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APPLICATI`.1�1 FOlR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �[]�MECNANIGAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS:��(jZ�C(��f,,qT .ST- <br />�j �M-u�t�WREdS Clrv )m r��ONC <br />_!lF f�� VCZ �75C L� t U <br />MNII�WRE55 � Clir rm --- m..u.� <br />ARCMiECTOi1DE51GNER M�IIMDnE55 CItY Ilr �uONF <br />PlWlM1CCONTR�CTOR M�IIADOHE55 CIfY 71P P1qNE STATEIICENSE� <br />1 / _ 1T — <br />�oT a�ocK a <br />PNICELTNII.D.MI4BEP n <br />���� ��I4/ ���� � <br />CONSTRUCTIdI IOAN IENDER. �DDRE55. TEIEPIqHE MlMBER <br />TYPE OF Fl%TURE OR �TEM <br />WATER CLOSET (TOILEn <br />BATHTUB <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />UUNDRV TRAY <br />CLOTHES WASHER <br />FEE <br />SUB TOTAL S I <br />PERMIT �- <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />iRdlT SI'ip�LK REM SFTB�CK S�UE SETB�Ck <br />USE IONE lOT �PE� V�C�NT SIfE <br />❑YES ❑ NO <br />NEIGNT LIMT�TION ra a owewnc site ov aiocrt.i <br />UNIfS <br />o�,E <br />❑YES ❑ NO <br />HEATING SYSTEM: /CI GAS ❑ ELECTRIC ❑ <br />r.rn�ucrvrnsor�umr�roH wo <br />I HEREBY CERTIFY THAT I HAVE READ AND EICAMINED THIS <br />APPI,ICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINIINCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WNETHER SPECIFIEO HEREIN OR <br />NOT. THE ORANTINp OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REODUTINO CONSTHUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WMICN <br />APPLICATION IS �- COMPLY WITH TME STATE <br />CONTRACTORS L 18. GW A 296200 WAC. <br />x � -��'% <br />SION11fUR � D� <br />GfY BUSINESS IICENSC NO <br />MECMANICAL <br />NO. TYPE OF EpU1PMENT FEE <br />FORCED AIR <br />HEAT PUMP <br />PLACEINSERT <br />FIREPLACE <br />RANGE <br />PIPING <br />1USTFAN <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE f <br />CnEf,N NUMpfO I fEF I REf.fIPi NO <br />�n _--�.. <br />nunniHc <br />Pl11YpMf. <br />MEC�I�NIC.�I <br />�DOI IIONAI. PI �N C��f C.M <br />mncn <br />SiAtE OUR01N6 snnCrinnOF <br />CITY OF EVERETT runi m vmrns <br />LOCAL SALES <br />TAX CODE IS �105 TOTA� <br />