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5 APPLICATIrN FOR CONSTRUCT"ON PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT ��77 <br />BUILDING DEPARTMENT I HEATING SYSTEM: �f 6A5 U ELECTRIC U <br />259-BB10 <br />DEMOLITION I I COMBINA71ON ul BUILDING I49ECHANICAL }x PLUMBING I I SIGN <br />ERR usA Atxxass city m rwrE <br />SND1_rm�t� f W1t- _L57o?-iew, — - <br />city lE' agrE ETArEtEEM. <br />P.C. QoK �L�7Q1,am4S W71 9t�10ty6RIG1f1t <br />I I AnMTKW I I At TPRATIM I REPAIR DEMOLITION I I WOODSTOVEIFRPL INSERT I I <br />N <br />canNfr PnsE a NdH <br />k VT 9OS 131Q <br />PEscna[twra Alo wuArt rUUtAn Mh P <br />tT-• <br />vnlrvv+u rrtrnn�n mn� I <br />S• � 1 C _ 1'p�11 • 1 e <1 ,�N�r, <br />Iron pr nRI rK rmKr rlslxmN rttayRR AtrAGHaA1 91 <br />Lm rtacK ur __— <br />n <br />-- - / -- <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THI <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. At <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPED <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OI <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVI <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANOTHER STATE OR LOCAL LAW <br />REGULATING OR TH <br />PERFORMANCE OF CONSTRUCTION. THAT II AMAUTHORIZEDBY THi <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICI <br />APPLICATION IS MADE AND I COMPLY WITH THE STATI <br />CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br />x 1) LA,,) S min 9; <br />wutct i�xwn of <br />ra ). �•r�g l) n'r <br />PLUMBING <br />MECHANICAL <br />NO, <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET LTOILET <br />AIC-AMNDLO UNRS-H.P. <br />T <br />BATHTUB <br />_ _ <br />_ <br />FORCED AIR SYSTEMS-B.TU. M E.A. <br />' <br />1. <br />LAVATORY WASHBASIN) <br />UNIT HEATERS-B.TU. M <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />I <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />' <br />DISHWASHER <br />7 ' <br />RANGE HOOD <br />1 <br />LAUNDRY TRAY <br />7 <br />WATER HEATER_ <br />CLOTHES WASHER <br />WOOD STOVE <br />I <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />HEAT PUMP <br />�— <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAWS-AAWLEADERS <br />EXHAUSTFAN <br />I <br />SINK ISERVICE-BAR, ETC. <br />' <br />7 I <br />I. <br />SUB ro1At <br />f <br />SUB TOTAL t <br />PERMIT <br />f <br />PERMIT i <br />TOTAL FEE <br />f <br />TOTALFEE f <br />' <br />FOR OFFICE USE ONLV! <br />rROKI uiRACA <br />REM M1MOI <br />eOE AHAAq <br />RI111GIEcx R <br />R <br />.07 <br />rtC <br />Mx <br />W <br />"1s <br />tOTWA <br />M tar - <br />%" <br />FEES <br />VALUATION <br />FEE <br />RunlKrq <br />ALAIBIIAT <br />37 <br />�S�nt� <br />76i <br />tm atsxn ulwMar <br />17- <br />omrtt Acrwt <br />- <br />rmwa. eswtu.ru.n <br />r'°Fy I <br />AIrERltPU <br />) Sf GAR <br />KU VEtartE <br />eAMtEtR <br />/•� <br />MECIIAMCAL <br />i <br />AMOONALPLANCHECK <br />igg <br />_ _ <br />OglaNlLy)OAP FaEEEI. mIEUU IEMMt,TArm <br />A No Z <br />AEAEM FUR e.IrA¢tro <br />-wmowwm <br />STATE BIIADKlR 91IICNARDE <br />"TAua 7rtARE <br />AFFnPtTor. <br />2 13 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />runuc wmxs <br />2 <br />70TAL <br />�_ n1 i/9 <br />