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APPLICgTII N FOR GONSTRUCi .�DN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />i �� �- <br />❑ DEMOUTION ❑ COMBINATION C�YBUILDINO LS MEC�iAN/ICy�AL � � !�J' PLUMBINO ❑ SION <br />IoROJECTADDREBS: ;LOS 9`��` P;�� •a•W' O�� �I //��. �,r <br />^.�+.�.w X��- 4•�' C. LJ��.. (� 3� � 7`'�����.,UJ� 9dz90 337 - 3s Z s <br />tENY/i uM 41011[ss (lir )iP MbNF <br />�RLNRGTd10ESIONEN M�NNMM1E55 1�'I 71P PNpNF <br />�.'o. Cm.�...x:..,..,Jx. l�3u 7G`�'' _�a�� s��-�s:s 41ec�.�z IY� crc <br />aer�na ca+rn��cton u�n � ess an v� r�um 51�iE IICCMSE I <br />MECNIUMCIiI CONTR�Cidi 4/JL �OORE55 f.IIY T�P PIIONf ST�fF IICFNSE � <br />AUAbNb CONTRN:TOiI M.:II A0011E55 LIfY 71P p1qN{ STAIF IIf:FNSE � <br />oexae¢ wauc �w sou•ne <br />S <br />wr x� e�ocK <br />c <br />SF <br />�►230 <br />1'I'a02` 0007 — O2Z� OOoI <br />PMGEI T1Uf I D. MIMBEP <br />�wm�,co� �� ��R �om�5g.� �S,! 4� — 0 7 y v <br />Ce....b <br />P.bMsllW -- ----- — --- — ---- <br />NO. TVPE OF FlI(TURE OR ITEM FEE <br />�-VMTER CLOSET (TOILETI T <br />UVATORV <br />SHOWER <br />6 DISP <br />URINAL <br />DRINNINO FOUNTAIN <br />FLOOR DRAIk <br />BACKFLOW PREVENTERS <br />RINN lSFRVICF — BA0. El <br />SUB TOTAL S <br />PERMIT f <br />?OTALFEE i <br />FOR OFFICE USE ONLV: <br />fpONTRFTRA(:M PE�RRFIBAGN <br />USE TONE IOI �f1F� <br />IIEIOIIi LI4II�TION NO O! OWCIIINb <br />IIMIS <br />NO f11 SI�w15 <br />2 <br />!FY�Z <br />iN1E NMM PEO'D <br />�rrc nr r.tws� -� ri�Nx �rrnr <br />�� I��IF_�� <br />SIDE SETB�Ck <br />HEATING SVSTEM: �AS ❑ ELECTRIC ❑ <br />%3'i - x -1 � Y ��,,,. <br />I HEREBV CERTIFV TNAT I MAVE READ AND E%AMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br />PROVI510NS OF LAWS AND ORDINANCES OOVEHNINO THIS TYPE OF <br />WORK WILL nE COMPLIED WITH WNETHER SPECIFIED HEREIN OH <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO AIVE <br />AUTHOHITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTIIER STATE OA LOCAL LAW REQULATINO CONSTRUCTION OR THE <br />PEf1FORMAN�E OF CONSTRUCi10N. THAT I AM AUTMORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORI( FOR WHICN <br />APPLICATION 13 MADE AND 1 COMPLY W�TN TNE BTATF <br />CONTRACTORS LAW 18.27 Rf,W ANO 286200 WAC. <br />z <br />I��"�rK. LJaA.c�., b/i.a�^►�— <br />sicw�ru oe <br />GTY &19NESS l ICENS[ NO <br />YECHIINICAL <br />N0. h'PE OF EOUIPMENT FEE <br />A/C—MINULQ UNR3 ' <br />FOiiCED AIP SVSTEMS ` <br />HEAT PUMP � <br />FIREPIACE INSERT <br />(3H5 FIREPLACE <br />GASRANQE <br />FAN <br />S <br />f <br />PI�NCIICCM NIIYP(11 _/ �([( � AFf.FIPI NO <br />VM:ANf S��E rcca <br />❑YES ❑ �Nl p11110iN1i -' <br />fi�iE Of BII%1 /1���a / <br />�� �IV IT PIIIM111N(1 —_'___ <br />RA NI MFCI�AINGI <br />OYFS � --'--- — ---- <br />' MHAIi0N�1 f1�Nf:Bff.M <br />Up411 <br />SGiI fllllllll� SIInL1U0fiC � <br />GTYOFEVERETT ���wi��:wonns <br />LOCAL SALES --- - - -- ---------- - - -- <br />_ TAX CODE IS J105 Toin� <br />� �! / _/ i <br />I`•� <br />�i'; - <br />