8115 XAVIER WAY 2016-01-01 MF Import

I � f�s Everpnen ; CITYOF ; everett BUILDING DEPARTMENT 259•8810 APPLIC/�-r'ION FOR CONSTRIi �TION PERMIT everett e TO BE COMPLETED IN INK — PLEASE PRINT woness I �iC � enr zm PMONE � � b $ //S i; �Q l<% �'v�rr<7�` 3� S' / 1O�RE55 GIIY IiP PMONE iLUMBiNOCONiR�CTOR M�RA��RE55 Gi�v ZIP �MONE LiGENSE• ❑ NEW ❑ AODITION ❑ AL7ERATION ❑ AEPAIq ❑ DEMOLIIION ❑ 1VOODSiOVE/FRPL INSERT ❑ BUIlDINO REIOCATION ppowe[o we ar nu�winu I HEREBY CERTIFY THqT 1 HAVE READ AND E%AMINED TH�S APPLICRTION ANO HNOW THE 54ME TO BE TRUE AND CORRECT. ALl PFOV�SIONS OF LPWS AND �Ew�OesGmvnonuvpaorenrv�sr�ownee�owoaert�cHrom�cormSl '—" ORDINANCESGOVERNINGTHISTVPEOFWORKWILLBECOMPLETEDWITH WHETHER SPECIFIEO HEREIN OR NOT.THEGRANTINGOFAPERMITDOESNO7 PRESUME TO GWE AUTHORIT Y TO VIOLAtE OR CANCEL THE PROVISIONS OF i. o�ocK or ANVOTHERSTAtEORLOCALLAWREGULATINGCONSTRUCTIONORTMEPER- FOFlMANCE OF CONSTRUCTION. THAT 1 AM AUtHORIZEO BY THE OWNER OF TMIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I CO PLY WIT'- fHE STATE CONTRACTORS LAW IB27 RCW AND 296.200 SiGN� NE CONIR�CIORORAUIHOPREO�GENT D�Ti+ PLUMBINO TRAY URINAL ORINKINO FOUNTAIN euowee��crue� ITEM FEE NO. TYPEOFEOUIPMENT NC — NHNOLG UNITS — H.P. �— FORCED AIR SYSTEMS— 6T.U. nr.uruvercoc_orn �a SUB TOTAL PERMIT TOTAL FEE erra or VENTILATION FAN RANGEHOOD WA7ER NEATER WOOD STOVE METAL flREPLACE ti CHIMNEY FIREPLACEINSERT HEAT PUMP GAS PIPING F%HAl1STFAN a � a E vncnn � sn c FEES ❑ YES ❑ NO � NOAFOWEIIINGUHiiS BUILDING PLUMBING esrnc occ �ono � u r MECHANICAL n r+ -- IIEiG11ilIMITP110N pTHER STATE BUILDING SUtiC1iARGE S7ATEENERGYSURCHARGE � PUBLIC WORKS TOTAI $UBTO PERMIT TOTAL F FEE