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APPLICATI00FOR CONSTRUCT& PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />/� 3200 CEDAR STEET • EVERETT, WA 98201 • (425) 257-8810 <br />❑ DEMOLITION ❑ C9 A' , -jam NN <br />/ oMINI � R SIRLWN6 ❑MECHANICAL ❑ nUA1SRKi ❑ 610N <br />nr Nox <br />N25 333o4ao <br />CaR/517-1(L77 CO <br />HEATING SYSTEM: XGAS El ELECTRIC ❑ <br />Rfscapf Swvwerx�+rsw.R�.—//R+.rf uYo <br />c cr nsor �NnNk-6�-�/09 <br />/ <br />^J <br />r <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />AP PLICATION AND KNOW THE SAME C BE TRUEOVER IN CORRECT ALL <br />GOVERNING THIS TYPE OF <br />PROVISIONS OF LAWS AND WTH WHETHER <br />WORK WILL A COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT GOES 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 WHWH <br />APPLICATI N 15 MADE AND I COMPLY WITH THE STATE <br />CONT ORS LAW 13 27 W AND M 200 WAC. <br />pNX oun vN NNdNn ,.R�� <br />�(lEW �*zSIIJ�M C <br />Itc.S Pt llpla NgrtniY ISIOMI NIowwAn.cN,rgcOAfsl <br />Iol 5 N t✓ NIX. or <br />yQ((NC R r !! <br />rwK:R m l a to <br />iVZ}?iunnmai2i6. e +,_A 446g <br />M m <br />_ <br />CnY M15,ES51SFM1[[M <br />PLUMING <br />MECHANICAL " <br />NO. <br />TYPE OF FIIRURE dl ITEM <br />FEE <br />NO. <br />TTE OF E011R34m <br />FEE <br />WATER CLOSET (TOILET) <br />AC —AIEALG UNITS <br />BATHTUB <br />— <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />— <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KIT CHEN SINK 3 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 />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />GAS PIPING <br />� <br />EXHAUST FAN <br />_�_ <br />_ <br />SUR TOTAL 3 <br />SUS TOTAL $ <br />PERMIT % <br />PERMIT II <br />TOTAL FEE 3 <br />TOTAL FEE 3 <br />FOR OFFICE USE ONLY: /"-Td-7 i_�) <br />I MINI Vip/LN <br />J <br />1`1, <br />M.RSf IRACM <br />SqE Sf IF.Cx _ <br />J <br />AN10HC..n. <br />r S r_\ <br />Iff �ff I <br />j S.�I <br />Pfff MO <br />I'll 7UVf <br />� <br />1 <br />IouwA <br />v.uN191t <br />❑Yf5 PY <br />FEES <br />VALUATION <br />FEES <br />ft,~ <br />_ <br />_ <br />VO / Fi/1 <br />NFK nnM,.110V Ii <br />SIf.2MN11UAPp.❑,f5 <br />" <br />.p011(WN. IN. <br />M <br />OIIKR <br />- <br />iPEA1MMPEOU <br />M.£Ov <br />vMl p.xl RiNnspcu.nnf <br />_ <br />_4.fO <br />IYpFMfowl <br />-/.� <br />NANSAPM nBY <br />ont $ <br />CRY OF EVERETT <br />LOCAL SALES <br />TA% CODE IS 3105 <br />en�w,v^s <br />- <br />I O <br />TOTAL <br />