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APPLIIGATION FOR CONSTRUCTIOIN PERMIT <br />CITY Of EVERETT • BUIIDING DIVI3!ON <br />320U CEDAFl STREET • EVEPETi, WA 9920! � 259-8810 <br />❑ DEMOLITION f"1 COMBINATION lit BUIL�JINQ fcl MECHANICAL kl PLUhi�iNO ❑ SIQN <br />PROJECT ADDqESS <br />9��� ���- ,�,.rr a�. <br />owr+en MnILA0Uf1ES5 cur nr PIIONE <br />sPia.a u.,,.�,�___, r��.i 2g� t 8t1� Ave. 1V NA-2Ql Gverett. F�� 98204 2,Q6/513-9006 <br />IENANf MTILbUfiESS cllY Z�P CIIONE <br />AqC1111ECiOfIbES�ONEP MNL�UUf1E55 CIIY i1P PIIUNE <br />OENEMI,CONIMCipi MAILAOOf1E53 CIIY 21P PIIONE 9t�tEUCEN5E1 <br />_5�,�,_t HanQ,� i'nc____1761j Ath AvP_ W. !IA-2,nj, F.vereL-t.�^lA 9�704 7fly/51'�-9�(lF SF.iFY`P711�KN <br />MECVIMlIG1LCONiMCtOf1 M41LAbpRESS CI1V Zm PIIONE SfAIEIICEN5E1 <br />PIUMBINOOpNIRqCfOR MAiIADbPE55 CIfV iIP PNONE STRfELICENSEI <br />CONTR�Ci <br />�ar 3S e�ocic <br />CONSIIIUC110N LOAN LENOEfl. <br />N, �• <br />PLUMBINO <br />iW0 COPIES� <br />�w� �(.� Cf t �ieS%� <br />TYPE OF FIXTURE OFl ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVAIORY�WASH BA51N) <br />6HOWER <br />KIiCNEN 61NK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOiHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PflcVENTERS <br />FOR OFFICE USE ONLY: <br />U9EZONE�✓� IOTAR � _ <br />( %� <br />IIEIONTUTAIT�TION / t10.OFUWELLINO <br />n g . UNIB <br />OF <br />N0. <br />�� <br />siae seTeACI( J <br />VACRNT SI(E <br />❑YE9 O NO <br />OF BtOM.I. <br />D . �� <br />L <br />BASEMENf � � <br />❑YE9 H'F!O <br />HEATINO SYS �EM: 6q QAS ❑ ELECTRIC O <br />coNtnm rensor+nNo riwr+e �+o. <br />Beverly King 206/S13-9006 <br />1 HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE THUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PEHMIT DOES NOT PRESUME TO OIVE <br />AUiHOAITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW 9EOULATINO CONSTFUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THI3 PROPERTY TO PERFORM TfiE WOHK FOF WHICH <br />APPlICA110N 19 MADE AND 1 COMPLY WITH THE STATE <br />CONTq ACiOflS LAW 1827 RCW AND 298.200 WAC. <br />Selec ames, In� �/��� � <br />sia nl�iunE onie �'�— <br />CIfY BUSiNE53 UCENSE NO. <br />NO. ITYPE OF FIXTUPE OR ITEM FEE <br />NC — A/HNDLQ UNIiS — H.P. <br />1 FOHGED Alq SYSiEMS — B.T.U. M E.A. <br />— B.T.U. M <br />FIREPLACE INSE <br />QAS FIREPLACE <br />OAS <br />FAN <br />7UNCya� � ��� IFEE AECEIVT <br />euaoir+o <br />� PLUMBINO <br />MECH�NICAI <br />I10bIIION�L PLAN CI IECK <br />OIIIEfI <br />STAIE OWl01NU SUOCIIMOE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />rueuc won!cs <br />iOtAL <br />