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APPLICATIO�FOR CONSTRl1CT1�1 PERMIIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 257-8810 <br />I O UEMOLITION O COMBINATION ❑ BUILUING ❑ MECHANICAL I7 PLUMBING ❑ SIGN <br />PROJECTADDRESS <br />ioy�� ��_ �� w_ ���.�r� r��. ,�z�, <br />� owe�cn <br />Cv <br />A{1GHI1WiOf1UE5qNEP MNU�DRE55 CIfY IN ' MNkIC <br />�I <br />GCNCM��pNOlnGipO MLiLA00PE55 LItY 3V Ylqll[ S�A�[p�[rySE� <br />/� <br />M[CII�IIIULCONiII/.C1011 M41�0011[$$ G�Y $Ip MION[ $IIIEIKCN.•.CI <br />1'I.IINUIIIGC01110/�Ci011 1A�RAWI1[SL LIIY 11P pIKKIE SI�IEIIC[115E• <br />n.n <br />3;52- <br />�ND <br />lio� l� o�ocn or �Cun�q <br />�.�. �Z <br />' vnncEunx m r�ouo[e <br />iSn�in4-O7�0-Gli ad <br />eaisinucnor+ioeHierrocn.eoa�Ess.reieruariee�uuecn <br />PLUMBING <br />NO. 71'pE OF FI%TURE OR ITEM <br />WATER CLOSET�iOILET) <br />onrnTuo <br />LAVATORY (WASf{ BASIN� <br />SHOWER <br />NITCHCN SINK B �ISP <br />DISHWASIIER <br />LAUNDRVTHAV <br />CIOTHES WASHER <br />UH�NAI <br />Df11NKING FOUNTAIN <br />FLOOR DRAIIJ <br />I FOR OFFICE USE ONLY: <br />rror+isem.cK nun; <br />7 n / <br />S <br />HEATING SYSTEM: ❑ GAS <br />CI <br />I HEREBV CERTIFY iNAT I HAVE RfAD ANO E%AMINEO 71115 <br />APPLICATION AND KNOW TNE SAME TO DE TRUE �NU CORRECL ALL <br />PROVISIONS OF LAWS AND OPDINANCES GOVERNINCo THIS TYPE Of <br />WOFK WILL OE COMPLIED WITH WHETHER SPECIFIED HEREIN Oft <br />NOL THE GHANiING OF A PEFlMIT OOES NOT PRESUME TO GIVE <br />AUTI{ORITY TO VIOLATE Ofl CANCEL THE Pf10VISION OF ANV <br />OTHER STATE Ofi LOCAL LAW REGULATM� CONSTflUCTIUN OIl TME <br />PEPPORMANCE OF CONSTRUCTION. THAT I AM AIITHOIiIZED �Y 7HE <br />OWNER OF TIIIS PROPERTY TO PERFORM THE WORK FOR WHICiI <br />APPLICATION IS MADE ANO I COMPLY WITIi iHE STATE <br />CONTPqCTOfiS 1027 RCW AND 2962UO WAC. <br />x / - � Z �' � <br />SiGru1 o�lE <br />CIIY�USiNE SLIC[IIS[Iq. <br />TYPE OF <br />CLOTHES <br />METAL FIREPLA( <br />FIREPLACEINSE <br />GAS FIREPLACE <br />Nuu9EB <br />,{ vnt�vrsnE FEES <br />Y fJxES lTn� <br />uuwum <br />siic or oiocn i <br />2 1� S PlU4BiM: <br />815EMENt � MECIPNqµ <br />mcs N.�?o <br />.1W�1qN/dRµCpECR <br />OII�Ef1 <br />SI�IE BORDifq SUPCnI,OGE <br />CITY OF EVERETT ruoi�: rronas <br />LOCALSALES � <br />TAX CODE IS 9105 TOTAL <br />SUDTOTAL S <br />Z� I nc<[mr i+o <br />