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APPLICATIA FOR CONSTRUC&N PERMIT <br />CITY OF EVERETT X BUILDING DIVISION <br />9200 CEDAR STREET X EVERETT, WA 98201 P 257.8810 J� <br />DEMOLITION COMBINATION X BUILDING MECHANICAL PLUMBING SIGN <br />DIHPY CGIIMC1L111 WlACp1E[9 all lP RIDIE SIAR LCEI; r. <br />6LCPw.r afArr tleEl-nzAmsrA„ L..IA.✓ g4cz3 gc-Yo3=WZ G ¢Aft o6koA <br />4lC1UNiµ LdliPYig1 MAE AOpIE35 [nY l0 `PCE SIARLICLNI <br />KtMW ]CMinA " Dk AD ss CITY lP i,, E StARLXANSE. — <br />COal.YT MCI, W MfA <br />2 cVc c <br />HEATING SYSTEM: FI OAS W ELECTRIC ' <br />DE unmt ve Aw $OUARE coolApE IxvanD <br />L7 a LE! Pot LAF (V <br />rPEasoxAw ro <br />i.;,J �t�-<f03 iCS z <br />-vZA-ALA <br />marouD us(a e1pLCP0 <br />I HEACOY CERTIFY THAT I 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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY 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 WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 10 27 RCW AND 296200 WAD. <br />X -A a/ <br />lFpµ pFSCntIXN(f MpPFptY 15nJM1 EELQY OR NitKN ONO CAS61 <br />LOI ROCX_ —CIF <br />aAP(EL iAA 1C NUMBEp <br />dad ovi ass od <br />Cp181PUCig11lOANl[WFP.ACgI(881(lIF1Ur1(IAIYp[P <br />8gNA1WF CAPE <br />Clly W LX[881CFN6E MU <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EOLIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC—AHNDLG UNITS <br />BATHTUB <br />I <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />—T— <br />EHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />LOTHES DGYERS <br />i <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />1 <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />! <br />FIREPLACE INSERT (WOOD BURNINOI <br />FLOOR DRAIN <br />OAS FIREPLACE <br />BACKFLOW PREVENTERS <br />I <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC I <br />I I <br />GAS PIPING <br />I <br />EXHAUST FAN <br />I <br />SUBTOTAL f <br />SUBTOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />PLDNT VTWK <br />PCW SEISYX <br />SXX UTIVCK <br />^M'CeNWOLR <br />V <br />«E <br />PECCVIw <br />LIVE TCNF <br />1.01 ARA <br />5YANI VIE <br />::Rs nw <br />FEES <br />VALUATION <br />FEE <br />i— <br />EEg7L011A11LN <br />wIXUHllm <br />UMIS <br />VROI KMII <br />nuuew <br />DP[M A!:. wa SNWE <br />UCCUI'WI LOAU <br />MSEYEM <br />nRs III <br />11CCWNX,X <br />ADgipN.µ PlWLp4LK <br />F WE 51PXglA ROD <br />PEAS <br />OTIFp <br />FPE µAPMP(GD <br />PEASCW <br />SIAtE SIIA[IKIJ pApIMO[ <br />rrrtaCax�T <br />nAxsM v e. <br />/ <br />mr( <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE 15 STOB <br />rvelcwplKs <br />TOTAL <br />