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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT• BUILDING DIVISION <br />32DO CEDAR STREET • EVERETT. WA 90201 •259-8810 4Affr <br />❑ DEMOLITION L] COMBIN�ATIO�N� I$ BUILDING IN MECHANICAL CI PLUMBING El SIGN <br />PROJECT AD RESS: a, I (S_r� y+h <br />s,,c)&'vfyLessen_ 4Af11 <br />nIA 4N 4IIt61 <br />t[YwIII YN 4MeK 51 pt[ !jl' ryrpll[ '-- <br />• t(911A MfNMR YN •Tla4tf bh' T M1os <br />h" _ M1VIf 91AIE ICE Me <br />PIU'R %TATE LICENSE. <br />4N AOIKKFS - pp. ��..___ rypK <br />2 J_ J,f/ _— FutEI C[4R. <br />HEATING SYSTEM: ❑ GAS J!d ELECTRIC Cl <br />R A1FYl Al <br />111t f�•� <br />OraAAI� <br />frWiy'.r RIM(WIryI°IK lru <br />J.OLmP <br />+nr1LIr11n •. <br />> <br />`QOIr.° <br />___ <br />1 IIEREOY 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 />WORN WILT. BE COMPLIED WITH WHETHER SPECIFIED HEREIN on <br />NOT 111E GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTIIORRY TO VIOLATE OR CANCEL THE PROVISION 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 WORN FOR WHICH <br />APPLICATION 19 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS 21 RCW AND 296 200 WAC. <br />LFrl•l °EfcArT d nn IfIIDA4 R1°wwrtrKntw°c°rlLtl <br />Lot)u{p,I,R9L� R°f.1 y/��_ d L,/ L 1I L C 1 Aid 7) <br />l <br />I ne�V CS \ <br />O4I an <br />IYIIGFI to I ° MAIRA <br />9R MA![nPLUMBING <br />cantnucipNluMIlfMKnZIGASINI <br />MECHANICAL <br />NO. <br />TYPE ITEM <br />FEENO. <br />TYPEOFEOIIIFMENT <br />FEE <br />WATER CLOSE <br />I <br />NC-MINOLGIBEaOATHTIIB <br />FORCED AIR SYSTEMS <br />LAVATORY (WA <br />I <br />_IETS <br />HEAT PUMP <br />SHOWER <br />' <br />UNIT IIEAIERS�I <br />KITCHEN BIN 1015P <br />DISHWASHER <br />I <br />CLOTHES DRYERS <br />RANGE HOOD <br />t <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />t <br />VA700 STOVE <br />URINAL <br />DRINKING FOUNTAIN <br />' <br />MF.rN. FIREPLACE (WOOD BURNING)I <br />i1RF.MACE INSERT(WOOD BURNING) <br />t <br />FLOOR DRAIN <br />OAS FREPLACE <br />I <br />BACKFLOWPREVENTERS <br />GAS RANGE <br />' <br />SINK (SERVICE — BAR, ETC ` <br />GAS PIPING <br />SIT MUST FAN <br />I <br />I <br />— <br />I <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f 1 <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />[n°Nr Vle'CXO <br />RYI6[le.Ce <br />4°E e[[A.aI <br />ry•Nfl� MMNn <br />r[F � <br />RrFptlq <br />°+F +411 , <br />I� Z- <br />tpuM• Va lWE <br />(� O.fs p+16 <br />bW""TILAIe 4IFp Ruall <br />MIT 4 <br />FEES <br />VALUATION <br />FEE <br />_ <br />441.n <br />-- <br />tJ� (.ff <br />— <br />NFbNIIINi.IgN <br />EMI <br />nNMSMt <br />OCCUMGNC.0 a I'm$ <br />3 1 / <br />mcwmltu.° <br />e•Y1f Nr <br />Olre1,4 <br />wpiwm <br />IxK emIwUAR°'u <br />Ir•MM�' <br />•mMw4 nY.bra <br />mrK" <br />Iwt• mftfou <br />SiMT MMIYM 4MY.1TATIM <br />trn dtdnl <br />n•IM 4wn4ene. <br />Q- alt V c7�9i <br />=DETOTA� <br />__ <br />_� <br />