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�, _ <br />APPLICATII..� FOR CONSTRUC7.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BnUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SION <br />PROJECT ADDRESS;� �� ,3(7 �•, _ �, I n „ „Y J�r,,o <br />uu� a�ss <br />MCMTEL70R OESIGNER MNl �ODRESS C11Y 71P MqNE <br />OENERKCONTMGIp1 MNL/�WRF55 CIIY /IP PIIONE SUTEIMENSE• <br />M�ECM�MCIILCONTRACTOR NAILAOORE55 (:ITV 21P PIqNE STATELICENSE• <br />o¢ warc �ro sou�ne spqr� Mvaveo I, <br />_�aas '�•-v2uAc..� d- f!t <br />MIOl09EDUSE OFlUKOM/O <br />� oesawna+or viarEmv �s�own ee�ow aa �n�w <br />tOT lLOpt OF <br />MIICEL TIUI I.D. NIMER <br />CONSIRUGTION LdW lENOEN.l100PE55. TElEP/10pE M111lER <br />K�� <br />NO. TYPE OF Fl)fTi111E OR ITEM <br />w�reAcxoser�roaen <br />��� <br />LAVATORY(WASH BASIN) <br />BFIOYYER <br />KlTfxiEN SMNt 6 DISP <br />DISHWASHER <br />• IAUNORY TMV <br />CG OTMES WASHER <br />URIPIAL <br />SUB TOTAL S <br />PERMIT S <br />FOR OFFICE USE ONLY: <br />FRd/T SEiSACI( IIEM SETBACN <br />IISE ZOqE <br />NEqNT 11MT�T10N <br />�ur�r�cr w a s <br />RRE SPItlM(LFN REO'0 <br />FlRE NMM REO'D <br />LOT�RE� <br />HO OF DWElllpb <br />UNITS <br />SiOE SE7MCk <br />V�CANT SIfE <br />DYES ❑ NO <br />512E OF MOdf I <br />❑YES ❑ NO <br />' IiP PNOHE STIITE LICENSE � <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />conucr reasaN �ro w� no <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVIS�ONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLIED WITH NMETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITV TO YIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REOULATINfi CONSTRUCTION Oq TME <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />ONMER OF THIS PROPERTY TO PERFORM THE WOAK FOR NRIIf,'H <br />APPLICATION IS MADE ANO I COMPLV WITH THE STATE <br />CONTRACTOqS LAW iB.27 RC AND 29 200 WAC. <br />X ( —J �—� �o <br />� WTE <br />GTYlU9NE3$ IICENSE NO. <br />�• I rn� af Ea�eNr I �E <br />/rN � N111V <br />FORCED AIR <br />HEAT PUMP <br />UNIT HEATER <br />CLOTHES DR' <br />FiAN6E HOOD <br />WA7ER HEATE <br />WOOD STOVE <br />MEfAL flREPL <br />flREPLACE IN�� <br />GAS FlREPLA( <br />(iAS RMl(iE <br />OAS PIPIN6 <br />DQIAUST FAN <br />BULDING <br />PLIIMBING <br />MECMAMC/�L <br />ADpIION�L M�N CNf.CN <br />OTNER <br />ST�IE BUIID�NC SIIpCN�fK:E <br />CRY OF EVERETT runur.won�s <br />LOCAISALES <br />TAX CODE IS �105 TOTAL <br />SUB TOTAL S <br />PERMIT f <br />TOTAL FEE f <br />�EF I �f.E1PT Np <br />