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APPLICATI` N FOR CONSTRUCI.ON PERWIIT <br />CITY OF EVEFETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, Wq g8201 • 259-8810 <br />O DEMOLITION [] COMBINATION ❑ BUILDING p MECNANICAL (' <br />PROdECTADDRESS: / • ❑ PLUMBING gSIGN <br />��(ZO/ /� . l 2on nl ,a�-r��, �'�� a c�� l��i� 9J';�Oi -� <br />�Cn/le�e ��/n��. /�'1c`i G'�ti� k�R/11�,�/✓ Fi ° Sc , /1/� •/'A �f •�c {J <br />OWN�R 1 / M�IL�UfX1E55 rvrv ._ �-" -" � /J "l /���1 ✓/ /�% �/Y �I.J ��_1 <br />•RCMTCCi W pE51GNCq MAII AIXIf1E55 <br />CIfY <br />�LUMBMCCONfR�CIpi MMl�IXN1E55 '-- <br />CIIY IIP �-- pIqNE STqEIICENSG� <br />caroe Momc �rvu sov.nE roouae x�vaveo - <br />°��P rni- cn�o�; o . <br />LEG�I <br />tot <br />eiocK <br />f41r,•.':,^,i <br />CONSTRUGfqN LdW �ENOER. HppqE55. iELEI'110HE NUMBEfi <br />NO. TVPE <br />WATER GLOS <br />8 OISP <br />TRAV <br />URINAL <br />FOR OFFICE USE ONLY: <br />fRONi5E7B�GK �� RE�qSETR�L�A <br />use zone �''"'� <br />lOf11RF� <br />�-% 7�r� <br />NE16Hi U ATION NO OF <br />�ooF c,n(� ���s <br />DGGUP�IICY lq (K 51(MC(5 OCCIIP <br />TOTAL f <br />�tlT S <br />�L FEE E <br />8�5� <br />HEATING SYSTEM: O GAS ❑ ELECTRIC ❑ <br />cc»iur � rtnscx� �rm r��arc r�o <br />I HEIiEDY C[HTIFY Tf1AT I NAVE READ AND E%AMINED THIS <br />APPLICA71pN AND KNOW TNE SAME TO BE TRUE AND CORqECT ALL <br />PqOV1510N5 OF LAWS AND ORDMANCES GOVEpNING THIS TYPE OF <br />WOfiK WIIL DE COMPLIED W17H WHETHEH SPECIf1ED NEREIN Oq <br />NOT. 7�!{E ORANTIN6 OF A PERMiT DpES NOT PRESUME TO 61VE <br />AUTIIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STNE OR LOCAL LAW f7E0UUTINO CONSTRUCTION OR THE <br />PEHFORMANCE OF CONSTRUCiION. THA71 AM AUTHORIZED BV THE <br />OWNER OF Tl115 PROPERtY TO PERFORM THE WORK FOR WHICH <br />IIPPLICATION IS MADE ANC I COMPLV WITH THE STATE <br />�T ORS LAW t_�ND 296.� WAir O^ %..x <br />(:IIY PUSINESSN6[7P`E Pp <br />MECIIANICAL � <br />FEE NO. TYPEOF <br />' NC --M1NDL0 Uf <br />i FOf10ED AIR fiYST <br />i NEAT PUMP <br />_�. UNIt IiEATERS <br />� C�OTHES DRYERS <br />—�_ <br />' RANGEHOOD <br />� WATER HEATEFi <br />� WOOD SiOVE <br />' MCTAi FIREPLACE Q <br />� FIREPLACEINSERT� <br />' -- GAS FlREALACE <br />i GAS MNGE <br />GAS PIPIN , <br />FXIIAUST FAN <br />SIDESE7B�CM,� P111NCIi[CkMlMflfO <br />Nii �'J ��,3...''�� <br />vec�N,sne rEEs <br />❑YES NO <br />OIIIlO�Nfi <br />512E Of BIOGRI <br />P111M01N0 <br />8115EMENT MECII�Mf.AI <br />❑YES ❑NO <br />�DD1710NAI PI�NCII(CN <br />ou�en <br />stni e nun uu�a sunru�nat <br />CITY OF EVERETT rimi ir. wonns <br />LOCAL SAIES <br />TAX CODE IS J105 TOTAL <br />SUB TOiAI f <br />PERMIT f <br />iOTAL FEE S <br />fFF /� � I REf.EIPTNO <br />•r,-� <br />'1 <br />� <br />