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APPLICATIA FOR CONSTRUCAN PERMIT�//IV/��y��7 <br /> CITY OF EVERETT+BUILDING DIVISION `/ <br /> 3200 CEDAR STREET A EVERETT,WA 98201 +(425)257.8810 <br /> ❑ DEMOUTION JA COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: __S7 <br /> /2�7 �.0 <br /> Itnwl uu/uI�NKR ss an >• n10w <br /> APa.ncl rK]AVK•" - .Iu 1GvmFu arT F+' PKrJ <br /> dNCAN 1 Ic anii+rZi 5[T�'` � L7�1�llJi srL35��S <br /> al. !R P+M A+q IC(M <br /> YFCn+MCN r:lY111UCIDP UN H[R ss an 1+ PV1r tn1F LKMSf• <br /> nllyHDCWIR+..Ia1 NN MR ss an m A'U'1{ SaIFIKEW". <br /> cwrRAcr n+cE d rlow <br /> HEATING SYSTEM: OAS ❑ELECTRIC ❑ <br /> I'!lCM1Ii M'JIIRAb SDU+RI t MYgYTD ^ [M IP11NIy��MfYI M] <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> monouo AR q R"LOIND``�� PROVISIONS OF LAWS AND ORDINANCES GOVERNING TIIIS TYPE OF <br /> J WORK WAIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> :I[wLA>tulwrpnvFwdE nIbIDISn IDwwrtlAcn rrlo CaEsr NOT, THE GRANTING OF A PFRMII DOES NOT PRESUME TO GIVE <br /> 01 ftcK+ Or a AUTHORITY T- VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR I OCAL LAW REGULATING CONSTRUCTION OR THE <br /> S`L�NLIBY PERFORMANCE OF CONSTRUCTION THAT 1 AM AUTHORIZED BY THE <br /> OO OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION 15 MADE AND I COMPLY WITH THE STATE <br /> FAAALTL MID MAR0 CONTRACTORSL AW IR 21 R W'nNO 2"200 WAC <br /> CONSTAFId(OAK EMKn NXAnf55 RII n X Nmµ rJ e2" <br /> Na `une ' wn / <br /> OIY SUMMS]I[FIIM rq <br /> _PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE ON ITEM FEE NO. TYPE OF EOUIPMtNT FEE <br /> WATER CLOSE?(TOILET) AOC_NHNOLO UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PULP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK E DISP .CLOTHES DRYERS <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL _ METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACKFLOW PREVENTERS GAS RANCE <br /> ` SINK(SERVICE—BAN.ETC) GAS PIPING <br /> EXHAUST FAN <br /> _ SUB TOTAL !I SUBTOTAL f <br /> PERMIT f PERMIT f <br /> TOTALFEE f TOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> FPWT Glow+ wF11w"mw ]AIEMtUCA �watS+MKRKrli wortw <br /> IRT NINF IOU MEA IX"I LIF (' E _ VALUATION <br /> DIES a W, AytM <br /> wgHT IAMIAIgN MIOr DwIInD NFE <br /> I� ) <br /> Y.. Yf afAANi III.�IMMI ION( AI MAI / WMMlM f <br /> Dy] YM/1 <br /> FR PROD PE A." <br /> A 1nNAA PMI aIfd <br /> _ OIKR <br /> FR AIMM-ma 0 IS-" <br /> •IAII MRDP11 NICMAPK <br /> Pw DF rani nAn APmoHnn.' 111 CITYOFEVERETT nEi r.IYOwA ' <br /> LOCALSALES — '--- —�— <br /> Dm 10 S _ TAX CODE IS 3HIS TOTAL _� <br />