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APPLICATIA FOR CONSTRUCTSIN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 • (425) 257.8810 <br />❑ DEMOLITION ❑ COMBINATION Id BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: C ST <br />o No4,c✓ ply Y�1wl .Zo/! 71 fi EuQ.vy/' 3ufryS.S?�/% - ._-- <br />Hwxl Yw mo"trss all lw MSM <br />�SV/F`C <br />IIIMHCI OIr IKLdrFR YM MIaIEEs EIIY !T 1'xdI <br />mx"mcWINtld1 YM 11dwISs all Ar PITH t11111KEM1r <br />SCENE-� <br />MCtIYKM GKItRECtd 4N EIKInfS flM1 !T M1IOL KIEII IKEM[I <br />%IMM6 CONIRKIP YM AOOIIIEI CITY !10 MIM El11FIKEMSEr <br />awlAEcl lxcE d <br />HEATING SYSTEM: ❑ GAB ❑ ELECTRIC <br />dfcwsEYn scum rmtEd nvatYo <br />c ELi IfIIEOxEM b 3 <br />sSS S Y <br />AM P Fr <br />Crw is ctv <br />�So zs6G <br />T6� n <br />I HEREBY CERTIFY THAT I NAVE 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 />HcnosEopuR d Inwdn <br />WORK WAIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TI DIVE <br />lf,,MWRFIKnd ncRKnl'EIO'KK MIQI OR mEGl lwOcaKu <br />lol 3 -� waa � d <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCH. 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 />CONi CTORS LAW IA ZF RCW ANO ZI6 ZBD WAC <br />Mw:flTu to NAYKK <br />A. (JI✓ __ <br />CdI\1111FIKlNIWMIfMKR IdIrt6f HlfHlblE MA1EER <br />�� <br />u•II <br />GiY fYYxlfS IKINSI rrO <br />PLUMBING <br />PLUMBING <br />MEC14AMCAL _ <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—AMNDLG UMTS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNITHEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATERHEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL _ <br />METAL FIREPLACE (WOOD BURNING) <br />-- <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />OACKFLOW PREVENTERS <br />GAS RANGE <br />SINK(SERVN —BAR, ETC) <br />OAS PWM16 <br />EXHAUST FAN <br />_+_ <br />I <br />T <br />SUB TOTAL S <br />SUB TOTAL 1 <br />PERAMT E <br />PERMIT f <br />TOTALFEE S <br />TOTAL FEE A <br />FOR OFFICE <br />IRE <br />«o <br />Ol[$ O mu <br />MdtlMHhr srtldwCdlr �- Gl <br />IMIF f M1INNII _ .__._-_..•_-_ <br />YIt QQMYI tow KSSf% G4 <br />VICxsYfw <br />EpG1EFW PIYILWEK <br />OIMA <br />lIAII&%btI0f=t4W - <br />_ _t__ <br />r1i <br />TOTAL <br />