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APPLICATIL��1 FOR CON�TRUC7.,N PERMIT <br />CITY OF EVERETT • BUILOING DIVISION <br />9200 CEDAR STREET • EVEREIT, Wq g8201 • 259-8810 <br />��MO�� ❑ COMIBINATION ❑ BUILDING ❑ MECHANICAL ❑ p�UAABING ❑ SI(iN <br />PROJECT ADDRESS: <br />MLMTCCTpqpESKNER MNI�WNE55 GITY <br />��� 1'NONE <br />7iC ����E ST�TE UCENSE � <br />aUABR!(fCONTRA�Tpp 4ut11DDRE55 Cltt <br />IIP PHpNE ST�TE IICENSE � <br />conm�cr �E � �K <br />.� �—�. _ <br />UESpME WpV( ANU SOWIRE FOOTIIGE W VOLVED <br />ioT �'? -I > e�ouc �f� / <br />��siiiliit���l� <br />� <br />8 DISP <br />TRAV <br />J/y <br />ONE MMEER <br />ITEM <br />SUB <br />— � TOTAL <br />FOR OFFlCE USE ONLY: <br />i11dIT5EiBAp(_ _ / PEARSEiBALK <br />ll�� <br />� � _2 �o,.aE� — <br />/IEI6HTUUITATIO'1 NpOFOWELl1NG <br />•7 ) � UMIS <br />S <br />f <br />SIDE SETB� <br />WC�N� <br />❑r s ❑ rro <br />SIIE pF BIIXiR I <br />❑YES ❑ ryp <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC p <br />CONT�Gt PERSON �NO F�qryE Np <br />I HEREBY CERTIFV THAT I HAVE READ AND EI(AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COqqECT Al.l <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WIIL BE CAMPLIED WITH WHETHEF SPECIFIED HEREIN OR <br />NOT. THE ORANTIi7G OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OH LOCAL LAW RE6UUTING CONSTqUCTIq� pq TME <br />PERFORMANCE OF CONSTqUCT10N. THAT I AM AUTMORIZED BY THE <br />ONRJER OF THIS PROPERTY TO PERFORM TME WORK Fpq yVf{ICM <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />e9M�CiL18$,LAW iB.27 qCW AND 296.200 WAC. <br />GTV BUSiNt55 LICENSC Np <br />FORCED AIR <br />HEAT PUMP <br />UNIT HEATEF <br />GAS <br />/ I �UN CI IECN NUMBFO <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />BVIIDIHb <br />FUINBING <br />MECN�N�C�I <br />ADpIIONq. M �N �pC LN <br />O1MER <br />ST�IE BUIlOINC SI1RCIURGE <br />rviAi ir, wonKs <br />70TAL <br />��re <br />SUB TOTAL f � <br />PERMIT f T, — <br />TOTALFEE f � <br />fEF D CEIAT NO <br />/32 � <br />VALUAT6N FEE <br />�1 Z'i/� �l`✓�i - <br />