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APPLICATI�N FOR CONSTRUC'� iON �CRMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION � COMBINAl10N ❑ B�ILDIN(i ❑ MECHANICAL ❑ PLUMBING �] SIGN <br />PROJECT ADORESS: �or�`L�-- _ � �%� ���,�q� <br />ior <br />Oi WOf1M <br />uui <br />roouae wvaveo <br />��� 5� <br />loti� sF <br />os auidr�o <br />ON Of Piqi'ERrY IS <br />_ aiocK _ <br />rNiLFI�/Jllo NUUBFR <br />CdISTqUCTp1 IONI IENDER. <br />NO. <br />3 WATEF <br />KITCHEN SINK 6 DISP <br />OISHWASHER <br />UUNDRY TRAV <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTI <br />SINK (SERVICE — BAP <br />r.m <br />br <br />� <br />nr <br />HEATING SYSTEM: <br />f�OH�ALt VERSpN MN PIqNE <br />1 �W � /I(O 1 <br />JNE 51�1E uCENSE � <br />RoasEt�i I I�u <br />N1E SniE UCEuSE � <br />3� T ' �43�/ �3c�: <br />NIE StATEIICENSE� <br />:� bs3`s�°o AIY�gJ <br />GAS ❑ ELECTRIC ❑ <br />s - Sr - � <br />� I HEREBY CERTIF THAT I HAVE REA AND E%AMINED THIS <br />APPIICAT10N AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br />�E� j�r� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />5 NOT. THE ORANTIN�3 OF A PERMIT DOES NOT PRESUME TO 61VE <br />G AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW HEODUTINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PqOPERTY TO PERFORM THE WORK POH WHICH <br />APPLICATION IS MADE AND I COMPLV WITH�t THE STATE <br />CONTRACTOFj6{,�W iB27 RCW AND 288200 WAC. /, � <br />NU4DER % � �� , N <br />_ �MW�iUPE .�C <br />� <br />C�TY OUSiNE55liGE iE NU <br />MECHANICAL <br />�,'M �— FEE NO. TYPI <br />' A/C—NHNDI <br />: FORCEDAIRS <br />'—T <br />SUB TOTAL f <br />FOR OFFICE USE ONLY: <br />i1pNT SETBAG1t PE�R SEiB�CIt <br />2� zp <br />USEIONE 101 E� <br />fZ- I �� C <br />NEIOMI IIWT�TqM � NO Oi OM'EIIIMO <br />Ztl UNIIC , <br />�.. <br />OCCUV�NCY Iq p SIM(5 OCCUP�NIl0�0 <br />u-� 2 <br />iIR SPPiNKLEPREO'D �F�SON <br />�vv¢ar.or�sr -- rinNs•nnnov¢nar <br />�1/.- i <br />JL-lei n.�e4�Ti�97 <br />SIDE SFTB�CN <br />CLOTHESORVERS <br />RANGEHOOD <br />WATER HEATER <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GASRANGE <br />PUN CI'ECK MNdBER <br />'.�41r. G�3 <br />vc�N� s�re rtes <br />�s ❑ �o aunowa <br />SIIE Oi B100R I ' <br />2"Z UI a� S, f. ,.,°"'"�"° <br />BASE EN7 �� MFCM�N�C�I <br />�vES QNO <br />�DdIION�I %�N bIfGK <br />O���Ef1 <br />SI�IE PUROM65N1LIUnGE <br />CITV OF EVEHE7T nuni�r.rronex <br />LOCALSALES <br />7AX CODE IS J105 TotnL <br />iFf <br />DAtE <br />SUB TOTAL f <br />PERMIT S <br />TOTALFEE S <br />11Ef.EIPf /q <br />0 <br />��i <br />, ��,; ._ <br />