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APPLICATION FOR CONSTRUCTAN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />32DO CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />❑ OEMOLITION ❑ COMBINATION ❑ BUILDING ,(MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: / 1P Ct blr <jT , <br />PIYtiP RAYS <br />�E WR/f —4. <br />♦"TECT ORD,Of fn MM. ss GM1 !m Npw <br />GENEMl 0W1.clm N4lN ss OIY lll' ggNE nI.Y1f 110EN5EF <br />UE <br />NIFX 1ylsiS4 <br />fDNFIMCI I'q[F OF V.OIIM j 00 <br />� 9�.00 <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />flE Z.4NOSOUAPE,OQTAG NVCIVF0 1 <br />C'YIIGY Ir I',!. 4I ♦- C L'<St-r Y <br />CONTACT K.S W)V1UNf <br />/l <br />KlOnre tLD,tt& A,r Ft N;i Zc IcYk <br />y's APcP/-,�7V7 <br />CC1'1 Xp <br />oc \ I, Jv. cT <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 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 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 WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT S LAJf( 182T R AND j95.200 WAC. (/ �J <br />K lam �f' 4 /44 <br />SK' ATIXIE MIT <br />lvwosEoou a nuITKNO <br />LEWL OFK TKY1 Of A"IvarM KLON M ATI cH IYq COINER <br />LOT ROCK a <br />TNMCEL TO 10 YMTBER <br />CbKI1111C11CN 10A111[NOER.AOMFSS. TFLEgplEMI A <br />CITY "wss lCrxu w <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—AAINDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <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 />_ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />IXHADST FAN <br />SUB TOTAL f <br />SUB TOTAL f <br />PERMIT f <br />PERMIT III_ <br />_ <br />TOTAL FEE f <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />I RONI1110.1n <br />KA. tf(PACK <br />E SETMCK <br />mm CIKCK1 rn <br />f[f <br />MCHPI YIN <br />um lwE <br />rolAMA <br />Y¢AWWE <br />FEES <br />VALUATION <br />FEE <br />DYES ❑ No <br />nmI <br />IICIWII IIYM1lA1roN <br />MpOM[lUN6 <br />WE or R0d11 <br />DMIn <br />g11YBIND <br />1 <br />Np IK EI(MI <br />OCLU'.NI IDAO <br />nA$FYEVI <br />OPpmAN.Y <br />YEOI.Mf.AI <br />DYES OM <br />AMIMALMA404ECK <br />I'MESIN ERWOD <br />W." <br />OUKR <br />Flp[4MYn[00 <br />Rf A.D <br />sl.i[ BUIDKNI AIRCIIAII({F <br />ngacowl <br />q.vs AgroWOeY <br />CITY OF EVERETT <br />qmm vonKn <br />— <br />--}_ <br />LOCALSALES <br />TOTAL <br />i <br />OAT t <br />TA% CODE IS 3195 <br />