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APPLICATI. N FOR CONSTRUC . JON PERMIT L61 <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />ATY a <br />everett F HEATIN08YSTEM: ❑OAS OELECTRIc O_ <br />BUILDING DEPARTMENT <br />rTIAIINp WNiR.tldl WI APPR[66 �- I:IM1 II MANE ICFNSfr <br />w, ma <br />NFW ADDITION ALTERATION REPAIR DEMOLITION WOODSTO'/ElFRPL INSERT BUILDING RELOCATION <br />LOITRACT MEE Or MtIM �� <br />rP <br />C�d'1�1i'Li�RTP�JPM <br />I Od0 <br />AN.ID.'1.rLIO_MF <br />, 1PC� Plb Y1f1 �� <br />dlLpef ANpidIARF idJI [0 <br />^ <br />--L�✓(F/'y}y�� <br />/7 n pp \) <br />l..wnc lW�'�J�o1 <br />o a onD <br />rpDrDgiM ..v iQG <br />L <br />LQ[./CMeux, <br />EXAMINED THIS <br />1 HEREBY CERTIFYY THAT I HAVE READ AND ANDCORRECT. <br />APPLICATION AND KNOW THE SAME C BE TRUE AND CORRECT. ALL <br />7HIS TYPEHEREIN OF <br />PROVISIONS OF COMPLETEDAWS AND WITH WHETHER SPECIFIED <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />TO VI <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION CR 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 I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC, <br />snNAtuRE n cwraAnoR of Aop wrlopafo eoENl�oArE <br />xc <br />IFON pFBCRATgId MOfNR IENgYNMIOW AnALN rdRI coRAN <br />'-TW �JLJ 1 <br />UI,C <br />APgIGN16 U1Y B111MfplllCr ANDF18f165 N!v� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC—NHNDLG UNITS—H P <br />BATHTUB <br />FORCED AIR SYSTEMS-6 T.U. MEA_ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B,TU. M <br />SHOWER <br />CLOTHES DRYERS <br />VENTILATION FAN _ <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE A CHIMNEY <br />_ —�— <br />T <br />y <br />_ <br />KITCHEN SINK B DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />.TEAT PUMP <br />BACKFLOW PREVENTERS <br />GA9 PIPING <br />ROOF DRAINS—RMNLEADERS <br />EKHAUSTFAN <br />_ <br />SINK (SEFNOE—BAR. ETC.I <br />i- <br />-T <br />SUBTOTAL <br />f <br />SUBTOTAL $ <br />PERMIT <br />f <br />PERMIT f <br />TOTALFEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />intlNl ff IBALR <br />RM6L W. <br />WIN um" <br />RAN CNECA HUNTER <br />rEE <br />RECEPTNO <br />lNEt <br />LOTARIA <br />NACANT MR <br />FEES <br />VALUATION <br />FEE <br />BURDMO <br />flNd wwn NlowNLE <br />rrriaaNLT atluu <br />Tavr.s+ Ava�IR+nN.+ <br />r1O1 <br />RUMBMD <br />EIEe tX Elm <br />i1O a AIDREA <br />AAMYFNT <br />MECHANICAL <br />i <br />ADD17ONALPLMCWCK <br />(K,CdRNCr LOAD rEN lAYRA4ER6 REDO 141DNTlAF1ATKN <br />R[AAdiiM FPRAN [M <br />OTHER <br />STATE BUADM6 SURCHARGE <br />MAxEe� <br />nArn oeY <br />CITY Of EYERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />rvpLlG xroRRs <br />Tout <br />