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APPLICATIG J FOR CONSTRUCT JN PERMIT <br />CITY OF EVERETT • BUIIDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING I� MECHANICAL ❑ PLUMBING ❑ SIGN <br />PRUJECT ADDRESS: H�%�/ S�O �Ll�n� � �R, �� <br />owrrta <br />Mu1�0011E55 <br />Cltt Im PNpNE <br />TENANT MNIMOPE55 CITY 7�P <br />I1RLM�ECT OR DESN:HEH M�II 110011E55 CITV 7iP MqNE <br />OFNEPQCONTR�CIOR M�R�Ud1E55 CiIY ]�f PiIONE GI�IEIICFNSE• <br />�.�X � L Pi¢C' . Fi L <br />MECN�NICALCANTR��TOiI MARADI%IE55 CITY 71P PIIONE ST�TELKENSE� <br />� <br />oEscw�eE <br />n�vaveo <br />tor eioac <br />A0011ESS. TELERIONE Ml1ASER <br />WATER <br />LAVATORY <br />SHOWER <br />DRINKING FOUNTAIN <br />ROOR ORAIN <br />bACKROW PREVENTERS <br />SUBTOTAL f <br />PERMIT S <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />FI10NT %TBACK RE�p SFTB�CN SIDE SETB�Ck <br />USEIONE IOTME� V�GIN�SIIE <br />❑YES O ND <br />NEIf3NTLIMITATION NOOiOWEILMG SIIEOFBICGrtI <br />UNIi$ <br />❑VES ❑ NO <br />IIEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONI�CT 1'[RSON A/q MqNE Np <br />1 HEHEBY CERTIFY THAT I MAVE READ �4ND EXAMINED THIS <br />APPLIC�TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS TVPE OF <br />WORK WILL BE CAMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br />NOT. THE ORANTINO OF A PEPMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCIIL LAW qE6UUTINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTIOM. THAT I AM AUTMOAIZED BY THE <br />OWNER OF THIS PHOPERTV TO PERFOHM TH�. WORK FOR NMICH <br />APPLICATION IS MADE AND I COMPLV WITH TME STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />zr- ��-� <br />X <br />SION�TVPE 1 � D�TE <br />dTY BUSME55 LICENSE NO <br />NC — NHNDLG UNIT3 <br />FORCED AIR SYSTEMS <br />WOODSTOVE <br />MEfAL FIREPLACE <br />FIREPLACE <br />PUN CIIECN NUAI9CR <br />BUIIDINA <br />{'ll)u01NG <br />MECII�NILl1l <br />�OUIIIONN. PI AN Ci�f LK <br />nn��n <br />suienunowcsunaunce <br />CITY OF EVEREIT runur. wonxs <br />LOCAI_ SALES <br />TAX CODE IS 3105 TOTA� <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />fEF �aECF��TNO <br />FEE <br />