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APPLICATION FOR CONSTRUCTIRN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STRFET • EVERETT, WA 98201 s (425) 257-BBI0 <br />i I DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: AnI[ .SW' E'er <br />aGO•E- 1/2 u 004-1. d( 96204 NZ 5-)__ <br />ovwwn r •mnss bR !r a.«.rl <br />IINeMI MM Mu,'wss tln i FV,1 <br />•nCNRIt On Awb,in uY •AnK6i OR le q9R <br />g1tylNa CONA•rraP VUL"INDlN C." IV nIGA str-r11CTNW. <br />calmxt nxf a rlolsl 32 7 rp ` t? <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ — <br />mV;fWfF woq.�ul sou aolsm .Iwl�Jo <br />J+ c1 J le rOOc <br />cwl.cl nNsor •Nln.rr No <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 TII1S 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 I927 RCW AND 2%200WAAC pn <br />X`�'A"fj� • 6_O^7 U <br />vo uv elnld[I,I <br />Y1fe1{S <br />tfa4 xYnggAlwontnn lslX)Mtettawwenecw Two caeca <br />lot ftm IN <br />consm¢tivHtlultrtan. NKwtee RltnKYA nwnrn <br />EKAN11n 0.11 <br />CnlF %stCENMn0 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF RXTUII[ OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />AC—ANINDLO UNITS <br />BATHTUB <br />FORCED MR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />_ <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />WOOD STOVE <br />URINAL <br />I <br />METAL FIREPLACE MOOD BURNING)_ <br />DRINKMO FOUNTAIN <br />FIREPLACE INSERT BVD00 BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC <br />OAS PIPING _ <br />--_ <br />EXHAUST FAN_ <br />SUB TOTAL f <br />SLID TOTAL f <br />PERMIT E 1 <br />PERMIT f <br />_ <br />TOTAL FEE S <br />TOTAL <br />FOR OFFICE USE ONLY: <br />IANr vTAKe <br />wmwlwK <br />wMIALL. <br />nrticI9rX rK.. <br />O S <br />qr - <br />mef"M <br />t1M ralw <br />10IWA <br />W.WTOTAL <br />FEES <br />VALUATION <br />FEE <br />hntnrn-nI.M/I(1NfMY1f'4r0anp4 <br />RYIMQUtNnFrHI <br />FnbNM1 HKCN•AMCITT <br />_ _.L <br />LTA05 <br />nts r.lxu.e <br />TOTAL ___ <br />