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n <br />� � <br />APPLi�l��IL.� FOR CONSTRUC7.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DENIOLITION ❑ COMBINATION �J BUIIDING p MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: ��(j mn l'� A/?J P� <br />01H�E/R p �r MUL11ppiE55 CIfY I�p pHpN� <br />�.! P �f- . ) /' � !'i1 r' �i v n � � v r� .�,� 9 P _7 /� � 2 UQ � � B � �l <br />GTY IIP PIqNE <br />ira��- �o � sT�v�- �f 5��uens---- N��er�� iay�o <br />r+�w....nc��.n .N�wwncy� clrv Iip n11pNE STATELILENSE� <br />PIUtiBRMCp/TRACfOR MIJlA0q1E5S CIfV IIP PIqNE STATELICENSE� <br />CONTMCT M110E OF VIORN <br />%� �7 Z HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />OESCRIlEM�ORKANDSOW�FOOTKiENVOWED LONTACTPER$pNANOP11pHElq _ . _ <br />�or xoac <br />iU � <br />� <br />s�.�.�—nu� �oyu �c�c�c. <br />CONSIINIC710N LOMI LE/AER.IIDORESS. TEIEPIqHE HIMEER <br />•,�[�:....:i„rl <br />�..��� <br />BATHTUB <br />KITCHEN SINK 8 OISP <br />URINAL <br />SUB TOTAL S <br />PERMIT S <br />FOR OFFICE USE ONLY: <br />FIpNT SETB�p( PEM SETMCK <br />.-, „ � �-- , <br />USE ZONE� <br />r <br />NEI6Ni LIMTATION <br />� r / <br />AIMM REO'D <br />ra a ovrtwroc� <br />UNIf$ <br />IO�D <br />FEE <br />SIDE SEtBM:k / <br />S <br />V�CANT S�TE <br />❑YES ❑ NO <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF U1WS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOL THE 6RANTINfi OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL T. HE PROVISION OF ANV <br />OTHER STATE OR LOCAL UW REOULATNU CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MAOE AND I COMPIV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW ANO 296200 WAC. <br />r �i�.l��_ L� �f � - 9' � <br />� WTE <br />GiY BUSNlESS ItCENSE NO. <br />MECHANICAL <br />NO. TYPE OF EOINPMENT FEE <br />NC — NHNDLO UNITS <br />FORCED AIR SY�TEMS <br />UNIT HEATERS <br />CLOTHES DRVERS <br />MEfAI FIREPLACE <br />FIREPLAC.E INSERI <br />FAN <br />SUBTOTAL S <br />PERMIT S <br />�UNGIECKNUMBER fEF <br />�y��� vyZ�= <br />BUIIDINC <br />SIZE OF BLOG/f I - <br />5 � �. PlUM01NG <br />BA$EMENT � � MEGN�NILAt <br />❑YES �150 <br />•�OIIION�L Pt �N C��f CN <br />on+en <br />STAIE BUIIDING 51InCNMIGE <br />ar CITY OF EVERETT rueucwonKs <br />LOCAL SALES <br />��7 TA1( CODE IS 3105 TOTAL <br />