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APPLICATIA FOR CONSTRUC7SN <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET a EVERETT, WA 98201 •25B-BRIO <br />❑ DEMOLITION ❑/ COMBINATION ❑ BUILDING) MECHANICAL <br />� <br />PROJECT ADDRESS: �� Lk) Q Ecd I L..� S-[ <br />m <br />naJeiCCi ODDE FR YYI AW<SS CIM1 m <br />PERMIT <br />PLUMBING ❑ SIGN <br />RIMWCGIiPAtipl YAPARAIF51 GM1 1V prgNi STALE LPMENSE• <br />CWIMCI�E a <br />HEATING SYSTEM: ❑ OAS []ELECTRIC ❑ <br />YAlE YA.Yet Alp ramwF Rynl,<o J <br />coIPACT KPsw Ard PI1014w <br />I He RESY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRITE 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 LOCK 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 />CONTRACTORS LAW 18.21 RCW AND 298.209 WAC. 1 I <br />X—�1 ANLhA�^'-A QVQ S/L}J <br />o I6f a ellllOrlA <br />f ' <br />LEDAIxs RIa PM1 [9A1Ylr Fl wwARACP TPO CV[SI <br />LOT M a <br />`/C _ ��.-�� <br />LC <br />iM 10. MIle1ER <br />COM51N1FIgN10W LFMRP.A0Mf53. 1FLFP1iA'MllilFR <br />PONZIITE —� DATE <br />GM1 RIIRESS IKEM^E M <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYROFEGIXPMNR <br />FEE <br />_ WATER CLOSET (TOILET) <br />NC—AAIIDLO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />NEAT Pl1A1P <br />_ <br />SHOWER <br />UNIT HEATERS <br />to <br />KITCHEN SINK d 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 MOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE— BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL S <br />SUBTOTAL 3 <br />3U <br />PERMIT 3 <br />PERMIT $ <br />/ <br />TOTAL FEE 3 <br />TOTAL FEE. $ <br />FOR OFFICE USE ONLY: <br />r RONr BEtnAcx <br />aUI SETBAC. <br />Y[If sEleA[M <br />M..CIPC..'D <br />s 3 <br />II �o <br />�E� <br />la a4Pi <br />.SE EONE <br />_ <br />NatAaA <br />vAD.NIAN <br />❑YFS ❑ M <br />FEES <br />VALUATION <br />FEE <br />BI.I MIM1 <br />NFM.NT LI411ArgV <br />NJ IXpwEILW <br />IMIr{ <br />AhaRCUI <br />M1 041P4O <br />GCr�Nh ANCr MttfI1vNT <br />OCCWANI LOAD <br />PASE4FN1 <br />Olts ❑. <br />4rG1AWA, <br />--i— <br />AMI"4 RAN G6CM <br />FIRESMPATLERMOD <br />of ASW <br />OOPn <br />- <br />T'.(Awi4nEO9 <br />SIAIE BU I(TID APICIIAME <br />11RaroNST <br />PLIA_APIW)VEO er <br />DATE <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />RMlr wOR.A <br />TOTAL <br />