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APPLICAT& FOR CONSTRUC8011 PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERET'„ WA 98201 • (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION _ ❑ ASUILDIPIG d ❑.KCHAIWAL _ O PLUMBING ❑ SIGN <br />PROJECT ADDI <br />1f N.N1 Am ATOMITSS MY nP PrgNF <br />.ACE.1FC1 On DE4ONEn VAp.ODpESS _ .CIIY . T. <br />'ZD / <br />21� 7- <br />YFCTIANICAI CoAnnACTUR VA'I AFXWFSS 1IM1 llr P,lcYr STATE IICFvSE• <br />PIIIAUPEG COUTITACIM V.II ACIMESS CITY IT, rnP,F SIATF I ICPSF• <br />cDNInAc1 rnlcE Ur Mw <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />pFSC N�BF Y�IJRM.N�O S'6IOOIAGE NVp VCD <br />COV I.C1 11n50v AM1 rlrflyf vV <br />1UA�PF <br />I HEREBY CERTIFY THAT I HAVE READ ANU 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 WIIL 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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION 15 MADE AND : COMPLY WITH THE STATE <br />CONTRACTORS LAW 18 2/ RC W AND 296 200 WAG <br />.� <br />PlgTgsfOuSc a ODAnNr. <br />tcOAL DESCRwOoe OF PNDPERry 1MTOWlleaow OR ArtAcn UNOCOnES1 <br />tot MOCK OF <br />II IA. 10 I.I.M. <br />4-� / O/O O/;? O007 <br />OMMITUCIKM1LOAN IFNCf R. ADMTESS. TEtkA10NE NLAAI <br />nl 1 <br />CIIY BVVMSS IIL NSF IIU <br />P BING <br />MECHANICAL <br />NOi <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NQr <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AYC—AIHNOLG UNITS <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS _ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />/ <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 6 DISP <br />/ <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />�T <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 />-- <br />EXHAUST FAN <br />T <br />SUB TOTAL S <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />TOTALFEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />f"T VTBACK <br />FIT"SfTBKK <br />SIDE SEIB.CK <br />MAN CAECA tPLIAMP <br />o ooa <br />1FF <br />PECFMr NO <br />USE EONi <br />101 AREA <br />vA W SITE <br />OYES ONO <br />FEES <br />VALUATION <br />_FEE <br />BUIG'rr <br />— <br />Ruunw: <br />FC VTI <br />_ <br />IlEsom HNTAI" <br />NO Or DWrtUNG <br />uNUS <br />SI:EO MFIWI <br />' <br />') <br />k—LM.\CY <br />rnrn»• <br />,7-prtwli <br />O:CUPANI 10.1) <br />BAmWNI <br />OYFS O <br />Appll[WAI RAM CNFCM <br />i I <br />FIPESPINUXLEPREO'D <br />PFAFCN <br />OUYfP <br />Fm AIARVREOD <br />IIf iSM1 <br />smr emlD.f SIMUAWK <br />I WE OF rpTcr <br />RAMS APrnovrn nY CITY OF EVERETT <br />LOCAL SALES <br />DATE TAX CODE IS 3105 <br />RIBUr.vnTR•S <br />-- <br />— — <br />TOTAL <br />- <br />