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-., <br />APPLICATI4.� FOR CONSTRUCTrJN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-BB10 ��" <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ( �IA��]CHANICAI ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: `-� �i Z(1 C`� RP�+�1 li AV � U'� g�3 <br />owr�n ww�od�ss an zir r� <br />� _ _ _ �(...� ,f,l..�_ . _ /1.1 /.� nN,_� "?I/� � �i/n� <br />11qpMTEGT OR OESIGNER N111L AIX)RE55 <br />1 <br />MF <br />i'L <br />oE� wcw� �to sou� roor� �vwveo <br />�lyl-.5'tA 1�.. �� �l c� f1CL <br />� �� l�i 1� i1 �►o�Flc� <br />` ( �� v� A��l� -� t��l� <br />o use oF euxu�o <br />lEMlOESCRIPTION OF PIIOPERTY (511DWN OEIOV <br />iot e�ax _ oF. <br />�". "'":,�1 <br />TYPE OF FlXTURE <br />31NK 8 <br />IER <br />TRAV <br />URINAL <br />DRINKIN6 FOUNTAIN <br />7NK1 COPIES� <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />F110NTSEil�1Gt REMSE7MCK <br />USEIOME �OTARE� <br />11fpHTUMIT�TION N01f�DYVEWNO <br />o�TE <br />�,r <br />GTY <br />un <br />an <br />FEE <br />SIDE SETMLK <br />VACANT SIIE <br />71P _ P110NE SGTE}ICENSE� <br />PIIONE <br />SUTE LICENSE � <br />HEATING SVSTEM: �GAS ❑ ELECTRIC ❑ <br />CONTAGT iER50N NA PIIONE NO <br />� C <br />� Z�z� ���� <br />1 HEREBV CERTIFY THAT I HAVE NEAD AND Ef(AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF IAWS AND ORDINANCES (iOVERMNG THIS TVPE OF <br />WORK Wlll BE COMPLIED Wlhl WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTIN6 OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW RE6UlATINO CONSTRUCTION OR TME <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTIiORIZED BV THE <br />ONRIER OF THIS PROPERTV O PERFORM 7HE WORK FOii MMICH <br />APPLICATION IS D OMPLY MATH TME STATE <br />CONTRACTORS .4ND 200 WAC. <br />an �u icense no. <br />MECHANICAL <br />NO. T/PE OF EOIIiMENT FEE <br />ivai—�vnn <br />FORCED AIF <br />HEAT PUMP <br />RANGEHOOD <br />WAiER HEATER <br />MEfAL FIREPLACE I <br />FIREPLACE INSERT <br />6AS FlREPLACE <br />GASRANOE <br />SUB TOT/l S <br />PERMIT f <br />TOTALFEE S <br />PlANC11ECkNUE�BER . I iEF I RFCEIPTNO <br />❑YES O ND BUILDINC <br />&2E OF E100�T1 <br />PUlA�81N0 <br />lASEMENT MECNIINIC�I <br />❑YES � NO <br />�DDIIION�L''L�N GN(:Ck <br />01NER <br />ST�IE BUIlU1N6 5�1fiCM�RfiE <br />CITY OF EVERETT runur,vroe�s <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />