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APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT • <br />BUILDING DIVISION <br />0200 CEDAR STREET R EVERETT. <br />WA 98201 R257-8810 <br />❑ DEMOLITION COMBINATION n BUILDING <br />❑ MECHANICAL Il PLUMBING SIGN <br />PROJECT ADDRESS <br />OMkR WI AMR SS GM1 <br />i[IMNI YK10PFii Gt <br />iP RUIE <br />NICMiTECi(MIDFi4NfR L,ft sl GTt <br />tv OM}E <br />OFR�.L fpRRAD1CP uAAAMRFEi GTY <br />!v IRAINfLHiG ElA1.I KY!NEFI <br />n 4- SE <br />SAto*!cd '?Arlo 33s 4[/fS /1flEeIKOB 7�lL <br />Erx r 7311 IS3�L9G1E <br />YFGIRMC4COx1RACrG1 WxW is CRY <br />tv n1}E 0111E lILERfE• <br />0.WBNB EdRRK10R WaRUC1E68 Crt+ <br />Iv nghF 61nE 16(x5[• <br />eoNTWD'ERce °I3AErJ A� <br />HEATING SYSTEM: CIOAS ❑ELECTRIC !l <br />OEURIf NCYRAM Bd1ARE rao1A0F NYEIVIO <br />C XT RRSCN YUR M <br />e1LN14f-,C <br />1F <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />LI <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />RID.asEo usE euKnrn <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING nIIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />LE04 Of0CRPT.R ar. Fyl lOx 11[10w OR Al1RGI Two Mnril <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT __ wac. oI <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 1 296 20D WAD. <br />.APLEL to ID NIw1eER <br />OGISTRUCiKNIOAN if 1A%P. LL u. RIEn SAlfA <br />i <br />BF✓v R BA1F <br />CRT BUYNC60lK[K5[ND <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />No. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC—ARMDLG UNITS <br />BATHTUB <br />1 <br />FORCED AIR SYSTEMS <br />! <br />LAVATORY GNASH BASIN! <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />1 <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOW <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />_ <br />DRINKING FOUNTAIN <br />FIREFLACE INSERT WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />_ <br />BACKPLOW PREVENTERS <br />! <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />! <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />I <br />SUBTOTAL A <br />SUBTOTAL S <br />PERMIT 5 <br />PERMIT S <br />TOTALFEE 5 <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />FRONIELIBACK <br />RAP SEtBAC. <br />f[E BFiBKII <br />Ry1 GEC. iO <br />L <br />IEE <br />RFCfvIM <br />IISE lCNf <br />IOIAR• <br />vACA <br />EE9 <br />VALUATION <br />FEE <br />n .f' n No <br />llut� <br />Nfpxl lRBtA1GN <br />NWM OK[LLND <br />SUL DI MOLTI <br />MIS <br />R YN0 <br />pXIMMf.1 'd GE1MEE <br />OCCIX'ANIIWO <br />YBEYfxr <br />YEMAM•.4 <br />OROIF <br />nYE6 n No <br />FRE 0PRM1uR Rao <br />TEASON <br />ADGr101Ml RMIGEC. <br />OTRR <br />'"[RA mgv <br />InA5;M1 <br />BIAIE Macro NAIDHIAPaE <br />Im OF sl <br />nANSARRaov[onr <br />CITY OF EVERETT <br />wuE Rave <br />LOCAL SALES <br />TAX CODE 18 J105 I <br />TOTAL <br />I"Tt <br />