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APPLICATA FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT •BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • (425( 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />�✓ �✓ _✓ _�G>��� 45nr�,.>w,.�i1 9Y2g41 . f/_a - f/ D_7l➢'/ <br />,Ir <br />I/RnY Gwlmrlw. <br />V+n RX"ss <br />- nA <br />!Ir <br />A«M cl All llcll. <br />WCRI.NCNCb41l1+CIW <br />4+4 PpbE 5S <br />an <br />llr <br />Ag4l t1.111KFNt!• <br />AIMBING CpNin«rf011 <br />V+f +W.K6S <br />all <br />lR' <br />rNbw .AlI1..CNX• <br />cWn.cI APcr a <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />a SCMPF MjIM+Nb $ql+Rj FQQtPa NVOIVCO <br />F01111C1 n RS(MI+NR rIXM Np <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 />WOPK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. '.HE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUIHOPITY 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 AUTI/ORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON ACTORS LAW 18;11 RCCW AND 296200 WAC <br />/ _/ ���� ��O l' <br />�ITI-(IT— <br />T.5wm0 ma BlmpmO <br />IrOu ascAPlgNalwaenA lsNowN NLOwbR An.pN two cattsl <br />101 elm <br />MRCF1 unp MnWn <br />cbVStnlK:tpry1MNIFM1fR 4KVE5S IH[HgNE MNRFR <br />cnr euSINE451rlNv vb <br />MECHANICAL <br />PLVMBINO <br />_NO. <br />TYPE OF FlXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />FEE <br />NO. <br />TYPE OF EOUN'MENT <br />UNITS <br />FEEA/C—AnBVDLG <br />BATHTUB <br />FORCEDAIR SYSTEMS <br />LAVATORY IWASH BASIN) <br />_ <br />HEAT PUMP <br />--�-- <br />SHOWER <br />VNIi HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />Wg1ER HEATER <br />CLOTHES WASHER <br />WOOD STOV'c <br />URINAL <br />METAL FIREPLACE (WOOD BUR NINGI <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />FIREPLACE INSERTOVOODBURNING) <br />GAS FIREPLACE <br />�— <br />BACKFLOW PR[VENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />�— <br />_ <br />SUB TOTAL f <br />SUB TOTAL f <br />PERMIT f <br />PERMIT f <br />TOTALFEE IIITOTAL <br />FEE f <br />rvn vrrl4.t Wt VNLT: <br />I n11Nt V1Rvn <br />M+R $f1B¢Y <br />SIa NIIPc. <br />SvACANt <br />Irr <br />IOlant• <br />yIE <br />Orrs OrowM—t11NG <br />ES <br />VALUATION <br />_ <br />SIZEM B10Gn1 <br />OwlFEASIN <br />"1111��W.IrrFR <br />— <br />--_OEXXIIAN110ApOns <br />rPK HARM RkpTI <br />I <br />NIC4 <br />n{+e0y <br />SIAE BOlLINll SRICIUPPE <br />TYPEaC <br />_ _ _ <br />A+41, AP r08By <br />wlt _ <br />CITY OF EVERETT rnRl r. wblM4 <br />LOCAL SALES <br />TAX CODE IS 3105 )TOTAL <br />—" <br />