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APPLICATI019FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />0200 CEDAR STREET A EVERETT. WA 08201 • (425) 257-B810 <br />[.1 DEMOLITION ❑ COMBINATION 0 �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:,(,�%[��;I�e Cro,s�f9--�::-��'SI�Cs-Q.E '_Z�$;�1b %-�✓ EI�'C-)j-. <br />ItMwl um ylplllss nir In — <br />nlorR <br />tRLY1rtCl pllpyprlSR uw NK]lf S% <br />r+elrt fr.rl <br />n1111PMr CMIRAr.TM W41nnI1StS CI6 1rV Mp1E ptlE llC[A31. <br />CONIRACI MCIp NVprr �� �—^`— �• <br />lNS f f <br />HEATING SYSTEM: ❑GAS DIELECTRIC ❑ <br />pXRSi ou f MJ WI SWIAaVI o <br />- hmr s�1� rao 4n J K food <br />cDNucrnR)pN.l(I nfYR rq <br />— <br />I HEREBY CERTIFY THAT I 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 WIIL 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 />APPLICATION 15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IA tf RCW AND 2% 200 WAC <br />�/I� V <br />E S��.tl�o � f 6 6 -F e <br />�'Rp'Avollsl Mllldxn <br />N. men <br />LfoAL XRTrpNp PllptRn IPIORM YIOYI OR AOAp T1Yp CpRM <br />for Moral p_ <br />IMr BIAS III WIIIKA <br />CdItIMILrgN10W 11MFR.IMMFSS iH(nIryF M1411FM1 <br />lrWAIUII! nAn <br />PLUMBING <br />CITY MISR[SS LCIW W) <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EGUIPMENi <br />FEE <br />WATER CL05ET (TOILET) <br />NC—AAIMBLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE H000 <br />-LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />I <br />METAL FIRFPLACE(WOOD BURNING) <br />DRINXR/G FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />_ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC) <br />UAB PIPING <br />EXHAUSTFAN <br />f� <br />I <br />_ <br />SUBTOTAL 5 <br />SUBTOTAL 5 <br />PERMIT 4 <br />PERMIT 5 <br />TOTALFEE 5 <br />I <br />TOTAL FEE 5 <br />I <br />FOR OFFICE USE ONLY: <br />Rlrf Tl Ro <br />+. ru1MR Mml MY <br />all GRu MRflnn <br />IIMIAIgM AKI p PwlllMO EYf p MOORI <br />UMIA n1AA1M <br />OYrs Or <br />---- <br />WWII <br />SON MKPMII VF IJIn1r <br />CITYOFEVERETT <br />nKlc w(YUA <br />LOCAL SALES <br />-- <br />TAX CODE IS 3105 <br />TOTAL <br />