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APPLICATICA FOR CONSTRUCT )N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATINGSYSTEM; ❑OAS ❑ELECTRIC ❑_ <br />2598810 <br />)(DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />pWlrt'f MARA0 ss Cm M "AW <br />JckLL la���rclA �I I-/ L5 114N 5 E. S . zso B.11�y It l� 98�b4 45 r 3847 <br />TENANI MAL ctrr n PXnK <br />AIICMiFLrMMlEVC.i MARA SS <br />Cltr <br />!P <br />tNlP1[ <br />I jr! Assn. rso r,[ru <br />"260 <br />O[MMl fMCTon Wl Ap WlfSS <br />CT, <br />NIA <br />MgMF BiM[l6[MSEt <br />f As!;=. AJp 24oi"5� S.C. <br />13olke-BaWa. <br />90021 <br />ASS-ISIS ALDR�Aarlo'LRy <br />YELXAHIL4 IRYtOM YA4A ESS <br />Clio <br />N <br />RS1L STATE ICEMNA <br />nUEINOfAH1RACip1 MAX AMMSS CT' M MCME STATE LICENSE <br />CLASS C[ MM <br />NEW ADDITION ALTERATION REPAIR DEMOLITION " WOODSTOVE'FRPL INSERT BUILDING RELOCATION <br />CCMTRACI MICE ff <br />C011TACT IERed MIO MORIF 1q <br />Fa MIrRIOAMoll - ZJ CC J <br />pPE�SCRME :" AM) SIXIARE rwtAK VARkwo <br />(ZaEsylra i, <br />rRM.as[nInE lR euAnMo—�^ � <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 LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREM OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 />CONTRACTORS LAW <br />J,1021 RCW AND 296200 WAC• (� <br />xAwwnf !!�L 1/7�w.- es 4a-1Y^{� <br />E[IYY MWAIT tl a PR Rfr IMCAAM KIM CR A"ACM FYI1N CI s, <br />WT xoLK a <br />lJr O/ n'a 'kSLv <br />AOpIFS! I12ia 54 4.V(/L R� W <br />' <br />41T <br />PISIW vi <br />PLUMBING <br />MECHANICAL <br />NQ. <br />TYPE OF FIXTURE ON REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET( TOILET) <br />AlC—AHNDLG UNITS—H.P. <br />BATHTUB <br />_ <br />FORCED AIRSYSTEMS—STU. M E.A. _ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS--B.TU. M <br />SHOWER <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />i <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' _ _ <br />_ <br />METAL FIREPLACE ACHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSEHi <br />HEAT PUMP <br />GAS PIPING <br />FLOOR DRAIN <br />BACKFLOW PREVENTEGS <br />ROOF DRAINS—RAINLEADERS <br />_ <br />_ <br />EXKAUSTFAN_ <br />SINK (SERVICE —BAR, ETC.I <br />_ <br />I <br />SUBTOTAL { <br />_ <br />_ SUBTOTAL { <br />PERMIT { <br />TOTAL FEE { <br />_ <br />PERMIT i <br />TOTALFEE { <br />FOR OFFICE USE ONLY: <br />rKONTK*SACK <br />REAR KIlALII <br />SM KtSACII <br />�, yIECFR <br />)% <br />'If <br />RECFPI NY <br />11Bf ZCMF <br />ION AREA <br />VM:MEr MBE <br />FEES <br />VALUATION <br />FEE <br />SUKDNG <br />PLUMBING <br />_... <br />' <br />7— <br />, <br />—7- <br />TVR IN MIS AILMAKI <br />tM 1. MR, Kl114 <br />�T benura WN <br />EIYIC <br />SMtmlAw <br />NodsIORC! <br />6lSEM[M <br />MECHANICAL <br />AM ITGNAI PEAK GiDN <br />pCCUMNLY IOAp <br />EN1E lVWMIFRI MOO <br />MtIX1lMMtCx <br />SPRINKLER <br />MAIOM FIy1 KRINMIeR! <br />81ATE BUA(IFAI SURCHARGE <br />xrAllEw <br />MArn APPnweoty <br />CITY OFEVERETT <br />LOCAL SALES <br />TAX CODE 18 31011 <br />Pu&x: wonKe� <br />MAL <br />' <br />