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APPLICATIO . FOR CONST�UCTI �N PERMIT� <br />CITY Of EVERETT • BUILDING DIVISION <br />3200 CEVAfl STREET • EVERETT, WA 88201 • 25B•8810 ��--- <br />❑ DEMIOLITION ❑ COMBINATION ❑ BUILDI O MECHANICAL ❑ PLUMBINO ❑ SION <br />PROJECT ADDRESS:�9 /C'�1 y''�.I S �' . <br />q� n_ / / Mu11100nEs9 cln l�r p MpHE <br />X 7..,n� � N/�Ue! �'InO.//�C G'/ C6 G�I�O%�} II�Q �lJ�%i'� <br />YNl <br />pn• <br />�VC / <br />71P n��ONE <br />nuca�rn�cron �:n�oon[ss - �-nr I nr r�w�e Sl�tEli[[NSE� <br />4ECNAMGLL CONTR�C70R M1111 �Dd�ESS f:ITY 71i` P110NF ST�IE IIGENSE � <br />PlU1MMqCONTR�Cfd1 Y�iL�0U11F54 CItY IIP PNp/E ST�IEIICENSE� <br />pElCpls( Wptlt�NplWARE ipOTAOE <br />ior <br />r <br />,�, r��:�,.� <br />eE�av oa �n�cN <br />�Op1E9S. tFLEP110�1E MIMaE11 <br />PLUTASINO <br />NO. TYPE 01 <br />WATER CLO5ET <br />KITCHEN SINK 6 DI <br />OISHWASHER <br />LAUNDRVTRAV <br />CIOTHES WASHER <br />FOR OFFICE USE ONLY: <br />iPANTSGTBK.M RE�RSiTlACM <br />U9E lONE <br />IIEqNt LIMITIITIOM <br />n <br />HEATINa SY6TEM: ❑ OAS ❑ ELECTRIC ❑ <br />CONI�CT PER90N 11N0 P11011E NO <br />I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMIPIED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CARRECT ALL <br />PROVISION5 Of LAWS AND ORDINANCES OOVERNINO THIS TVPE OF <br />WORN WILL 8E COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRE3UME TO OIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PHOVI610N OF ANY <br />OTHEH STATE OR IOCAL lAW REOULATIN�3 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERiV 10 PERFORM 1HE WORN FOR WHICH <br />APPLIC��TION IB MADE AND I COMPLV WITH THE 6TATE <br />CONTRAQTORS 4AW 18.27 RCW AND 298.200 WAC. <br />t(�`��T � �! "� � �/.�lJ�%(o <br />'�J 11UIIE D�IE <br />CI`Y BUSINF.SS LICENSC NO <br />FEE I NO. <br />NC —AMNDLa UNRS <br />FORCED AIR SVSTEMS <br />HEA7 PUMP <br />WOOD STOVE <br />METAL FIREPLACE I <br />FIREPIACEINSERT <br />OAS FIPEPLACE <br />(3AS RANGE <br />FAN <br />SUB TOTAL f <br />PERMIT S <br />91UEBF1l/iCN I�I�M1f.4CCN <br />�� <br />lpl �uE� v�C�NISitE rcca <br />pYE3 ❑ MO oimrn�t <br />NO Of D1YEllING 9�lE OF o100/f � <br />UNIIS p1�14p�Nti <br />OCCUP�NIl0�0 l�SFMENI MECN�1Mf.Al <br />❑vE3 ❑!/G — <br />Rf�50N �Od1iON�1 Pl�NC111CM <br />an�[n <br />r��c� <br />SGIE BUIl0�N0 SIIfILN1111(iE <br />��Ns�PvaovEner CITYOFEVERETT riiniMwnn.S <br />LOCALSALES <br />,,,,� TAX CODE IS 7105 TOi�I <br />fEF <br />TOTAL S <br />uIIT f <br />REf.FIPT NO <br />FEE <br />