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APPLICATIO»FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 96201 A259.8810 <br />DEMOLITION f�MSINATIO/�N ❑ BUILDING „� MECH/AyN/)CALPLUMOING I 1 SIGN <br />PROJECT ADDRESS: >J /t`Q/ )J\7Y <br />MAR M ss a" TP nON[ <br />A nGIORmA m M.RA %% an RN n10rN <br />RIIWMO WNIR/LtOR MARfe011ESS am w AgMf InIE UGHfIKe <br />G011RACI p PRl}t <br />HEATING SYSTEM: ❑OAS ❑ELECTRIC ❑ <br />peowef Ara uuARf IOOIAOf MYQVFo <br />avl.cl rcRyoN.ra naR No <br />I HEREBY CERTIFY THAT 1 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 />CATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONT TORSL I84 CWAND2962WWAC. J <br />` I <br />efa M1E p vaq is <br />zi Al <br />M ae )ONO pERn IMa rr M{OnprAnACN IRowrtq <br />lot I cn p <br />SIP <br />TARIO MMMR <br />CONSIIIIICMWIwN1fN]ER. AppR83. nlfl'raR MVYKR <br />wlf <br />pneUSaESSIR:[NSf 110 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AC—MINDU3 UNDO <br />' <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />' <br />)MIT HEATERS <br />' <br />KITCHEN SINK A DISP <br />, <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRYTRAY <br />' <br />_ <br />WAIEN HEATER <br />CLOTHES WASHER <br />r <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT (WOW BURNING) <br />FLOOR DRAIN <br />r <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />i <br />SINK (SERVICE —BAR. ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />r <br />, <br />i <br />I <br />' <br />SUB TOTAL S <br />BUB TOTAL 9 <br />PERMIT S <br />r <br />PERMIT $ <br />/ <br />TOTALFEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />fRONI SEIR.CF <br />RYI eF1eAp <br />eaf Mll.A <br />nANl1[LR <br />r- <br />fff <br />RpIRI NO <br />MM NW <br />IU1.RA <br />v9" <br />One O NO <br />FEES <br />VALUATION <br />FEE <br />"twi <br />RIONIINeIAtaN <br />NO ROYRlLR10 <br />UMIA <br />NMpe{WRI <br />RINNNI <br />OCNPNN[t Ia df�RN{ <br />URPI� <br />OUIMNIIWO <br />eSYNLNi <br />OfF6 ONU <br />.RM.MEM <br />AOd1aNAlnWCrNCN <br />FfIEeFMRRRSRREOO <br />RASON <br />GIRO <br />fR HARM ROU <br />R.MIN <br />6t.lE eOl Onll SiRCN.Mf <br />^ <br />nKmr. rsl <br />nANL ARFRo.Tner <br />wit I <br />CRY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS D105 <br />nRi r. wOrwR <br />TOTAL <br />—� <br />