUBTOTAL 5 <br />I <br />PERMIT 5 <br />ly PERMIT sl <br />I <br />TOTAL FEE S <br />TOTAL FEE 5 <br />FOR OFFICE USE ONLY: Dn ) P - cool <br />FRONTSETBACKA <br />REAR SETBACK <br />Its <br />SIDE BE,BACK <br />CNECKM140EER��J <br />FF/(,/ <br />PECENTNO. <br />UU ZONE <br />LOTAMA J <br />J Y <br />vACANr SITE <br />OrEs O rw <br />FEES <br />VALUATION <br />FEE <br />euILONc <br />3jii <br />MIGHT LI 1TAMM <br />5 <br />NO a ONclulp <br />U. <br />slzf a &OOlil. <br />S- p sM <br />wuB Nc <br />OCLIWµCY NORSTRIC OS <br />�/ -/ c5l <br />CCCOYANT LOAD <br />BASEMEN, <br />❑rE5 NO <br />MECHANICAL <br />AWNwNALPLWCNECK <br />FWESPPMLLRREOO PEARON //��,�/T/p u- <br />1E? <`N+L/AN •j <br />OiNER <br />FIDEALMMPEOD <br />T A" .v� <br />30! T / <br />V-• <br />S,ATE BUILDING SURCHARGE <br />irPE acDNST <br />RANB APPPDrEO Br <br />` <br />wrE /Od <br />E SALES <br />LOC3 <br />LOCAL <br />TAX COODEDE IS S 3105 <br />NBLIC wOPKE <br />TOTAL <br />f &&V/s&b Eu/cDdn- To < oCow <br />