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WPr�N��' -� 311T; C � 283-� . <br />APPLIICA'�'ION FOR CONSTRUCTION PERMIT <br />CITY OF EVERE7T • BUILDING DIVISION <br />32U0 CEDAR STREET � EVERET7, WA 98201 • 259•8810 <br />❑ DEMOLI710iJ <br />PROJECT ADDqESS <br />� COM9INATION I�k BUILDINQ <br />902�" �,Jes� Nt�ll c�r; <br />k] MECHANICAL kl PLUMBINO ❑ SI�N <br />. ......_.._.......,_ ,.��. z��� ruoNe � <br />..Sel�h u�c� rnn �,2¢,1� 8�� Ave. W NI�-201 rveXg� VIA 9£3204 296/513-9006 <br />IENANT MNIAtlUtlE55 C�7Y . EIP PIIONE <br />Ai1CIX1ECfO110E51ONE11 MAILAOOf1E55 Clir iIP PIIONE � <br />OENEMICONIfiACTOR MAIUtlUtlE55 CIIv iIP PIfONE SIAIELICEN5E1 <br />F�lact yrn,�g•1uc`��� nfh avP W�A-7.N. �- PrP��L�IB. qezn4 �o.6/st�-qnn� SFr�x�rritnrz.ra <br />MECHN11CAlCONIMCIOR MNI,AbURESS ' CITY ZIP PIIONE SIAtEIICENSE/ <br />OLUN9INUCONtP�CiOR MAIL�7DRE55 CItY ZIP p�IONE STAIEUCENSE� <br />SOUARE i00T110E <br />ior 3 e�oac <br />� <br />� <br />IEIEPHONE NUMBER <br />�P �i <br />uB�' Sf. S�. � 9 <br />�TYPE OF FI%TURE OR ItEM <br />WATEq CLOSET (TOILETI <br />FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />ipONTSEIBACK } f1EAPSETBACK <br />iJa.� /J.a/ <br />Cf� LC/ <br />U8E2 IOTAREA�/ <br />3 �..J S � <br />IIEIONTUMIVITION / t10.OFOWELUNO <br />/7 v. . UNII9 <br />� <br />HEATINO SYSTEM: bd CiAS f7 ELECTRIC ❑ <br />CONtACi I'Ef150HAND PIIONF NO. <br />Peverly King 206/513-9006 <br />I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIB <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORHECT. AlL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIS TYPE OF <br />NiORK WILL oE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />'� NOT. THE ORANi1N0 OF A PEHMIT DOES NOi PRESUME TO QIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF AkY <br />OTHER S7ATE oR IOCAL lAW REOULA7INO r,ONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED B1' THE <br />OWNER OF THI3 PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION 13 MADE AND I COMPLY WIiH THE 87ATE <br />CONT ACTOFlS LAW 1827 RCW AND 298.200 WAC. <br />Se ect s, Inc. <br />z� xBY: ��rP Ylv� �/��5 <br />siaNntune on�e <br />u yda/) CITY BUSINE53 LICEHSE NO. <br />SI�EFEIBACK J <br />_� <br />� VACANTGIIE <br />� nres o wo <br />SIiE OF tlLDOR.I. <br />I1�� SF LwinlG ; <br />SF Gl�2ACs.� <br />BASEMENT � �� <br />[IYF9 ClNO <br />TYPE OF FIXiURE OR ITEM <br />NC — AMNDLO UNITS — H.P. <br />FORCFO AIR RVSTFMC — R �I I I <br />RANOEHOOD <br />WAiER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (1NOOD BUHNINi <br />FIREPLACE INSERT (WOOD BURNI� <br />OAS FIREPLACE <br />QAS RANOE <br />OAS PIPINO � <br />EXHAUSTFAN <br />SUB l0 <br />PUN CNECK <br />euamr+a <br />PLUMBINO <br />MECIIANIC�I <br />hObItIONAL PUN CI IECN <br />O711Ef1 <br />STATE 0Wt01170 SUfiCIlA00E <br />CITY OF EVERETT ruoucwanKs <br />LOCALSALES <br />TAX CODEIS 3105 IOtAL <br />FEE iiECEIPTNO. <br />VALUATION FEE <br />_ 6 v3�t <br />� <br />_ O ' <br />