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APPLICATION FOR CONSTRUCTION PI MMIT <br />CITY OF EVERETT • BUILOM DMSION <br />WOO CEDAR STRSET • EVERETT, ��4W111A DWI • MMI0 OL <br />❑ DEMOLITION ❑ COMBINATON ❑ BURDNID t� MECHAN"L ❑ PLUMB" ❑ am <br />PROJECT ADDRESS: 4. aL 5 �Re b I [ 2t=-y C($.aod <br />♦RLMrf Cr p111E5R'MR yy yt/1[St <br />My <br />M MIOI{ SIAN ICTPMP <br />n111MMicmlwlm um ss .11 m nlpE {1MLOMII- <br />cowlR•cin a. 3910,po <br />HEATING SYSTEM: OAS ❑ELECTRIC ❑ <br />niSCAf waw nn'f1U•w ronlyN MravYn <br />curl•crrtnbLyunnw Nn M_ <br />` <br />` <br />-'1'1�- k3(5 <br />T <br />JnM1:T&IL SO GQI ��r UUT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THE <br />APPLICATION AND KNOW THE SAME TO SE MA AND ACT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TO% OF <br />WORK WILL BE COMPLIED WITH WHETHER SFECETEO HEMEIN DR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PIIESHIAIE TO DIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVII" Of ANY <br />OTHER STATE OR LOCAL LAW REDULATAVS COIMTRLDMOI OR "IS <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AVRIORIEm SY THE <br />OWNER OF THIS PROPERTY TO PERFORM TINE WORM P011 "HIC H <br />APPLICATION IS MAAND 1 COMPLY WITH THE STATE <br />COAT TORB LAW tE. RCW AND 7lN10D WAG. <br />f <br />F.aroxolm a MM nRn <br />IFOYQSCM'rinyp ApiRrr 141DRR XfI(PY OR1rrPCM nq L'Oo1E51 <br />wr Mltff p <br />N111CFl1MInMMR <br />50c� OOI, pll-bw <br />ClMrI5Frd 1lHMIfMiR M101{Sb. rflflfgy[MRRKR <br />PAN <br />an XIIWN lSf 1AE M <br />PLLIMIIMO <br />MECHANICAL <br />NO. <br />TYPE OF FTTITURE OR REM <br />FEE <br />NO. <br />TYPE OF SDLW Ai1T <br />FEE <br />WATER CLOSET (TOILET) _ <br />ANC—AMUNITSNDLO US <br />BATHTUBI <br />FORCED MR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />I <br />AITCHF.N SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER ----RANGE <br />_ <br />HOOD <br />I <br />LAUNDRY IFAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD S-OVE <br />URINAL <br />METAL FIREPLACE (MOOD BURNANLV <br />DRINKING FOUNTAIN <br />FIREPLACE XISEfir (VIR700 Bunim"m <br />FLOOR DRA'N <br />_ <br />GAS F IEPIAIT <br />SACKFLOW PREVENTERS <br />OAR fWK1E <br />_ <br />SINK (SERVICE —BAR ETC.) <br />GAS WINO <br />_ <br />EXHAUST FAN <br />SUB TOTAL <br />3 <br />SUB TOTAL E <br />_ <br />PERMIT <br />S <br />_ <br />PERMIT E <br />/ <br />TOTALFEE <br />f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />InMI ViPy'M <br />nf•R KIPKv <br />SMf lop" <br />MA.Gl/W !* <br />fff <br />lwf .t lq <br />usr roNr <br />_ <br />Im •m• <br />vy;wl VIF <br />❑rtb Or,n <br />FEES <br />VALUATION <br />MPItIMR <br />IIr P:1111 M111NM <br />NO I/fTtlln,fl <br />InIS <br />SIII OI MIIYII <br />nIRAMM <br />T•M(:. M(P <br />11lICSnPNVIIRMnII <br />- <br />•nMll(WPI n•NCI,ILv <br />OIIRR <br />IIIIIy/JMMpOSnRI'm <br />Fllll�ANIIIAD <br />rN rrptl <br />CITY OF EVERETTLOCAL SALESTAX CODE IS 3105 <br />TOTAL <br />