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APPLICATIO.. FOR CONSTRUCTkiN PERMIT PTf`I1 <br /> TO BE COMPLETED IN INK LEASE PRINT <br /> CITY OI <br /> evlere <br /> BUILDING DEPARTMENT HEATINGSYSTEM: __ <br /> OAS ❑ELECT IC U ____ _ <br /> - ---- <br /> 2598910 <br /> /gwQ!DEMOLITTIION COMBINATION BUILDING ECHANICALLPLUMBING SIGN <br /> 6rL -�U 11W �no-eV�•si<. CITY gr 7w 37 / —17,97 <br /> YF"NI � MA4+WPE5n 'CRY IP PTICK <br /> AAC.111 CY M CfAl,4F R MAR A(IfIRF SS CITY }IP <br /> Of W RAI C0111RA ICYA MAIL AMWSS .E / FC�ITY• IIP y�Ey���/�f h10NF .CEMnfE <br /> MFGM{.ICAILPI <br /> 'Pl/K//1111n/K//w�� rw WILADONESSE 1C/—/,• C�CITY, 7F F4YIE !ILENYE <br /> case c�wdw 1 ox, <br /> NEW ADDITION /ALTERATNkI REPAIR DEMOLITION WOODSTOVFARPL INSERT BUILDING RELOCATION <br /> -- � / �E�E CONiACi RRbM 40 RIp4 N0 <br /> CP11M 9 MC[OE WOT //rLr/ IJ�b— <br /> D[SCRIFfYpRI.PIg6ODARFF AfH AYIdvfO <br /> PnoPonmusEv nuAww 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEGAL 1)1 106101`Pb!PFRrY ISTKRYN KIM OR ATTACH IMP CMASI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT wax a NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ! AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 PFRFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298200 WAC <br /> 6 <br /> DATE <br /> rwlFCi POOIIEnn Ll <br /> PPNwrt9cm LA:ENsr I., �YY` .I . ...I <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> _ WATER CLOSET(TOILET) AC–AHNDLG UNITS–H P —r– <br /> BATHTUB FORCEU AIR SYSTEMS–B.T.U. M E A <br /> LAVATORY RVASH BASIN) UNIT HEATERS–B.T.U. M _1— <br /> BHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHESWASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN AREPLACE INSERT _ <br /> FLOOR DW.IN HEAT PUMP 1 _ <br /> BACKFLOW PREVENTERS GAS PIPING Z PF <br /> ROOF DRAINS–JIAINLEADERS EXHAUST FAN <br /> SINK(SERVICE–BAR,ETC.) <br /> SUB TOTAL f _ SUB TOTAL f <br /> PERMIT f _ _ _ _ PER f <br /> TOTALFEE i TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> 1pWrSFIEPdI REM nERAGF n0[nfRPC1I RNI CNFCIIMNNR III RfC[IP.Ire <br /> UU"IF IOT AREA VAUNT PTE FEES VALUATION FEE <br /> BUADM <br /> TYEIp(ON114101YM1 rYq p(91gT 1[IWl Oblwir bOpM11f VPIE <br /> MaI PLUMBING <br /> &lE CI4O( NO Ix STORAS WEMEMT MECHANICAL <br /> O1:C11MNCrIpAp EwFSPRNAIfASRfOO KIOMILMRAVOIN ADDITIONAL PIAN CHECK <br /> OTHER <br /> REAA]H FOR IPRn11R f RS <br /> STATE BUILDING SURCHARGE <br /> PITAPF AY - PIAM AMIOEEow CITYOFEVERETT PI/BLIL WOI1Ns <br /> LOCAL SALES <br /> TAX CODE All TOTAL <br />