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APPLICATIC� FOR CONSTRUC7 . JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISInN � <br />3200 CEDAR STREET • EVERETT, WA 982U1 • 259-8810 <br />�� DEMOU710N � I COMBINATION BUILDING i I MECHANICAL i pLUM81NG � I SIGN <br />�PROJECT ADDRESS A i <br />., �ir r��or�r <br />S`�l'7 f cc•rc�r��� r��� 9b',�n3 � <br />�uan nnnnrss <br />7-�� ° � � rnrnr'��-� <br />n+ui�`�s� /L)/���m ��/--"—' ��. <br />�/�n� �7 /� �r �rr-�wNF <br />Mu�nnnEss �� � C-U�� �(��.�C"� !!l ��� c <br />r��r l�r rqONf_ <br />i1 ��/% �Uc✓�'1/'Cl�� (,fq�-�.1U� .3.3J--/?7+ <br />uui�oneFss , ��n, � <br />l�� r�wNe <br />�nn.�ooness citv <br />nr rnone <br />A/U UoU � <br />OESCRIOE WOqR �ND SOU�RE FOpuGF INVOIVF.D <br />LOi BLOCN <br />rnMGELT�X10 NUMBER <br />i �190� -a •v�a -��, <br />CON51RUC110N IO�N LENbEII. AO�f1E55. TEIEPHONE NUMBEP <br />Nn• TYPE OF <br />SINK <br />iicE SE� <br />HEATING SYSTEM: �GAS I l ELECTRIC �l <br />CON�RCt�PFRS� �NANDP�IIpNENO <br />—l.e.l-`.LIt3L' �C I� �% -'� �'7 . J.� Z �-I <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LqWS AND ORDINANCES GOVERNINQ THIS TYPE OF <br />WOqK WILL BE COMPLIED WI7H WFfETHER SPECIFIED HEREIN OR <br />N07. THE GRANTINO OF q pERMIi DOES NOT PRESUME TO �IVE <br />AUTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL lAW REGULATINO CONSTRUC710N OR THE <br />PERFORMANCE OF CONS?RUCTION. THAT I qM AUTHORIZED BV THE <br />OWNER OF THIS PqOPERTV TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW iB.27 RCW AND 296.200 WAC. <br />x._12 % �-%—�-�s.� 3'y-Y�� <br />SIOH�TURE <br />oare <br />Grr Bu51NE55 LICENSE No <br />ITEM - FEE N0. TYPE OF FI%TI1RE OR ITEM <br />' A/C —qMNOLd UNITS — H.P. <br />i FORCED AIR SYSTEMS — B,T.U. M E.A. <br />� HEAT PUMP <br />' UNIT HEATEFS — B.T.U. M <br />� CL07HES DRYERS <br />' VEN7ILATION FAN <br />i RANGEHOOD <br />� WATER HEATER <br />WOODSTOVE <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />fPONT SEIPACN t1Up SFTpM.K <br />�' [� <br />uSEioNE �, � �ot�nE� <br />� <br />NEIQNiLIMITATI?J1 NOWOWELLINO <br />�j. uNtts � <br />� <br />oCCur��Ncr ,ro or sron�Es a;r,ur�N� i0so <br />GRO P <br />3 1 l23 �r�. <br />/vlI <br />iPA,1N/RLi <br />N� <br />DF CON! <br />�i J <br />D�fE <br />FANGE <br />PIPINO <br />\US? FAN <br />[.� //O <br />vecevr srte � FEES <br />nr[s '�1 Nu -- <br />BIIILDM(; <br />SIIE Of PLf%irtI <br />•j°131i'� 1�106��/�l r�uumNa <br />P�SLMENf <br />urc�uHic�i <br />C� nrrs hrHo _ <br />ApDI110N�1. PI �N CNECN <br />O111ER <br />suTe eunoiNca sunr,runcE <br />CITY OF EVERETT runur, won�s <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />BURNING) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />rFE � Aer.Firr <br />i(o• DS l <br />