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L�7 ha7 � <br />D xl x <br />9H(H/� <br />4 x9 <br />yZH <br />K n <br />H x1 <br />�N�+J <br />VJ H <br />b70� <br />ON <br />��1�g <br />y� V C] <br />xaH� <br />rHH <br />OyN <br />n b55 � <br />�y� <br />H O V� <br />a <br />.., ,:,,,�,.� <br />APPLICATIOW FOR COPISTRU�1 rv�l PERMIT <br />the Eve�pmen <br />CITV OF <br />everett <br />BUILDING DEPARTIAENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />I I DEMOLITION �l COMBINA'fION I I BUILDING f"I MECHANICAL <br />owNEn nit noonEss clrv � zIP PuoNE <br />�,C��z� � � � /�DO � ,�2� J zO �u .1'-. � , <br />IEN�NT MAILRODP[SS C Y ZIP FIIONE <br />RRCXIIEGTOqDE51GNEq MAIL�DDHE55 . GIiV 21P PHONE <br />mni�nuu�mss <br />cnr �m rnune <br />everett <br />� <br />'PLUMBING LI SIGN <br />77vJ'] �i�),�GC'b`r/. <br />IICENSE / <br />MECIIANKr1lWMP/Gi0l1 1dNLP�UNE55 GIIY [IP PIIONt LICENSE� <br />• r�uuew9 cour cron rananooness cnr rm rnnur ucer�sr:r <br />�. Icv �r , J�.U. i�v� aov� � n, eE v oro �c�-��a. <br />cLnsSOFwonK ✓ WO�,LO CI d a�; <br />�NEW CI ADDITION L] ALTERATION 17 REPAIR I�.I DEMOLITION IJ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br />TENRNT IMPROVEMENI OA INTEN08 REIAO�EI ONLV CONIACT PERSON GND 1'IIDNE NO. <br />PROPOSEDUSEOFBUILDING " � <br />D/O'TS <br />LEGRL DESCf11PTI0N OF PROPEFfV �SHOJIN BELOW OR �iiACll FOUli COPIES) <br />�or o�ocK or <br />AOORESS <br />9 � <br />W�TER CLOSET <br />BATHTUB <br />LAVA10flY1WAS <br />URINAL <br />DRINKING <br />FflONi SEiO�CK <br />USEZONE <br />IYPE OF C01151. AllOWA�LE <br />SIZE Of O100. <br />OCCUPANCYLOAO <br />flE�SON FOR SPRINKLERS <br />APPLICATION �CC. 0� <br />�• � � <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND HNOW THE SAME TO BE TRUE AND CORflECT. ALL , <br />PROVISIONS OF LAWS AND ORDINA�'CES GOVERNING THIS TYPE OF <br />WORK WIL� BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR ! <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE �� <br />AUTNOfiITY TO VIOLATE OR CANJEL THE PROVISIONS OF ANY �� <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH[ � <br />PERFORMANCE OF CONSTRUCTI�JN. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV T�J PERFOFlM THE WORK FOR WHICH � <br />AF'PLICATION IS MA�E AND I COMPLY WITH THE STAiE <br />CONTRACTORS LAW 18.27 RCW AIJD 296200 WAC. '�. <br />SIGNNIIREOFCONIORCLOROf1�UT110fItZEOAGENi OAtE I <br />��-- ����,� G � ad- �� <br />4PPLIC�NTSGITYBUSME59l , N$�1� B SIN SNAAIF. ', <br />MECHANICAL '� <br />JO. TYPEOFEOUIPMENT FEE <br />FORCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERIiEATER h � <br />WOCD STOVE <br />MET�L FIREPLACE 8 CHIMNEV <br />FIREPL/10E INSERT <br />HEATPUMP <br />GAS PIPING <br />'cXHAUSTFAN <br />RE�IiSETORCK SIOESETBACK PLANGNECK NUM�ER <br />�ornnen wcnr�rsrte �EES <br />I I YES I I NO BUILDINO <br />IYPf0iWN51.ACN�I OCN�AIRY NOq[MLLPNGMi15 <br />cnwr <br />PIUM�ING <br />NO.OF STORIES O�SElAENt MECHANICAL <br />CI VES C�.I NO <br />fIRESPRNKLEP9REOD !EIGNTUMILATION OTHER <br />❑ YES I 1 NO STATEBUILDINGSURCHAqGE <br />SiATEENERGYSUflCHARGE <br />PLNlS/.Pf'liOVEDpY CITY OF EVERETf PUBLIC WO(iKF. <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />TOTALFEE 81 /H'b"�OD <br />F[E PELEIPTNOCI � O <br />