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.-, <br />APPL.IC,i�TIL.� FOR CONSTRUC7..)N PEi%MIiG <br />CITY OF EVERETT • BUILDING DIVISION �+y��� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 25J•8810 �rT <br />❑ DEMOUTION ❑ l:OAIIBINrA�TION Q BUILDING ❑ MECHANICAL �LUMBING ❑ SIGN <br />PROJECTADDRESS: GG 1 JJlJIz 1 AVf LVl'i/Pi�� h/�iT 7 <br />�>�� 11 s3 <br />OWNER M�ILADp1E55 tltt ZIP PNON[ <br />v/ZCnJ !a% ��'r' ��3J •� fi`R lux./.?�� ui:c� �t ,���,<��p�� ��G�-7b7 CG7LY3 <br />IENANT YNLMI0RES5 / CI.Y / 71P NIONE --- <br />�� <br />ARLNITECT pR pE51GNEq Mqt �OOqE55 CITY vin nw�� <br />Mul <br />M�111 <br />OESCqIRF Wq11N I1ND <br />CIfY <br />�; <br />S� -o <br />PIIONF SUiE UCENSE • <br />/ s"' //1YC � c �<' 98—'7/ �$ —!�! S' <br />CJ�j HEATING SYSTEM: ❑ GAS ❑ ELECTRIC p <br />' � . LONT�CT {'ERSONAND PIqHE NO <br />r /� ) ) <br />� ,/%/''�� �4��% / � / � S C .1- <br />� r <br />G-�.�GAr ��iv sv �'-� <br />PppPO$ED USE OF RU\IL / / <br />I/L%)LF� �/Ytp/ �/�✓l'' <br />lE6Al0�'SCRIPTION OF PIIO^ERTY (��� BELOW ATT N TWO CONES <br />lOi � BLOCN pF .��' 9� <br />5�✓ y� o�� �UE' /✓ �� i <br />Zr� n/ ,�v� � c= � t✓M <br />PAqCELTNtI.D.IiINMEP � <br />CON57t1UCTION Lw�r IENDER. �DD11E55. 7ELEA1p1E Ny�o EN <br />_ /72�7717f2 PAfL// / 'ISc-�t �u,i, <br />5/�/ -n`r�1 z <br />NO. TYPE OF FlXTURE OR ITEM <br />WATER CLOSET(TOILEn <br />BATHTUB <br />UVATOIIY �WASH BASIN) <br />Z SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />' UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />ROOR DRAIN <br />BACKFLOW PREVENTERS <br />FEE <br />SUB TOTAL f <br />PERMIT S <br />FOR OFFICE USE ONLY: <br />iRONTSETB�CK REM SEiB�CK <br />Z�o Z�' <br />USE IONE lOT ARE� <br />�'� � 5 8� <br />HEICNT LIMITATION � N�l OF OV/E14N6 <br />� UNIIC � <br />sioe serq�eK <br />S <br />VAC�NT S�iE <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TYPF OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOR�TY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER :;TATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AN AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM T,�E WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS I.AW 1827 RCW AND 2g6.200 WAC. <br />x `�..._ �r% �� O�-f�� /s�* yL <br />swN ne ' o�Te <br />D27bSo <br />c�n eus�r+ess i�cer+sE r+o <br />FEE <br />FORCEDAIRSYSTEMS I � <br />UNIT HEATERS <br />CLOTHES DHYER: <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE <br />FIREPLACEINSERI <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />SUB TOTAL f <br />PERMIT f <br />TOTALFEE S <br />PUN OIEGN NUMpCR I PEF � I REf.F.IPf NO <br />c �-�,a <br />�5 � � BUIIDING <br />512E Oi BIDG T I <br />676 g � � �1U401NC <br />8A. MENT MECN�NIf.�I <br />❑YES Nn <br />ADDIIION�L i'UN GIIECM <br />ou�en <br />sr�ie ew�n�r+o suncrunce <br />CITYOFEVERETT rueimwonns <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />