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APPLICATION FOR CONSTRUCTI%,N PERMIT F <br /> Rw EwgAn TO BE COMPLETED IN INK—PLEASE PRINT <br /> Cm m <br /> everett HEAT ING SYSTEM: ]OAS ❑ELECTRIC J J <br /> BUILDING DEPARTMENT <br /> 2598810 <br /> Mao.DEMOLITION COMBINATION BUILDING ,MECHANICAL {PLUMBING_ SIGN <br /> l.al A P)ruoP 5tiLyl - s `, P1 �mFUeIP <br /> n%nAKt MAL wart% c it mole <br /> 1m,c, <br /> AFCMrECrdIiKSON[R WAArxm[SS CRY ZIP RNd4 <br /> O[NFRAL COMRKtaI YAKARDAFRS CM lip nATI! IKANrFr <br /> a Y��°�f- 311011 f-hll Arc. [��e.�ett �13aC.1 as95331 Nci�llxLl�rusR:� <br /> nLAArra cwTRAcmn LMEANR[% atr n n1OME LAXNS[r <br /> ,sdlTle� <br /> aAM n waw <br /> NEW ADDITION - - ALTERATION REPAIR DEMOLITION WOODSTOVE)FRPL INSERT ; BUILDING RELOCATION <br /> �}. m[rACTnRSdAxo rHGN[No <br /> caNFRAct rain s w QA( 'h ( <br /> o[ waw AAD[Kwx raorAa wvaATo <br /> Lka <br /> + l arc <br /> uM FK eu'L 1 I HEREBY ERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L[04 p[ V 1WERWj WiM pF ATTACH I"cony, PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> Lm anal a NOT THE GRANTING OF A PFRMIT DOES NOT PRESUME TO GIVE <br /> _ AUTHL RITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE )R LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> KM OEEMANCL OF CONSTRUCTION.THAT I AM AUT"ORIZED BY THE <br /> OWNER OF THIS PROPERTY TO P0FORM THF ` AK FOR WHICH <br /> APPLICATION IS MADE AND I COMELY WITH THE STATE <br /> CONTRACTORS LAW IS 21 RCW AND 296 20J WAC. <br /> �1 � FIGXATIME Gf rott�R�ac�ro�R�aR�w�i�w/Pmaoaa,'[x'r Tnrc '!`fin', <br /> uere <br /> rrnl[cT A[AYEM I d 1_LL:L�LIIY�LL���-L r l 1111a21� <br /> KAMI6[R a9W[%l/.[N8F xC141UMISN!%MM4 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOLMMENT FEE <br /> WATER CLOSET(TOILET) AC,-A,HNDLG UNITS-N P F <br /> BATHTUB FORCED AIR SYSTEMS-B.TU. M E <br /> LAVATORY(WASH BASINI UNIT HEATERS-A.TU. M <br /> _ SHOWER CLOTHES DRYERS <br /> KITCHEN SINK A DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHESWASHER WOOD STOVE <br /> URINAL METAL FIREPLACE f CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC. <br /> SUBTOTAL f SUBTOTAL f <br /> PERMIT t PERMIT f <br /> TOTAL FEE 61 TOTAL FEE t <br /> FOR OFFICE USE ONLY: <br /> rRGNI 11*7 K REAKMTM EOf RIMCK RAN LM[CK MAARR Fr[ R[CFwy NO <br /> LAY[GRE LOT AREA YACANTMt[ FEES VALUATION FEE <br /> WILDING <br /> O <br /> IN ms NL(IRrll MI a[[rt A[IWl OnNNw. rerwru,n <br /> br PLUMBING <br /> MI[wi%vi wOsT g RA3IFw r MECHANICAL <br /> TCLLPN[CTLOAP rwE[pMwLE11SR[OO [EATNT ATM ADDITIONAL PUN CHECK <br /> OTHER <br /> R[ASCNPOFL[MrLLEq <br /> STATE BUILDING 6URC[MROE � <br /> MTAII[M nANEAMIpY[OB. CITY OF EVERETT PURLK:wa+KS <br /> IOCAL SALES ' <br /> TAI(CODE IS J105 TOTAL r 1 ee <br />