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-. <br />APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl OEMOLITION �l COMBINATION f� BUILDING F�MECHANICAL �l PLUMBING (l SICaN <br />PROJECT ADDRESS � G� � `,� � � �p � � <br />O <br />-..�.-.. m.�..w�r�n cm zm rHovc <br />�i��,eC C��so t �IGS" ��f/noar/� �r-%!� �s O/ .�S -j 3�3 i <br />TEN�NT M�IL�DDPF.55 dtV 71P CHONE <br />ARCMITECTJPOESIGNER M�II.ADORE55 �ITV )IP PNONF <br />GENERMCANTMCTIXi MalA0f1RE55 Ci1V ]IP P�ION[ SiAtELIC[NSE� <br />�vt`rc��7` �-vcv�/.k c� S� . sG /2 �• sie��, t�rU, �ie�isdi� `1�.�3 �3.i 3— 3?2 2 <br />MECNRNIC�LCONTRACTOR� Mu�ppDR S � �ITY 71V PIIONE $TRTELILENSE� <br />PLUMBING CONTR�GTOR MAIL �DDRE55 CITY 21P FNONE SiATE LICENSE • <br />�utSl:/Nine K� SW�REFO�O^T� INVOCIVED <br />t 7Q _ L�� V ��G r�`il� <br />tw Yh � r YG 4 n �� � <br />��_ <br />SED USE OF BVILDINO C�'/'� <br />J �� <br />LEGIIL DESCRIATION pF PROPERtt �SNOMM BELOW OR 11TTACH <br />toT eiocK or <br />PARCEITA%I.D.NUMpEP <br />CONSTRUC710NIOANLENDER.�DDRESS.TEIEPHONENUMBEP <br />NO. TYPE OF <br />WPSER CLOSET <br />BATHTUB <br />SHOWER <br />Uld <br />FEE <br />SUB TOTAL $ � <br />PERMIT $ <br />I TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />fRONT5FfP4Ck RERIiSFTBACR SIDESETBRCH <br />❑SEZONE LOT�REA VACINLSILF. <br />IiVES 1 NO <br />HEIGNT �IMIiATION NO Of DWELLING 512E Of 9lOGrt1 <br />UMfS <br />/MS MPPOVEp OY <br />UAIE <br />(IVES I16'O <br />HEATING SYSTEM: I�i'�;AS �l EIECTRIC f� <br />CONTr1CT PERSON nND PHONF. NO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE S0.ME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A FERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLAT': OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LA\V REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CUNSTRUCT!7N. THAT I AM AUTHORREO BV THE <br />OWNEH OF THIS PROPERTV TO r'ERFORM THE WORK FOR WHICH <br />APPLICATIQN IS MADE ANC I CGMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 R�''J AND 296200XJAC. <br />CITY BUSINESS UCENSC NO <br />A/C — AMNDLG UNITS — H.P. <br />FORCEDAIPSVSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — �.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />Itl1:7��1_CN7 <br />91:71�[r' <br />Pl6N CIIECN NUMOf.R <br />ouiineic <br />PLUMPING <br />M[CII�NIGRI <br />AOO�11pN�L PL�N C��fCK <br />OtN[R <br />STPI[ PIIiIOMf SURCIURGE <br />CITY OF EVERETT rimur,woms <br />LOCAL SALES <br />TA7( CODE IS 3105 TOTAL <br />SUBTOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />fGf � Pff.PPT ND <br />FEE <br />. <br />