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�i �i � <br />D�x <br />C H <br />>HV� <br />4 <br />K n <br />H �1 <br />� H � <br />fA H <br />H <br />�x <br />H17 <br />OH <br />��g <br />�j]Y (] <br />9H� <br />� <br />NH <br />g� <br />n 5b � <br />C'] � <br />�Hf�i� <br />HO�n <br />� r.._ <br />APPLICATION FOR CONSTRUCTION PERMIT <br />Ihe Everyreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />' I 1 DEMOLITION I_] COMBINATION I I BUILDING _ I l MECHANICAL L] PLUMBING <br />�fICHItECTOR�E5IGNER AUILAODBESS <br />�DOflESS <br />�V11� <br />adc <br />CIIY <br />GItY <br />citv <br />LIiY <br />GIIY <br />�� . <br />i�.? Y11V��t <br />l�ex df 7 7oS7 i7 / 3�- <br />21P PIIONE <br />ZIP PNONE <br />Z�P PNONE UGE <br />LI�' <br />1'11ViVC LII.CliJC • <br />ucenst+ <br />everett <br />� <br />❑ SIGN � <br />IJ NEW IJ ADDITION U ALTERATION I I REPAIR I I DEMOL�TION I I WOODSTOVE/FRPLINSEFiT I.�.I BUILDINGRELOCAiION <br />TENRNT IMPIIOVEMEL'T OR W f[RIOR f1EMODEL ONLY CONir1Ci PGRSON AND PIIONE NO. <br />GpNLPACT PNILE OF WORN: <br />�ESCf118G W JRK RND SOII�fiE POOlAGE INYOLVED <br />LEGAL!1E5'JI11PtION OF PROPEPTY <br />lOT OLOCK _ <br />TYPE OF <br />SHOWER <br />iINK 8 <br />iER <br />TRAY <br />fRONiSEt�nCK <br />USE20NE <br />1YPE Of LONSi.ALIOWABIE <br />S2EOFOLOO. <br />OCGIIPANCY LORO <br />f1E450N FOfl 5?IiINNLER3 <br />avrucnnor+ar.a ov <br />oF <br />nrintn roun coPiEs) <br />� <br />FEE <br />I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�PPLICATION �ND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS �ND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN GFl <br />NOT. THE GRANTINCa OF A PER1�11T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL T'!E PROVISIONS OF ANY <br />OTHER STAiE OR LOCAL LAW REGULATI\ CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM TFIE WORK FOR WHICH <br />APPLICATION IS MADE AWD I COMPLV WITH THE STATE <br />CONTRACTOFIS LAW 1827 RCW AND 296.200 WAC. <br />SIGNNUf1E0FCONtMC10f10RAUt110RIZEDRGENT DATE <br />X „ <br />M ISGIIVOUSIHESSLICE' N .A USINESSN4ME <br />MECHANICAL <br />JO, TYPE OF E�UIPMENT FEE <br />NC--A/HNDLG UNITS—H.P. <br />FORCEDAIRSVSTEMS—B.T.U. M E.A. ! <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTIUITION FAN <br />FiANGE HOOD <br />WATER HEATER <br />WOOD STOVE, <br />NETAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />R[AfI5ET0�LK SIDESELO�CK PIANCHECNN0Al0E8 <br />�pTpq[� V�C�Ni51TE FEE$ _ <br />❑ YES IJ NO OUILDING <br />7YPEOifON5iAL10Al ����v eo0thvnuxsuvi�s — <br />�app° PLUMOINC <br />NO.OFGTOPIES 045[MENI MECHANIC�L <br />IJ YES I_I NO -- <br />iIRESP]NKL[llStiEO'0 ��EIGNTLIAIIi�iION OTHL(7 —_ <br />❑ YES I7 NO STATE6UILOWGSUFl:HABGE <br />STATE ENERGV SURCH417CE <br />PlANSAPPf10VEDBY CITY OF EVEHETT PUBLIC WORKS <br />LOCAL SALES — <br />TAX CODE IS 3105 TOTAL <br />PERMIT S <br />iOTAt FEE $ (. <br />F[E REGEIPTNO. <br />G <br />