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APPLICATkA FOR CONSTRUCAN PERMIT <br />CITY OF EVERE T •BUILDING DIVISION <br />a: o(t CEDAR STREET • EVERETT, WA 98201 • (425)257.8810 <br />DEMOLITION ❑ COMBINATION + ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: lbr ZIP -I IO- St. S f M►Om 98Yxw3 <br />Ik N ,k 4Yx_�K� Tu/�c uKT III. 7i�st.sE pl T.ea 4QW3 42i-3s7•113o <br />lf"W YM YIOnr 33 ah m nIM — <br />.RY•RCIOII nSLOMM YN YIplf 84 <br />awnftA l tlm <br />YN •aYNSM <br />- ab <br />�- 7K <br />IS•hl <br />SYf111LY1gt _------- <br />wc"Wftcmlwl< <br />Y"Ar—SS <br />ah <br />!/' <br />hl(Yl <br />SI•N IKIML• <br />ntAlw9CWIKWf1Y1 <br />YgmAlO <br />an <br />lro <br />- nVM <br />SIOr IKFNM• <br />cwlwclmKl a nYlnu <br />_ <br />HEATING SYSTEM: ❑ GAS Gl ELECTRIC ❑ <br />aFcwu waa eou•n Imnlol Yvdun <br />REII,Q,nI I)4 dr_taJfYd GK.TZy� <br />cwl•ctnmrr. •Nn r1+Wr Ilu <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TI/IS TYPE OF <br />WORK VAL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PCgMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REOtl ATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUIHORLIED PY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH TINE STATE <br />CONTRACTORS 1 AW 10 27 RCW AND 296 INK( WAC <br />�y�,,,�/J/ N �� <br />II f <br />rnorovo Inl tx wwdKl <br />1l11A1 Of Stw•fKNd PnaYRry131UMI w10W OR •NAfn1 Mq CQKSI <br />IOf Alf— Atm. DO/ p &L rffy dAj, <br />MIICTI fA•lP YAwn <br />CIMIwK11nN1nANIrYIrn AIKKNSS RIII.OlIIIAwrn <br />CIh FI4NLS31[ f NN KI <br />MECHANICAL -------- <br />PLUMBING <br />No. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC—AO*ADLG UNITS <br />BATHTUB <br />FORCED FORCED AIR SYSTEMS <br />LAVATORY (WASP BASIN( <br />HEAT PUMP <br />�{— <br />SHOWER <br />UNIT HEATERS <br />KITC/IEN SINK E OISP <br />CLOTHES DRYERS <br />pSHWASHER <br />I FU EHOOD <br />_ <br />LAUNDRYTRAY <br />WATER HEATER <br />CLOTHES BASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DAMNING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />GAS RANGE <br />OAS PIPING <br />EKHAUSTFAN <br />TmpFRk%T <br />SUB TOTAL S <br />PEPMH f <br />TOTAL FEE S <br />TOTAL FEE f <br />FOR OFFICE USE 04LY: <br />ranNl vtF•r• <br />nwsr lnAc. <br />floe ulA.cA <br />N rl� 11p0/7 <br />Nr <br />Krrtwt rq <br />Inr io+r <br />Im•Ix• <br />.Y:•xl vtl <br />OrfF O. <br />FEES VA WAT10NFEE <br />_ <br />wNfwF. <br />iiil <br />- <br />HIfW 11Mt.S1xW <br />Iq?fxM 111M6 <br />11NIIt <br />SV(a wP6N1 <br />__ <br />nIMIM <br />yrlN1Yf 'Y <br />OCI:1. IV•Nr <br />f•MII� <br />N`rv•�WS <br />YI fIMNI toW <br />SIYF F•NI <br />Orls O <br />I"SrtYI•Hnwq Yo _-- <br />-- <br />nAw1 <br />.odtltwN n•N C.C. <br />rq YAM moo <br />ttrtacaNal <br />M••m _ <br />nAN••I•twnYnAr <br />CRYOFEVERETT <br />LOCAL SALE8 <br />mtL TAX CODE IS J10S <br />SYII MnPMI HIKI w <br />— __. <br />nr•Ir tYxNa <br />--•F-- <br />-- — <br />TOTAL <br />I/ <br />