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.1 <br />APPLICATIC4 FOR CONSTRUCT&N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑11 --C--O77MB�INATION1 / 2, <br />BUILDING ❑ MECHANICAL ❑ PLUMBING <br />❑, SIGN <br />PROJECT ADDRESS:J_�� aA 'R QV \1�7.�'T"J- t,)4 <br />CONIRIICI MN:E w WDIIR <br />HEATING SYSTEM: <br />GAS AELECTRIC ❑ <br />EX ROYRF 77 RxOSOUARFF *c v 70 <br />5-0 <br />I.IAIJ ntn50x 1. nlg lb 1 <br />�3 <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 WITII 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 TI/E <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TI/E <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRALTO AW IR 2] R AN 6.200 WAC <br />1 <br />OF MROAxO <br />s[ousE /� L� <br />LEDAIa WMPIKHaINnMRrr lSrpRN Rnoww MlAet Lap COAEsI <br />EOI MOCK a <br />IaPCF tARID MANI[R <br />LOANI[MIER,bpIF55 iFIFRt'JRE MNRFR <br />CONS,MXE N61 <br />SgNATIPS, T DAIE <br />ptr BU4NE55llt[x5[ x0 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A 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 />_ <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL <br />S <br />SUBTOTAL f <br />PERMIT <br />f <br />Y)PERMIT <br />f <br />TOTAL FEE <br />S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />'ww"m7rRACN RGR SFIRACM SIRE SFIR/{X MAN pRlCRMMRtO F(f RFry. NIw <br />�O <br />um IIwrt lo[eREA vAc5Nt VIE FEES I VALUATION_I FEE <br />arts ❑Nu <br />RURllnE <br />Cj 0 <br />NF�aR lnxut.oN <br />xo wow[uMc <br />VIE IN' RIEXXfI <br />OMIT$ <br />1 x <br />d� <br />MIMBM <br />_ <br />YIFNW <br />WNSIMS <br />OCE'NaNI LEAD <br />BASEMEMt <br />�11�{C�CIMI'ANCr <br />Z <br />� <br />- <br />j[ } <br />❑rE5 QNO <br />AOptRY �� Da,.,.,GSe- <br />FXIE5gbM4ERRE0'D <br />INASON <br />OILIER <br />stATE RU <br />MIMI.. at <br />IMEAIMAIREOp <br />MA[. <br />"PI cpvsT <br />rvAxSArMIW`p <br />Rr <br />CITY OF EVERETT <br />JT��I <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />