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7Zcny <br />APPLICd�T1�J FOR CON�TRUCT�N P�RMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAh STREET • EVERETT, WA 98201 • 259•8810 <br />❑ OFMOUTION ❑ COMBINATION p BUILDING ❑ MECHANICAL ❑ PLUMBING U SIGN <br />PRpJECT ADDRESS: 8014 "C" Beverly Blvd. <br />OWNEiI MNI�UDRE55 CIIY 71P PI�M+E <br />we�ch's Conatruction Inc. 6233 76th Drive S.E. Snohomish 98290 337-3528 <br />TEIUNT MNL�DDRESS GIY 71P PIIONE <br />ARLIpTCCTd10E51GNER MNIAODOESS LIfY 71P P110NE <br />6ENEIWCANTMCTOR Mul�00RE55 CIIY l�f P��ONE SI�TEIICENSE� <br />Welrh's Gonstr�ction, INc. 6233 76th Drive S.E. Snahomieh 98290 337-3528 -- <br />MECNI�N�CACON7WILTOR MAIL�DDRESS fArv IIP P110NE STATEIICENSE� <br />PlUA61NGCONTRACIOR M�IlAD0iiE55 LIfY ZIP PMONE ST�TEIICENSE� <br />Robineon Plb <br />cor/riucr v� ov wonK <br />yqpK 11NU 5q1ARE f00iWE wVOLVED <br />Pf10PO4E0 USE OF BULDINO <br />t[au oEseroPnaN a vnorEnn (�rowN eEww on �rt�cN nvo coMes� <br />iot e�ocK <br />PANLEL TA1I ID. NUMBEP <br />LENOER.ADORESS.TEIEPHONk MIMBER <br />0 <br />TqAY <br />WASHER <br />SINK <br />FOR OFFICE USE ONLY: <br />iP[1NT SETBACK PEAlISETBACN <br />USEZONE <br />HFIOMT UM1f�T10N <br />OCCUPANCr MO 0� <br />IOT <br />ITEM <br />NO Uf OM'ElUNO <br />UNIIS <br />fAL S <br />f � <br />EE f ' <br />S�DE SE7BACN <br />VAL�Nt SIIE <br />❑YES O N� <br />S�IE Oi 9LOdf I <br />B�SEMEI1i <br />❑YES ❑ Nn <br />3 <br />HEATING SVSTEM: ❑ GAS ❑ ELECTRIC O <br />cor�ucr r[nsw+�r+n rNor+e wo <br />I HERE�Y CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />AFPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS Of LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WOPK WILL BE COMPLIED WITH \YHETHER SPECIFIED HEREIN OR <br />NOT. THE aRANTINO OF A PEHMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OFl LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEH OF THIS PROPEflTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS 1827 RCW AND 296200 WAC. <br />x 3�/z%-j <br />SIGN�lU11E DATE <br />CtIY C'J:1fIf.5c L�C[!tSC >/O <br />NO. TtlPE OF EOUIPMEHT �_ FEE <br />Nr — A/HNl]L6 11NfTS <br />HEAT <br />UNIT <br />HOOD <br />HEATER <br />S70VE <br />GAS PIPI� <br />tXHAUST <br />OIIIIf➢Nf. <br />riuuon�o <br />MEf.1111NICAl <br />•pp IIOHAI. PI �N U�f LN <br />pp1° (13 Hgada', <br />$1,V E BNI I�iNR Si IOf.11�fIRE <br />BY CITYOF::Y'ERETT runiMwon.s <br />LOCALSALES — <br />,q i TAX CODE IS 9105 To7aL <br />)TAL S � <br />T S "—T <br />FEE f _—!— <br />IEF � �ECFIPiNO <br />