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0 <br />APPLICATION FOR CONSTRUCTION PERM17 <br />/M� �µ� CITY OF EVERETT • BUILDING DIVISION <br />�p( 3200 CEDAR STREET • EVERETT, Wq ggpp� . p59-8870 <br />I-I DEMOLITION fl COMBINATION fl BUILDING f� MECHANICAL f� pLUMBING fl SIGN <br />PROJECT ADDRESS 1 <br />OWNEN ��' I I 1� S 1 . �V'P�Q�� W M • � V Z� I <br />MRIL ADOIlE55 ��n <br />-Da,2u�ir� �, liu.Fy ,o, goK ��4 , Eve�u.tt � uJa 9szo��������E / �/� <br />7CNANT MnILADLRESS (z�..y� %�2 I'�%J/LJ' <br />IlY 21P 1 0 E <br />SAM6' AS OWnrCv2 <br />ARCMIIECTORDESIGNER MAIIADURE55 __ <br />GENEOALCONIMC70q uui <br />� �-;' ��� � P110NE <br />".y(,. .�. // � IP SIAfLIII'fN5[• <br />UESCf11dG WO(iK AND SOUAIIF. PppIAGE INVOLVEU <br />Excaare S�rt �,a Fx:�urs ' Fu� <br />w�rN taP�aE sioK CP�r ser IJacu'� <br />TL6uCf(��Y I"u rr R� t�a /� s,yla <br />C1) 4�K4� �aeGR Inr�rg5 W/SfEpS CU <br />�bnUusk. 8kc� u i � s<� �b,� <br />i noroseu us� ov uuuowc <br />�i�Q <br />iecn� u�scmrpuon ar ri�ortntt �snawN naow o�� <br />lOT �� Ip BLOCN ,�� � _ Of �l <br />IION lOAN LENUFN. AODqE55. iGLEF110NE NUMBEfI <br />Tbu'�- N! _' f 5-17,2ndsr d. <br />SY�� A/2. , eua6 rUn1� u1k . 9b <br />NO. TYPE OF <br />KITCHEN $�NI( g � <br />DISHWASHER <br />LAUND— Ry -- <br />CLOTH�HE <br />URINAL <br />�� <br />DRINKI�p�NT� <br />FLOOR DRAIN <br />BACKFL <br />SINK fSEavir.F _ <br />FOR OFFICE USE ONLY: <br />fllON15Ei0qCK ) RGAlISFTUALI( <br />us6 2p p / Lut �II� <br />� -- Z <br />❑EICIII LIMIIQION� HO Oi pWg��N4 <br />UNiL`: <br />OCIUI'ANCY NO 01 SIpIbL$ OC(;UI•ANI LOqU <br />G� 3 I <br />N /a <br />Flf1EALMMHEO-D iv.e�...� <br />or <br />/ SIDE SE70ACR <br />VACAN� / � <br />� �,�s � � ��� <br />HEATING SYSTEM: f I GAS �~r ro� <br />Bl ELECTRIC fl <br />CONIACT PERSGII R!D PIIONE ND <br />% <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAIAINED TNIS <br />APPLICATION AND KNOW THE SAME TO BE TqUE AND CORRECT. ALL <br />PROVISIONS OF lAWS AND ORDINANCES GOVERNING Tf iIS TYPE OF <br />WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A pERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF qi�Y <br />OTHER STATE OR LOCAL LAW REGULqTING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 29G.200 WqC, <br />x ���... � <br />SIGNqTURE <br />on�e <br />CITY dUSmESS uCENSC NO. <br />N0. <br />-- ���—n.r. <br />FOflCEO AIR SYSTEMS — D.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — p.T,U. M <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIflEPLACE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />� <br />� <br />SUO TOTAL § � <br />PERMIT g <br />TOTAL FEE S ,� , <br />lPUNCIIECNN��yy p[q ��� <br />. //1^/� I7ECEIP7 NO <br /><t X / <br />bUIIpING <br />5RC Of OIUG/I I <br />�3Z� sf 1'lI/M�ING <br />u.�s[uENT <br />� Meuurvica� <br />fIYES p <br />ADpI I IOfIAL PInN CIILCN <br />omcn <br />sTaie omioinr. swiainncc <br />CITY OP EVERETT runuc wonKs <br />LOCULSALES <br />TA% CODE IS �105 TO7AL <br />J � <br />. <br />