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APPLICATI�1 FOR CONSTRUC'�DN PERMIT <br />CITY OF EVERETT • BUIIDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />O DEk10LiTION O COMBINATION ❑ BUILDINO C�MECHANICAL ❑ PLUMBINO ❑ SIaN <br />PROJECT ADDRESS:�� � Z��T S� 5L�_' <br />r �r�i wv�-� .-•,. �..,._._ <br />IN�W� T� p11� � MNl �OOIIE55 ��� �`� l�f 1'iIONF Gt�l[ IICFNSE � <br />��� <br />�Iq SOUARE <br />io7 e�acrt <br />� � <br />LENOER.1100RESS. <br />CLOSET <br />a DISP <br />CLOTHES <br />SINK <br />FOR OFFICE USE ONLY: <br />fIlONTSEM�L1f REM! <br />11FIONT LIMTIITION <br />on°�Pouv""cr Mo a <br />v� sawmc�n nea� <br />flflE NAIIM IIEO'D <br />FEE <br />SUB TOTAL S <br />PERMIT f <br />TOTAL FEE f <br />WOE SFIB�CM <br />21P <br />HEATING SYSTEM: � <br />c�ucr v�asori �v/o rr�orrt ra <br />PIIONE FT�IE I�GkMSk • <br />I SC�% i�l6M��S.3DA <br />PIqNE ST�IE IICENSE • <br />OAS ffi ELECTRIC ❑ <br />I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED TNIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT AI.L <br />PHOVISIONS OF LAWS AND ORDINANCES 60VERNIN6 TNIS TYPE OF <br />WORK WILI BE COMPLIED Wlhl WHETHEH SPECIFIED HEREIN OR <br />NOT. THE (iRANTINO OF A PERMIT DOES NOT PRESUME �i4 �31VE <br />AUTHORITY TO VIOLAIE OR CANCEL THE PROVISION OF �1NY <br />OTHER STATE OR LOCAI. LAW REOULATINO CONf i HUCTION OR THE <br />PERFORMANCE CON�TfiUCTION. THAT I AM AUTNORIZED BY TNE <br />Clyf�IE�OF S FiOPEHTY TO PERFORM THE WORK FOR WHICH <br />��P,liCATlO IS MI1DE AND I COMPLV WITH THE 6TATE <br />;ef�TRACT S L 1827 RCW ANO 288.200 WAC. <br />=�"' b���Hc7 <br />GfY BUSINESS IICFNSE Iq <br />TYPE OF <br />NC — AMNDLO UI <br />FORCED AIR SYSi <br />HEAT PUMP <br />WATE,3 HEATER <br />WOOD STOVE <br />MEfAL FIREPLACE i <br />FIREPLACEINSERT <br />e� <br />ruN a�cK rttwarn <br />IUf�RF� VeCANI5ITE �c¢_ <br />❑YES O NO OUIDINO <br />NOOiOwEWNO S�iEO�lIOORI <br />IINIIF P�IIMIIINO <br />OLCUPNIIl0�0 BASEMENf NFCN�MGI <br />❑res o Nn <br />ne�sa+ <br />eoairoN�i ruN a�rc■ <br />on�cn <br />RF��fN+ -- <br />S1AIE B1410�NO5�If1CHM1ItE <br />puNs�rrnovener CITYOFEVERE?T runnr.wnnKs <br />�M /_ LOCAL SALES <br />�..� /i�"dY%• TAX CODE IS 3105 iDTAI <br />SUBTOTAL f <br />PERMIT f <br />TOTAL FEE f <br />rEF nFr.rmiNo <br />FEE <br />