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APPLICATIC`1 �OR CON�TRUC'� �N PERMIT <br />CITY OF EVEFE?T • BUILUING DIVISION � <br />�2C^ CEDAR STREET • EVERETT, WA BB201 • 259-8810 <br />p DEMOl1TION C�7 COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBIN(3 O SIGN <br />PROJECTADDRESS:_1L_ JQ3rcI PI ,��, C—_',/'"fC''I '�' QR.�nR <br />TFN�MT uu� IJ1pnf55 —_---" '� "—" <br />;m <br />y 200 <br />Wi7,IK �ND 60UARF. <br />— / 5G / Sr. <br />NVOLVEO <br />� /Z�� <br />-�i `:� � �%' <br />�eau ocscmrna+a rrav�an is�bwn e� <br />ior,�_ e�ocK _� <br />VO�UMC �� nt ln�[ <br />lENOEP.AIMMIF9S. <br />TVPE OF <br />WATER CLOSET� <br />o�n�rue <br />UVATORY�WAS! <br />SHOWER <br />DISP <br />UUNDRY TRAV <br />CIOTHES WASHEa <br />URINAI <br />DRINKIN6 FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />SINK (SERVICE — BA <br />_��• <br />•^,UBTOTAI f <br />PERMIT f <br />TOTALFEE f <br />FQR OFFICE USE ONLY: <br />iRd/T5E78AClt _ / REAPSEil�CN / <br />!� <br />USEIOME /_� / ior�nte <br />�` i3� <br />NEIUIIILIMII�TION / NOIrOtOYIElLIN6 <br />On CaUpPANCI' Iq Of IIMff OCCUP�Nf lO�p <br />R-?/,, _� 2 <br />o�r[ <br />HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />CONI�Gf 1'fR50N�ND VNp1E Np <br />�'1�i•d 'Pctn+-1- 20(„��t-�1200 <br />I �iLn � 2J(o o� �/8" 027 <br />I HEHEBY CERTIFY AT I IIAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE THUE AND I;ORRECT ALL <br />;,L PqOVISI0N5 OF LAWS AND ORDINANCES GOVERNING THIS TYAE OF <br />WORK WILL BE COMPLIEC ,YITH WHETHEH SPECIfIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOF � NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE Oii CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW RE0IIUTINO CONSTqUCTION UR THE <br />Cp , PERFORMANCE UF CONSTRUCTION. THAi 1 AM AUTHORIIEO BY THE <br />OWNER OF THIS PROPERiV TO PERFORM THE WOqK FOR WMICH <br />. APPLICATI MADE AND I COMPLV WIiM THE 6TATE <br />�ON� OR5�7 RCW AN6?! .700 yyAC-' <br />� -/3�' <br />6ar�erunf � p� <br />fir�n��C0.�rM PCr�C�� <br />L, LItY U NE55 LICFNSE NO <br />nn <br />0 <br />�V V �NIl1YULli VIYIIO <br />FOfiCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT VIEATFRS <br />CLOTHES DRVERS <br />RANQEHOOD <br />WATER HFATEFi <br />�NOOD 5T� ✓E <br />lAETAL FIREPLACE (WOOD <br />FIHEPIACE INSEFiT (WOOD <br />CiAS FIREPLACE <br />GAS RAN�E <br />DAS PIPINO <br />9�OESEfl�CK/ puMu�F.c�iyatn <br />S `" ZL <br />v.ceNr snr FE 8 <br />❑�ES ❑ NO pUl01Nf. <br />SUE OI ElUO/II — — <br />ISL O S,F rumm�+c; _ <br />!� EMENI / MFb�eMf.q <br />❑rF5 �'r�o <br />.00�irzw.i n��+r.�irc� <br />omen <br />SI�IE RInlDM6 5�111C1UOOE <br />CITY OF EVERETT runur wonKs <br />LOCAL SAlES — <br />TAX CODE IS J105 7oiAL <br />SUB TOTAL S �_ <br />_ PERMIT f � <br />TOTAL FEE f � <br />fF �D � PFf.EIPI l ) <br />VALUATION FEE <br />-- —T— <br />�G S 7s ",� i l� 7 <br />� <br />i ��i <br />i�v ? a� <br />