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APPLICATION FOR CONSTRUCTIO% PERMIT( <br />CITy OF EVERETT • BUILDING DIVISION3200 CEDAR STREET P EVERETT. WA Y8MI A (428) 2574810 �-" <br />n DEMOLTTR3N Li COMBINATION pr BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ OWN <br />ifY.Yl <br />YM N 11& <br />fAn <br />In <br />xrrON[ <br />TivRCi MtYC(V1/[n <br />ENT><e.�uf: tA�siT� <br />Yw NYxr[]t <br />I�uRY>, `126 <br />Gn <br />1A%DDMFIAWt__j¢�} <br />Vry - <br />�.r]lr� <br />)m <br />M1fJ? ' <br />41ai'7L3B3'/7D E�Vf�ic4F2i�1W <br />nx}h t.trE LKiMEt <br />o. YrnN cmimCTY1 <br />uw NxMFtt <br />4[nr.4YN ClRinll:lltn <br />V.h NXfFtt <br />rr'Y <br />..r <br />hxlY( ]Tf.. LK[NS[r <br />rl °YIIFR [[MrP.ciar uw .aM[N Viv llr rN.lfF tiAR LLYMIIL — <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC <br />��fJ�.�.1y1rW[A11�M.1 :aGUPF (D°flyF NrOIVfO �T / <br />ONT 1 Kn]°Nf rrr04f Ad � y-r <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF L KN8 AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING, IMA OF A PEIT DOES NOT PRESUME TO ONE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW RLKOl1UTTN I CONtrRUCTX]N OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM ALFHORRED BY THE <br />OWNE THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APP A ON IS MADE AND I COMPLY WITH THE STATE <br />CO R T S LAW 15 27 RCW AND 295.200 WAC. <br />rrave(D IR a n�nr nrvn <br />I rnN atrnnlara rDDnEPn lvxn]N Anarw PnPCN IYIO CURfF <br />1m <br />C S <br />L.a 2A]UL__fl:Ili. ! <br />rMcrl inf I D MINMn <br />[(IVainlKixMl°.N l(NOfn NTnf55 iF\Eitblf MNPfn <br />'— <br />X <br />LPf DfTf <br />Gn HIfNFtS IKFMY NJ <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EOl1IPMERFT <br />FEE <br />---� <br />WATER CLOSET (TOILET) <br />AIC—AHNDLG 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 />�_�_ <br />WOOD STOVE <br />URINAL <br />( r <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 />I <br />SUB TOTAL S <br />SUBTOTAL S <br />PERV.T S <br />PERMIT S <br />TOTAL FEE S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />OvR O Va <br />Pur MVfr <br />14bN1IrWiPIKIY <br />MId IMTIIM <br />SN[a NW/il <br />n INPIVR <br />U1CIT1hCv Kr [F ]LT'.N <br />tICGIr.NI IOFO <br />PnV aY 51 <br />ufLnwxN•_—_— <br />f.rhllMr <br />ore] oNo <br />ApGTI(WN nwcrxc. <br />I �rFSKntxIFPPFOD <br />T.taF <br />O' P <br />�arAPnM Pf?P <br />T.]°Y <br />" <br />51. "f PInrL 'O SNPCUN1ltt <br />^:I..vmlxt <br />nnmF: var <br />""A"TP&Oner <br />CITY OF EVERETT <br />LOCAL SALES <br />T TA: <br />_... <br />TAX COCc 15 3105 <br />