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�n� <br />H <br />�HC~ir <br />H�H <br />�H� <br />�+j �I �ii <br />f!1 H <br />'Z <br />H <br />Oy� <br />��g <br />�j]Y (] <br />t"y2' <br />Hy <br />g� <br />H <br />n 5d � <br />W � <br />H l�i� <br />HOfn <br />'I�:, <br />�= i: <br />�`' ` <br />i�.l � "'•. .,�' <br />_ � <br />APPLICATION FOR CONSTRUCTION PERMIT <br />Iho E�rergrean <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8870 TO DE COMPLETED IN INK—PLEASE PRINT <br />I I DEMOUTION ❑ COMBINATION I I F3UILDING I I MECHANICAI_ f.; PLUMBING <br />.�1 1i11Y [IY YHUNt <br />'r/Ja�� ll..�I�n.. 7�+xd� '77nC�7 �7/ 3 ) _ <br />everett <br />� Ii <br />❑ SIGN I <br />,�,..,,.. , ....._..____-- - -._ _.. <br />_ � <br />RRCMITECTOP�E�IGNEP MAILGOORE55 CITY ZIP PNONE j <br />cenennica+rnncron rnnanooness cnr zm m�or+r: ucer+se. I <br />� �I �ifn�, ��. <br />MECIIANICAI ONifl�LTOfi MN�ADDPE55 QTV 21P PNONE LICENSEI il <br />MRII <br />QtY ZIP �HONE IICENSE I <br />_ .. _ _ n �. /.` � _ i / � . . _ <br />U NEW ❑ ADDITION ❑ ALTERATION IJ REPAIfi I I DEMOLITION I I WOODSTOVE/FRPL INSERT [7 BUILDING FELOCATION <br />TEN�Nt IMPflOVE1AENT OR IMEf110fl PEMO�EL ONIY GONiRCi PERSON r1N0 PIIONE NO. <br />CONiRACT Pfi10E OF WOBN: <br />DESCPIBE WOfIK ANO SOUARE FDOT�GE INVOIVED <br />LE�AL <br />iai <br />PROJECTpDONE55 <br />C[�e <br />BLOCN <br />IR�I.I�7:1'�i:L•li <br />I:7cLy�S�PPI <br />F110Ni SETOACN <br />115E ZONE <br />7YPE 0( CON51. ALlOWABLE <br />S12E Of OLDG. <br />OCGl1PANCYLOGO <br />REASONfO'dSPPINNL[RS <br />APPLICAlION 4CC. BY <br />LOW OR ATTACH fOUl1 COPIES) <br />OF <br />� <br />$ <br />FEE <br />I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED TH�S <br />APPUCATION AND KNOW TH[ SAME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHEfl SPECIF�ED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PFiOVISIONS OF ANY <br />OTHER ST�TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PPOPERTV TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLY 'NITH THE STAT[ <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNALl1FEOFGOIJTPACiOROqAUt11CPIZEDRGENT DATE <br />�Pf tSGIiV0U5MESSLICE �N .�USINESSN�ME <br />MECHANICAL � <br />NO. TVPE OF EOUIPMENT FEE <br />AIR SVSTEMS—�.T.U. <br />�TERS—B.T.U. M <br />FIREPLACE <br />FAN <br />REAflSEiORCN SIpE5El0�CH PLSNCIIECKNUM11pEp FE[ <br />LOTMEA Vr1C�NiSITE FEES <br />u ves u No euaoiNc <br />ttreovcoxscncmni ocar��r xoorow�wxcuxns <br />GNWV <br />r�urnewc <br />ND.OFSTOPIES CASENENT MECH4NICAL <br />❑ YES I] NO — <br />FIRESPlINNLERSREOD HEIGII1�Ih11iAtION OTI�IER <br />❑ YES Ll NO STAiE BUILDING SURCHARGE <br />STAiEENERGYSURCHAflGE <br />PlANSAPPBOVEDBV �ITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 rora� <br />$ <br />PEGEIPT NO. <br />� <br />� <br />i <br />0 <br />