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�. <br />APPLICATI�rN FOR CONSTRUCti ION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION 6d COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING n siGN <br />L�1G✓R�l-�f �lf EArrIE N/� �RR4/ 2 � 31 N��H b�lM 9yE E vlLaln' 9 4� cr t.Sti "7 4so <br />TENANT MIUL�WRESS CITY ZIP PHpNE <br />Sm�,E <br />�RCNRECTOROESH3NER MIUIMDRE55 CITV 11P PHONE <br />Nn�6�►�,r ��sr i��L N��N�.rro tvt' 2S1-1rSo M��c.1�z3��b <br />OENEMICONiMCTOH M/JLADOpESS CITV ZIP PNONE ST�TEIKENSEI <br />MECMMlIG�LCONINIICI(1N MNLADDRESa CITV 21P PNONE ST�TEUCENSE� <br />PLUAIBINOCONTFACTOp MAILADDRESS Cltt ZIP PHONE STATEUCENSE� <br />DA� 8f.�, �S 3�11rKR�hr� �,^r 2.f'9�.98o pAVC'� cn itsde. <br />ISa��° ,-. <br />ce� MroaK ��ro <br />Fr <br />- O�PC <br />ioT [. ��� e�oac _l.s_3— <br />�"..����',�.�" S632- 4.; 3-0 l9-oco� <br />CONSiiI{ICT10N LdW LEWEA. App1E53. TELERq11E M1MEEi1 <br />TrPE <br />WATER CLOS <br />BATHTUB <br />UVATORV (W <br />SHOWER <br />KRCHEN SIN <br />FOR OFFICE USE ONLY: <br />FRONTSET711p( ! REMSETB'CK <br />?� 5 <br />USEZONf� � IOTMEA <br />{/ � <br />HEATING SYSTEM: ❑ GAS [BELECTRIC ❑ <br />WNT�CT PERSON �ND PHONE N0. <br />LARRY N?�/3'�H LS� ^ i4Sa <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF UWS AND ORDINANCES OOVERNINO THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN�OR <br />NOT. iHE ORANTINO OF A PERMIT DOES NpT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REOULAT�NO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV ?HE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CANTRACTORS LAW 18.27 RCW AND 298200 WAC. <br />x a�1r'%�i�G-� ll- 2i-`�y <br />SIGN�NRE p/�Tfi <br />QiY BVSINE55 L <br />MECHANICAL <br />FEE N0. <br />SUB TOTAL S / <br />PERMIT S <br />'OTAL FEE S <br />SIDE SET&1C1I <br />S' ip <br />V�C/1NT TE <br />nres n ra <br />�T�TpI NO.pcDWEUJN(7 SIZEOFBLD6R1; <br />/ unrts .L <br />! ND.OFSTOPoES OCQIPANTLOAD B�SEMENT <br />�A ❑"ES <br />'�REOD pE/�$pry <br />� <br />FORCED AIR SYSTEMS — B.T.U. M <br />HEAT PUMP <br />UNITHEATERS—B.T.U. M <br />WATER HEATER <br />WOOD STOVE <br />6AS FIREPIACE <br />FEE <br />SUBTOTAL S �_ <br />PERMIT S i <br />TOTALFEE S _ !— <br />y� .� �.�, /3 <br />) PIANCNECKNUMBER FEE RELEIPTNO. / <br />�loa�a � 5gI 3 ��95/sd� <br />BUIIDINO / 7 <br />MECIIMlICRL <br />ADqTONAL PIAN CIIECK <br />OTMER /I��%/lrl'1 <br />STATE BURdNG SURGHIIROE <br />"""""'°, CtTYOFEVEREI'T rueucwoaKs <br />I �_ 9 TAX CODE S 3105 TOTAL <br />