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�PPLICATIOI�a FOR CONSTRUCTI�DN PERMIT <br />CITY O� EVCRETf • BUIIDING UIVISION <br />3200 CEDAR 51'REET • EVEflETT, WA 98201 • 259-8810 <br />C? dEMOUTION 5E1 COMBINATION IA BUILDINO RJ MECHANICAL kl PLUIIABINQ ❑ SION <br />PROJECT ADDRESS �,O' ���� ,���r \ �, � <br />D <br />owr+Eq M�IL11Dbf1[55 c�rv zm "� <br />m ioNe <br />RralA,.�•_ u�.snc._.�J� BtS_i Av_�1 BA_20.�.�YQK��k�FIA 9ez01 ?9.G/513-9006 <br />IEN�Ni MNl/�bbqESS rIIY . i1P PHOHE <br />M1CItl�ECfO00ESt0!F_0 MNl�Uf1f1E55 Clrv 2IP n110NE <br />OENEMLCONtRRCI0i1 M���AOUt1ES5 CIIY Zln pIIONE SfAfEUCEN5E1 <br />se]�e��Han�, T�ne" 1�e>> n r, Avp��.�A-7.Q,j�Ti;__•:�4IA 98204�Q�51�-9(1(lfi_,Fr�rmrvrncn� <br />MECNIIMCALCONtMCTOP MNLAbOf1E55 CIfV ZIP PIIONE SUtEUCENSE� <br />PlUM91NOCONIRM,lIX1 MN�AODRESS CI�7 ZIP PIIONE S/AIELICENSE� <br />C�hi <br />OF BUILOINO <br />LOt � BLOCK <br />MVOLVEb <br />OR 11ttACH <br />tEIEPHONENOMBER <br />�P '�7� -'Z.�4 <br />45� z(13n` $i-. S.(.J. Sa� <br />PLUMBINO <br />NO. TYPE OF FIXTURE OR ITI <br />Z WA7ER CLOSET (iOILET) <br />z BATHTUB <br />z LAVATORY (WASH BASIN' <br />O &HOWER <br />FlOOR DFiAIN <br />FOR OFFICE USE ONLY: <br />FPONT 78ACN PEM SETBACK <br />��i ��i <br />U9EZONE �;.yN LOTRREA <br />j� 3� cwr• C 39 S <br />HEIOIITlIM1/�iLON NO.OFOWELLINO <br />^7 R � . UNI18 1 <br />�—CJ <br />��� <br />OCCUPANCY NO.Oi5I017E9 OCCU7ANILOAD <br />°�'3 s � N /� <br />TYPEOFCONST. PUNSnPI'�+U1vtutl� <br />� `J � . <br />:5��-N oeie 7 / �z/5 s <br />S�OE 6EtBACN <br />5 <br />V�CRNT 611E <br />�es n r+o <br />} <br />f7YE9 LYNO <br />CITY OF EVERETT <br />LOCAL 3ALES <br />TAx CODE IS 3�05 <br />HEATINQ SYSTEM: bq OAS IJ ELECTRIC f_7 <br />coNtnct rensoNnrro riroNe �io. <br />I HEPEBY CFRTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PHOVISIONS OF LAWS AND ORDINANCES OOVERNINO T;iIS TYPE OF <br />WORK WILL BE COMPLIEb WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE 4RANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUiHORITY TO VIOLATE OR CANCEL THE PROV�SIO'1 OF AP'Y <br />OTHER STATE OR LOCAI LAW PEOULA7INO CONSTRUCTIUN OR THE <br />PERFORMANCF OF CONSTFUCTIQN. THAT 1 AM AUTHORIZED BY TNE <br />OWNEA OF THI3 PROPER7Y TO PERFORM THE WORK FOR WHICH <br />APPLICAiION IB MADE ANO I COMPLY WITH THE STATE <br />CONtp AC70FlS LAW 1827 RCW AND 288200 WAC. <br />Selectj �ames, I�n7cA.�D <br />XBY: /� ` L�IB'�^ �D/2�O�y� <br />sior+mm�e onis <br />CITV BUS�NESS LICENSE NO. <br />TYPE OF FI%TURE OR ITEM � FEE <br />NC — AMNOlO UNITS — H.P. <br />FIREPLACE INSERT <br />qAS FIREPLACE <br />FEE E <br />� I FEE I PECEIPTNO. <br />BUIl01N0 � � <br />PLUMBINU <br />MECII�NICM <br />AUUI I ION�L PLM1N CI IECN <br />0711E11 <br />SLV E 9WLOINO SUI1C!��tl�E <br />OUOUC W011N5 <br />torn� <br />' <br />