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_ � <br />APPLICAT�ON FOR CONSTRUCTIJN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETi; WA 98201 •(425) 257-8810 <br />DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />ROJECT ADDRESS: �2p � !'U� Du� c, � U �✓ �� �� , y � �U( <br />�._ .l� G �/.,,,<,,,., ����_�n �=�,�%✓G 5t. ��Cv� .L�%G. �/82oS` 33`iZ7,� <br />7EN�NT M�I1.��DpE55 LITY IIP PIIOHE <br />♦RCHIT(CTOFDE9GNEf1 M�IL�OIJRE55 LIiY Im PNpNF <br />GFNEMICONTMCTIXi M�I1�00�E55 GI7V 7�P PHO4f. Gf4TCLIC[NSE� <br />MFCN�NIWLCONTRACTOR MAR�WHES <br />PIUMBINGCONiR�:TOR Il� �DORES: <br />���� <br />CONTR�Ci C'-OFWORN <br />,� i vh vt�i o N 5 <br />OESCRIBE RN �Nb SOWPE FOj3(�GE IryVOIVF <br />j��M1 � �IIONf STATF. t�CENSE � <br />qtt � �z�p PHONF $TAtELILENSF� <br />� � .� � �1 S ��SgLL <br />, _ <br />- � HEATING SYSTEM: ❑ GAS ❑ EIECTRIC ❑ _ <br />GONTACTPFHSON�NDPNONF.NO <br />LEG�L DESCRIPTION OF PROPERTV ISHOWN BELOW OH �T7�GN TWO <br />l07 BLOCN OF <br />LOeNLENDER. <br />PLUMBING <br />NO. TVPE OF FlI <br />WATER CLOSET (?C <br />BATHTUB <br />LAVATORY (WASH E <br />SHOWER <br />KITCHEN SINK 6 DI'� <br />pISHWASHER <br />IAUNDRYTRAV <br />CIOTHES WASHEP <br />DRINKING FOl <br />FLOOR DRAIN <br />TELEI'MONE NUMPER <br />— BAF, <br />OR ITEM <br />SUB TOTAL S <br />PERMIT $ -_� <br />TOTAL FEE S I <br />FOR OFFICE USE ONLY: <br />fRONTSFTA�CN PF�RSFiBRCK <br />us�zoNF �o�eac^ <br />MEIGMI IIMI1�ilON NO OF UWELLING <br />UWf$ <br />OCCIIPnNCY NO @ 5��RikS IX:CIIPANI LOAD <br />ar�our <br />�iRC SPRI4KLER Rt0'0 <br />FIR[ AtARM REO'D <br />lYf F <br />UAiF <br />I HEREBY CERTIFY THAT 1 HA�E READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDiNANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE <br />PERFORMANCE tlF CONSTRUCTION. THA7 I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH TFIE STATE <br />CONTRACTORS LAW 1B.?�Z�1CW !j(JD 296200 WAC. <br />BUSINE55 LICENSC NO <br />NO. TYPE OFI <br />A/C — A/HNDLG U� <br />FORCED AIR SYSTI <br />HEAT PUMP <br />UNIT NEATERS <br />CLOTHES ORVERS <br />RANGEHOOD <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />$IDESEIB�CR PUNCnECKNUMBfP <br />vnc�r+r sne FEES <br />❑rEs ❑ No nunnmr. <br />SIZE Of glDGrtl <br />rwunwr. <br />BASEMGNI M1�pp��ry��p� <br />" ❑YES ❑ NO ------ <br />J.DDI I IONPL PI AN CNf.CK <br />omen <br />$tpif fillilf)�NG SUf1CURRCE <br />CITY OF EVERETT runiir.wo��Ks <br />LOCALSALES " <br />TAX CODE IS 3105 70TAL <br />' Z La ' 1 <br />FEE <br />SUB TOTAL 5 � <br />PERMIT E � <br />TOTAL FEE b <br />��� nFr.rmrHo <br />