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APPLiq-TION FOR CONSTRUCTIC�'' PERMIT� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET.EVERETT.WA OB201.257•8810 <br /> ❑ DEMOLIrION ❑ COMBINATION ❑ BUILDING m MECHANICAL ❑ PLUMBING ❑ S�Op <br /> � PRQIECTADORESS <br /> 4711 5�h Ave W <br /> OWMEII <br /> uut�fqnE45 GiV Zi vnOVE <br /> KarenTrulilb 171151hAveW Everotl WA 4257�0665 <br /> iE1MMi NNIIu'.ME95 UN � <br /> <NAME> <ADDRESS> <CITV> �ZIP> <PHONE> <br /> un +v n'°"e <br /> r.np�rt[croxo[siu,cn ��°�^E� <ZIP> <PHONE> <br /> <NqME> <ADDRESS> '��TM' <br /> Gtt ID VI�ONE BUlEl1CFNSE� <br /> cEwEwuwr�iwcron uu��wwcss <LICNO> <br /> <NAME> <ADDRESS> <CITY> <21P> <PHONE> <br /> �. i� m�we surzuceruE• <br /> MECWLV1fKCWiMLIdi 1.WLID�AE55 <br /> FaslWaterHeater 12601132AveNE KiAland WA 98034 �a+M'hcw`ZM <br /> �, � pHq�E SiAiEIICFN9E� <br /> viwauacorrtn.r.*on ww�Ess �Z�p� �pHONE> <LiCNO� <br /> <Nqr,�E> <ADDRESS> <CITY> <br /> conrwc*oniccorwonK HEATINGSYSTEM: OGAS OELECTRIC O _ <br /> 4<9.00 conr�c��nea+u�ovwN¢ra. <br /> ocuvieewa+ar.rrosawwEroo��ccw+awao <NAME> <br /> Remove/Replace 3as Ylater Heater <br /> <PHONE> <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TNIS <br /> MPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> vncwuous¢aemm�ro PROVISIONS OF LAWS AND ORDINANCES GOVERNING TN�S TVPE OF <br /> WORK WILL BE COMPLIED WITM WMETHER SPECIFIED MEREIN OR <br /> LFGAL�EbCMViICNti✓NC�ER�Y�SWMH9ELOWONAIIACXIWOCCRES) NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �i --&�____o� ________ AUTHORITV TO VIOLATE OR CANCEL THE PNOVISION OF ANV <br /> OTHER STATE OR LOGAL LAW REGUUTING CONSTRI:CTION OR THE <br /> PEPFORMANCE OF CONSTHUCTION.THAT I AM AVTHORIZED BY 7HE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WMILH <br /> APPLICATIO IS M E AND � COMPLY WITH THE STATE <br /> CONTRACTO L 1 27ROWAND288.YOOWAC. <br /> PM[ELi4LD.MINBEN <br /> � ��H5f200� <br /> fqN9iPUC1qNl0.WlENDE0./.WNESS.IELEVNPYENVMBLF SI�T - DQE <br /> <NqME> <ADDRESS> <br /> Cltt BUSiHE55l SE MO. <br /> <PHONE> MECXANICIIL <br /> PLIIMBING {g <br /> Np, TYVEOFFI%TUREORREM Fff MU• NPEOFEOUIPMENT <br /> 0 WATERCLOSET OIL 0 AIGM�ND�uUNRS <br /> 0 BATM�B 0 FORCEDAIRSYSTEMS <br /> 0 LAVATORY WASH BASIN 0 HEATPUMP <br /> 0 �R 0 UNRHEATES <br /> 0 KITCHENSINKBDISP 0 CLOTMESORVERS <br /> 0 d5MNh5HER 0 RANGEHOOD <br /> 0 LAUNDRVTRAY 1 WATEPHEATER <br /> 0 CIGTME5WA5HER 0 WOOUSTOVE <br /> 0 MEfALFIREPIl�i.E BUPNING <br /> 0 UPoNP1 <br /> 0 Of2VMINGFWNTNN 0 FIREPUCEINSERT BURNING <br /> 0 FLOOROftA1N <br /> 0 GISFIREPIACE <br /> 0 9ACKFlOWPREVENTERS 0 GASPANGE <br /> 0 SINK SERVICE-BAR.ETC. 0 GISPIPING <br /> 0 EXHAUSTFAN <br /> 0 � <br /> 0 � <br /> 0 � <br /> 0 p <br /> � SUBTOTAL S <br /> SUBTOTAL S <br /> PHAaf f PBMf S <br /> TOTALFEE E TOTPLFEE S <br /> FOR OFFICE USE ONLY: ncceirrrw <br /> fRONI5EIBI�[K lMSE10�CR S�CESEIBKN <br /> {Y/.NCNEC[NUMBEfl �EE <br /> or�E� ��Uyty�E FEES W1LUIITON FEE <br /> usczo«c <br /> GrEs crro ouaOMc <br /> MEI6Xi4uilAtlGN IIO.CiONFIIIMG LICCiBtM✓�J. ��b� <br /> pCC11pMCY NO.O�SIORR CCCVP/.NiIOIU BISFME1:t 4FCNI.MIGL <br /> GNWV OYFS OMO. <br /> wanor.uwwcncu <br /> pRESVPiNlLEflPCO9 AFAS�M <br /> OLMCR <br /> {IP[A4AMPE0� A�� S1ALflIIRD�MGSIMC�UNGE <br /> rcEorcwsr nµsuenovEoer CINOFEVERE7'f vueiwwoa+s <br /> LOCALSALES <br /> w+c <br /> TA%CODFI51105 T�7nL <br /> 1 <br />