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APPLICATIO.., FOR GOI�ISTRUCT[ �N PERMIT�}�. <br />CITY OF EVERETT • BUILDING DIVISION �� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />. � <br />❑ DEMOLITION ❑ COM8INATION ❑ BUILDING �C'S MECHANICAL O PLUMBING O SIGN <br />PHOJECTADDRESS: `1�CG�� �e-�),;��'L`� l�L��— � '"�L(_ �K�'� <br />pyyqEp MutA�piE55 CI(V IIP P110NE <br />��E !'�_�.�ICY�— � �L� I^lc�� ;�J'1 `i , !�C � �'� � �C � 5 �5 ��� � <br />.�...�. �.�� .�o« r.nr m r��or+e <br />onoeSicHer, � �Men.woness arv nr� �•��u�t <br />�Kl�\C , <br />PlUM9�NGCON7R�CTOP M�IIADDRE55 CIIY IIP PNpNE � SfAfELICENSE• <br />cor/rn�crvn�ceovvmnK . IHEATINGSYSTEM: �GAS OELECTRIC ❑ <br />� '�C'i r <br />pE$CRIBE WOi1R AND SOU�RE FOOT�GE INVOLVEO �nN1�C1 Pf f150N AND PNONE NO <br />VROPOSED USE OF 9UILOINu <br />LE6�L �ESCRIPTIpI OF %10% <br />LOT BIOCK <br />PAHCELTNfI.D.NUMBER � <br />CONSIRVC7�ON LONI LENDEP <br />�rt�cN mo <br />V V LJ �.� <br />IELEPNONE NUMBER <br />NO. TYPE OF FlXTUAE OR ITEM <br />WATEH CLOSET (TOILEn <br />BATHTUB __ <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASHER _ <br />LAUNDRYiRAY <br />CLOTHES WASHER <br />UR�NAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />PERMIT E <br />70TALFEE f <br />FOR OFFICE USE ONLY: <br />iRUNTSETOACN PF.�P SFTBACN S�DESFTB�Cn <br />USEIONE <br />HEICIIT LIMIi�TIOH <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TrPE OF <br />WORK WILL 13E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTIN6 OF A PERMIT OOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW FEGUUTIN6 CONSTRUCTION OR THE <br />PERFQRM4NCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY JD-P�RFOR NE WORK FOR WHICH <br />APPLICATION IS MA AND �1 JYI TNE STATE <br />CONTRACTORS lA .2l R AC. <br />_//�� <br />X ATE <br />SI6N�TUfIE <br />CItY BUSINESS LICENSC NO <br />NO. <br />I1EAT PUMP <br />UNIT FIEATERS <br />CLOTHES ORYERS <br />WOOD <br />PIPING <br />PERMIT <br />TOTAL FEE <br />f <br />PIAHCIIECNNUMpff1 IfEf I(1Ff.FlP(NO <br />IOI�RE� V�CANISIIE rcc.. <br />❑YES O NO �IIiI��Hfi <br />NO OF U1YElLING SIIE O� B106R1 <br />UNIIR PlUM01NG <br />OLW��NILO�U BASEMENT MFCIInWGM <br />❑YES ❑ N� <br />App1110N�1. �l AN G�� LN <br />RF�SON <br />ourtn <br />RFASpN <br />ST�IC OIIIlU�N6 SUnCluflfE <br />binNserrnovEnor CITYOFEVEREIT runiicwonKs <br />LOCALSALES <br />,,..� TAX CODE IS J105 TOTAL <br />