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APPLICATIO_ _, FOR CONSTRUCT�^�N PERMIT�� <br />CITY OF EVERETT • BUILDING DIVISION �'%Vj�j _ <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 ��� <br />❑ DEMOLITION ,p COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br />PRWECI'ADDRESS: �/oZ /���,�;-,� Iav�_ <br />. �,_ <br />S� �z. <br />iE1UNT Y1UtADDRE55 GI1Y IIP 1`uONE <br />� FSi� el L, ti�S.� / 9 � i /�f nnr r�.il ST E✓PJt+.,T q Y�z+' i_ 31� -� i 3/ <br />ARCMTECTdiDE51GHER M�IIMORE55 GTY lm PNONF <br />NSG �D �nc 33Zv FVF1ih„-r 98�%'s 3i5���-t72 NSGGfu� l3�ny <br />OENEPN GONIRIICTO{1 M�iL11IXIPE55 Crtv 7�� ���ON[ $I�IC IICCNSE � � <br />MECNIINICK GONTR�CTOR MAII �OWiE55 CI1Y 71P PIIONE S1AT[ LICENSE � <br />PIUTASMGCON7Pl�f,TOR MAIL�0011E55 Cltt I�P ��E Sf�TELICEHSE� <br />�ni� <br />WdiN �ND SOUARE FOOT�GE INVOIVED <br />LEGAL OESCIMPjION Oi RTY (51 EElO'M OR ATt11CM tW0 LOPIE5) <br />ior ��f1���_ '� or <br />PNILEL TiVf I D NU�AlER <br />ylD2 Qr� -/ �-0�9 <br />CONSTtIlIG11pI lOM1 LENOEN. /�OORE55. TELEP11p�E 1 IAEEH <br />PLUMBIN(i <br />NO. TYPE OF FlICTURE OR ITEM FEE <br />� WATER CLOSET (TOILET) <br />BATHTUB <br />� UVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />UUNDRY TRAV <br />CIOTHES WASHER <br />S <br />FOR OFfICE USE ONLY: <br />iRONT SETBACK �j� AEAq SETBACN � 9� <br />USEZOME ( �Oi�REA V�C� 511 <br />�' 1 ❑vE5 <br />NEIGNTUMIT�TION�� UN1I�DWEIIING S��OBI�RI <br />(� <br />(K 51(Ntl[5 <br />FIRE <br />HEATING SYSTEM: ❑ GAS ��ECTRIC ❑ <br />CONT CTPE1150NN1DP/qHENO <br />�1_�. c.. _ iti� t��,_,.,fl� <br />l�+l 3rs- �Y�z <br />I HEREBV CERTIFV THAT 1 HAVE READ AND EXIIMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR <br />NOT. THE aRANTINd OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL lAW REGUUTINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUiMORIZED BY THE <br />OWNER OF THIS PROPEHTY TO PERFORM TME WORK FOR WHICH <br />APPIICATION IS MADE AND 1 COMPLY WITH TME STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />X /�`'^�,� t-i . ��^-:� � 9� l99lv <br />SKiN�TURE O�IE ' <br />CITY BUSINESS IILENSE NO <br />NC—NFINDL6 UNITS <br />FORCED AIR SYSTEMS <br />WATER HEATER <br />WOOD STOVE <br />MEfAL FIREPLACE I <br />FIREPLACE INSERT <br />SUB TO' <br />PERMIT <br />PlANC11ErKNUMPFR � fEF RFCFIPTNO <br />� ��-///_ %l!� <br />� � ' BUIID�NC <br />PlUM9MG <br />MfCH�NiC�I <br />❑VES NO <br />MD�IION�L PL AN C��f GN <br />OINER <br />STIOE Bt1IlDING SI1fIC1URGE <br />CITV OF EVERETT runnr. wonKs <br />LOCALSALES <br />TAX CODE IS 3105 iOTAI <br />FEE <br />