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APPLICATIG'_'i FOR CONSTRUCT: `.!N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEOAR STREET • EVERETT, WA 88201 • 259-8810 ����r <br />❑ OEMOLITION ❑ COMBINATION ❑ BUILDINfi ❑ MECHANICAI ❑ PLUMBING $ SKiN <br />PROJECTADDRESS: `o��OR L.�zTt+.��fit F�VE� �V£RETj <br />oH+rtn �.� .�.,�« _'.. -�- --- - <br />PIUMBNGCONTRACTOR M�ILAOORE55 GfY 11P PIqHE � ST�TELILENSEI <br />........�... � ..�..�... ....... � "l.v.lJ. � <br />oesa� wowc �w wu�ne roor�ee Mvaveo <br />P <br />�ot O� ' e�ou%Q,� <br />m� - c�an- ��.-�vv� i <br />CON5T11UCTIW ION/ LENDER, �pOpE55. TELEPIId/E NIIA1lER <br />WATER CLOSET <br />BATHTUB <br />WASHER <br />URINAL <br />DRINKINO <br />�.. <br />SUB TOTAL f <br />FOR OFFICE USE ONLY: <br />ii10NTSETB�Gk PEMSETBAGN <br />USEiONE (AT�REA <br />�'3 �-,0 5 : <br />HE16HTLIMT�TION 1q OFOWELUNO <br />O _ . _ UNIiS .. <br />' f"v'ilJ4 <br />ADE SETBACN <br />N�i� <br />VIIC�HT SITE <br />❑YES <br />SIIE OF BIDORI <br />❑vE5 ❑ NO <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONTACf PERSON MD %1plQ Np <br />I HEREBY CERTIFY THAT � HAVE READ AND E%AMINEO TFI�S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES 60VERNIN(3 THIS TYPE OF <br />WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY <br />OTHER STAtE OR LOCAL U1W RE6ULATINO CONSTqUCT1pN OR THE <br />PERFORMANCE OF CONSiRUCT10N. THAT 1 AM AUTTIORIZED 8Y T}1E <br />OWNER OF TMIS PROPERTY TO PERFORM TNE WOAK FOR VMICH <br />APPUCATION IS MADE AND I O�M Y WITH TME STATE <br />CONTRA LAW 1B.2 N WAC. <br />� ��I � s-a4 -�t <br />AAC — NHNDLO UNITS <br />FORCED AIR SYSTEMS <br />GAS FIREPIACF <br />GAS RANGE <br />PIIJI CIIECK <br />BUIIDIN(i <br />Fl11MBING <br />MECIUNiL�I <br />�U�IIIONq. f`L�N Gi2CK <br />0111ER <br />$T�IE BUII�ING SIIRCN�RGE <br />CRY OF EVERETT ruenr, wonKs <br />LOCALSALES <br />� TAX CODE IS �105 ioiAL <br />TOTAL FEE f � ' <br />FEf /_/� NEf.EIPTNO <br />!= <br />VALUATION FEE <br />T <br />ii/7f/1 �/�i� <br />