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ARPLICATI�'-�1 FOR CONSi�UCT-�ON PERNAI� �w�� <br />CITY OF EVERETT • BUILDING DIVISIOIv <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-BB10 <br />PLUM8ING ❑ SIGN <br />❑ DEh10UTION ❑ COMBINATION ❑ BUILDING �3-1AECHANICAL ❑ <br />PROJECT ADDRESS: <br />-- • - •-• . i— - �..,,__ <br />TENNIT MNL�OOi1E55 ���Y �i� Pi�OME <br />�•RCIMTEGTd10E51GNER M�IIADDRE55 CIfY 7m P�IONF <br />I�IIFF +d'Y n'+cr ---- -- <br />GENER/�lGON10�C70R 4eilADDRE55 Cnv liP �iIONE SUTEUCENSE� <br />r- _. � . ._ � . . i< < /lenr.. l�l.?iii�hii-,ri<</9/ L�� <br />IiP <br />PlUA6MlGCON7RACTOii YM�A�%7i�E55 C�n' ZIP P110NF. ST�TELICENSE� <br />IEMI OESCNPTION O� PROPI <br />�oi e�ocm <br />FOOTAGE INVOWED <br />IOMI LENOER. ��E55. TElEP110NE <br />TYPE OF FlXTURE OR ITEY <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KRCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />HEATING SYSTEM: LN�AS ❑ ELEC7RIC ❑ <br />CONIACf V[RSON AND P110NE NO <br />FEE <br />— SUB TOTAL S <br />---i <br />PERMIT S <br />TOTALFEE f ' <br />FOR OFFICE USE ONLV: <br />iRONT SEiBhGN AE�R SF.TBACK S�OE SFTfl�CN <br />USE IONE LO7 �BE� VACANI Slif. <br />❑YES ❑ NO <br />HEIGNT LIAMT�iION ��OF DWELLING SIZE 0: fl� IIG/I I <br />n nr <br />nYCS ❑ NO <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />I HEREBY CERTIFY THAT I HAVE REA� AND E%AMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE 7RUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEHMI7 DOES NOT PRESUME TO OIVE <br />AUTIIORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW REdUUTING CONSTRUCT�ON OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTNORIZED BV THE <br />OWNER OF TNIS PROPEflTY TO PERFORM TFIE WORK FON WMICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW iB27 R.W AND 296200 WAC. <br />x � ,�,/ r��� / - /ti _2'�- <br />SIfiNATURE U11TE <br />CITY BUSINESS IN:fNSC NO <br />Nl� � rvn��wv vnu <br />FORCEDAIRSYSTEMS { — <br />HEAT PUMP ' <br />uAIITNF�TFNS %!i '�` AO� �� i .__ <br />HEATER <br />MEfAL <br />SUBTOTAL f <br />PEf1MIT f <br />TOTALFEE S <br />ri�Nc��ECK�+ur�Nfn reo InEr.emTr�o <br />.� 9//�_n. . <br />p111101N6 <br />PUIMI11N1: _'__'_____.__ "___. ___' <br />MFCI1�NIf.�I. <br />�ODII ION�I PI �N CN( CK <br />qu�En <br />StAIE OUIl0�NO511RCIUIIGE <br />Pllflllf. WOf1N5 <br />TOTAL <br />