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��� <br />H <br />�L', H <br />�HxCn <br />yzH <br />K n <br />H �1 <br />"�i1 H 'i1 <br />fA H <br />� � � <br />H C7 <br />OH <br />�/��g <br />y�Y Cp] <br />�Hh7 <br />HH <br />y <br />f] l'7 fA <br />Q � <br />HOti <br />_ .� <br />APPL.ICATION FOR CONSTRUCTIOW P�RMIT <br />Ihe Everproen <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />❑ DFMOLITION ❑ COMBINATION I:1 BUILDING I] MECHANICAL ❑ PLUMBING <br />OW/NER J �M/RILAD�PE55 �CITY <br />/.I �� N 1' p�S �O�YjT" I�'CJ�J Qe't' `,[i�j�/�l, �dU <br />1 N�NT MAII.����ESS ✓ ��TY <br />MCMItECTOR�ESIGNER MAI�A�DRESS CITV <br />M�IL �DOFE55 <br />mnanooness <br />ZIP PMONt <br />�_, l�e,x df 7 7057 i7 / 3)-,� ( <br />ZIP PHONE <br />ZIP PMONE <br />Z�P PHONE LICENSE � <br />LIY Y1IUIJL LII�CfIJC� <br />LII:I:II:iL � <br />everett <br />� <br />❑ SIGN <br />❑ NEW CI ADDITION Ll ALTERATION I. I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I 7 BUILDING RELOCATION <br />lEN',NiIMP(IOVEMENTORINTEPIOflREMODELONLY �CONi/CTPERSON�NOPIIONENO. <br />CONifiACT PBICE OF WOFN: <br />OESCf1IBE WOPN RN� SOUAl1E FOOTAGE INYOLVED <br />I HERE6V CEPTIFY THAT I HAVE READ AND EXAMINED THIS I� <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CQRRECL AlL ' <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR �I <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE i <br />AUTHORITY TO VIOLAI E OR CANCEL THE PROVISIONS OF ANY I <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE �� <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH ., <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE '�, <br />CONTRACTORS lAW 18.27 RCW AND 296200 WAC. ', <br />SIGN4Nf1EOFLONTRACIOf10pAUL110RREOAGENi OAiE '�, <br />lOT <br />PROJECTAODRE55 <br />li[�71 <br />ROOF <br />SINK 1 <br />OLOCN __ _ OF <br />nrma+ Foun cories� <br />� / <br />f:Ti1II[�1�CPZ�79 <br />HE�T PUMP <br />8 CHIMNEY <br />FRONTSETBACK NEAflSEIDACK SiDE5ET0AGH PLANCIIECNNUMOEfl FEE <br />USE20NF. IOTAPEA Y�CANiSITE FEES <br />I.I YES I 1 NO yUILOMG . <br />lYPEOiCONSi.AILOW�BIE lYPE01CON5I.ACIUAL ����x xo.aowaux;uxns <br />cnour <br />PLUId�ING <br />SREOFBLOG. NOAFSTONES O4SEMENt MECHANICAL <br />I.I YES I 1 NO <br />OCCt1PANCYLORU FIR[SPRNKLEBSREO'0 IIEIGHiLIAIITAiIpI! �T�{ER <br />❑ YES f.] NO STA7E BUILDING SURCHAflGE <br />REASONFORSPflINKL[fl5 <br />STATEENERGYSURCHARGE <br />nrrucnrioNncc.ov PLANS�PPPOVE�OY CITYOFEVERETT PUBLICWORKS <br />LOCAL SALES <br />TAX COUE IS 3105 TOTAL <br />Yq:, <br />NAAIE <br />flECEIPi NO. <br />r-ee <br />