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A�PLICATIOrr FOR CONSTRUCTIvN PERMIT <br />CITY OF EVERETf • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, W!� 98201 •(425) 2!i7-8B10 <br />❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ CAECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: G% Z'L Q � ��• �.� ' v-c iz t�1�5 � tS' Z"� <br />L � �2 �z/z /1�.,� F�t��ft � s�„tr%li�.��' <br />L L ✓�/ �' l�Jl. .v i� �� ai�� � <br />Orn n fR�J�-''–� <br />M;L[ �Ge�/c�l.�����,�.L <br />�_ �-0- =1 <br />�ncwTrcronoEsicr+en uu�eonaess cin rm r�w�+F <br />GFNEML CONtMCT0�1 M�It �D��E55 <br />--�iiY 1�r rnpvf. Gl�r[t�tENCE. <br />MFCN�NIL�LGON7R�CTOP M�R�CDRESi <br />f.11' 21P PNONf Si�TF UCENSE � <br />PIUMBINGCON7R�f,TOR M�IL��E55 CITY IIP PHONF 51�TEUCFNSEi <br />�ESGRI WORK �HD SOUAPL FOOUGE INVOLVED <br />ri�A(.IG ' UP �� <br />�c nr.e Sf u %�NS•" <br />Pf10i'OSEO USE OF BUI INC <br />LEGAL OESCi1IPlION OP PROPEI1fV ISHUK'N BELOW OR �TIAG11 <br />lOT 9LOGR Oi <br />PMCEL lA%10 NIIMBER <br />CONSTRUGTION IO�N i.ENOER. /�WPE55. LElEi9�ONE NUMP"cR <br />NO. TYPE OF <br />WATER CLOSET <br />BATHTUB <br />KITCHEN <br />URINAL <br />DRINKING F <br />FLUOR DRF <br />BACKFLOW <br />SINK(SERV <br />8 OISP <br />OR ITEM <br />FOR OFFICE USE ONLY: <br />rnnNr svrn�ry7 . nFnnscTn�c� <br />uSF lon� �J � 10� MEe <br />��� <br />NEIGIII 1 �MIlAIIUN <br />rv s innn c <br />� <br />`.� � <br />rint nur�N nEa�o <br />,� o <br />1 vPE .^.� cON<� <br />I�—,� <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />MO OV'DWELUNG <br />IRI�Iti <br />(H:f.UP�NIIO�D <br />/ <br />f1F�50N <br />nF��nv <br />p�naSnrrPovff <br />7/ZL <br />oa�E !A �I <br />smc <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC � <br />LONi�Ct CFPSON �Np 1'HONf NO 1(�� �,� O �f 7 R (' (/ <br />I L�✓ v J � L J:� N/� i L I\ ) 1 V—)� C Z <br />I HEPEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICAT�CN AND KNOW THE SAME TO DE TRUE AND CORRECT ALL <br />PROVISIONS Of LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE �OMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERM�T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OFi LOCAL LAW HEGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br />OWNER OF THIS PAOPERTY TO PERFORM THE WORK FOR WHICH <br />qPPIICATION IS IAADE AND I COMPLV WITH THE STATE <br />CUNTRACTORS LAW iB27 RCW AND 296200 WAC. <br />_—=�L��a� �( " �� �i % <br />x O�IE <br />S:GN�TUPE <br />GITY BUS�NESS IIGENSC NO <br />N0. TYPE OF E�UIPMENT �___ FEE <br />A/C—AMNDLGUNRS I <br />FORCED AIR SVSTEMS _ I <br />UNIT <br />STOVE <br />GAS <br />GAS <br />SUBTOTAL S i <br />----r <br />PERMIT b � <br />TOTAL FEE E ; <br />nu�unr n nFrcmr r�o <br />�, , , �f3s � � ,:3/���� <br />V�C�Ni 511[ _ " <br />D�E$ ❑ HJ PWIf11Nf• <br />SiZE PIDG� � <br />O-7 � r�uuniNr. <br />B�SfuP: � Mprnebu'.q_ _'_' "__ <br />�OvES �qn _'"—_—' <br />AI)Di IIONM. PI �N C��«K <br />oi��En <br />suir nunuinr snnuunr.c <br />GTY OP EVERETT runi ir. woo�Ks <br />LOCALSALES '- <br />> TAX CODE IS 3105 T�TAI. ___ <br />p <br />