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APPLICATION FOR CONSTRUCOON PERMIT <br />Cm OF EVERETT • KALOMIO DMSION <br />32W CEDAR STREET • EVERETT. WA 9=1 •259-NIO <br />❑ DEMOLITION ❑ COMBMUTION ❑ BUILDING ` ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: 17�tj' xx'2 Y � e,u <br />DENfnµf,ONlRKlp1 YK AWNi55 <br />Clir !m %IP4 {FRITFIIm— <br />1EQIANCRl CONTRKTOR YMI RDOREss Qrr rm R10NF STRTFFCEYSF. <br />nIMKCFwiRKtDR YYI NIL'I1F5f Qrc n PIL'iE STATELICENRr <br />r nI i A r_ i 4c a s_ c"-vz 27 A.PTSO/-/2 3fR Q <br />u u 6- <br />CONTRACT INFR F VVDrY t <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />dMKTRMONAMD A1Dl<ND <br />C(SFAeE WQN RN WRITES R]Ol/OE NVDLVED <br />b ` <br />I HEREBY 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 GOVERNING THIS TYPE OF <br />RnDEosf D ux aF IAIILQTFO <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />OFscrlLnlQl or NaFERrc IPKIRr EELDM 011ArtKNIgO Cpmsl <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEDAL <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT 1Aaa a <br />OTHER STATE OR LOCAL LAW REGLI ATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTKON. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY NTTH THE STATE <br />CONTRACTORS LAW 1027 RCW AND 296200 WAC. <br />MRLEUMID.MAIEFR <br />//��1(/��1 / 1-I �L/.1 <br />CONSITUCIiON LOAN IENOER. AOp1EE5. TFlEPrlb4 MRlFR <br />X <br />EIONA pA,E <br />/� <br />! <br />QIY XIINESS LCFMSE MD <br />PLUMMNO <br />MECHANICAL <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />MO. TYPE OF EOL!l9iM <br />WATER CLOSET (TOILET) <br />°O <br />ANC-AMIDLG UNITS <br />7� <br />BATHTUB <br />'oo <br />FORCED AIR SYSTEMS <br />ij <br />LAVATORY (WASH BAS N) <br />AD <br />HEAT PUMP <br />SHOWER <br />U NITHEATERS <br />Cl 11 <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER NEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE (W WD BURNING) <br />URINAL <br />FIREPLACE INSERT (WOOD BURNING) <br />DRINKING FONTAIN <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK(SERVICE - BAR ETC.) <br />GAS PIPING <br />DIHAUST FAN <br />Or <br />SUB TOTAL f <br />I <br />SUE! TOTAL 1t <br />PERMIT S <br />_ PERMIT f <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE UNLY: <br />Inpll fi TRAfN <br />REYI SEIeACM <br />SLOE Sf ISKM <br />C1^CR_ FEE <br />MAN � <br />RFCEmTMO <br />nSC lONf <br />lO1 RfCA <br />VKAN141E <br />FEES <br />VALUATION <br />FEE <br />OvFs ❑ NO <br />eUllIII�M1 <br />IICIOIN LNRTAIlEON <br />NO OF uMSLLINO <br />Lmns <br />SIZE Of eLMO' <br />nuNamD <br />(OO <br />XCNYIICAL <br />G, '(�[] <br />OCNPArICr <br />No MSIMS <br />OCCUPRNi LOAD <br />eASFYFHT <br />O"Qm <br />❑rfs ❑NO <br />ADQTpNu nw cNE�. <br />FORE SPRINNtrn RfOD <br />nEAson <br />OILIER <br />FIREµMMREOO <br />RFASON <br />SIAtF eUIfMM• SINKNAnff <br />nIY r. RaR.s <br />Trl`EO IfONST <br />MANS APPROVED Rr <br />CITY OF EVERETT <br />LOCAL SALES <br />- <br />1 <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />