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_ ,v�.�C� <br /> APPLICATIO.� FOR CONSTRUCT�.IN PERMIT everett <br /> ��E��,9,�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett MEATING SVSTEM: U GAS �ELECTRIC U — <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION ?(BUILDING MECHANICAL ! PLUMBING SIGN <br /> OWNER M�iL�DORESS CITY ZIP YHONE <br /> k'A�1Sf�5 (�VeL�okD .za01 A1�qM5 AVE• EV� jKiZo� 355-58/O ' <br /> TEINNT MAIL RODHESS GITV ZIP PHONE <br /> 5�4M£ �}S hROJ� <br /> PRCHITECTORDESIGNER MA'LADDRE55 GTY ZIP PIIONE <br /> TOM/ FDwlARDS EU. 3$5-yb77 I <br /> GENERAL CONTMCTOR MML ROORE55 CITY ZIP PNONE LICENSE 1`� I <br /> MECIUNICQCONTR�CTOR MAIL�DDRESS CITY 21P PHONE LICENSEI <br /> PLUMBINGCONTP�CTOR MMLADORESS CIT' ZIP PHONE LICENSEY <br /> C1A550F WONK <br /> . . NEW ZS ADDITION '� I ALTEHATiON . I REPAIR - � DEMOLITION _.. WOODSTOVE/FRPL WSERT . ' BUILDING RELOCATION <br /> CONTFCT PERSON AND VHONE NO. <br /> CONLMCTPRICEOFWOPK IS� �J� <br /> pESCqIBEWORNANOSWAREF00TAGEINVOIVED a[�ROOF <br /> DD� f . ��s*�d5 Naosc <br /> VROPOSEDUSEOFBl11lDING I HEREBV CERTIFV THAT I HAVE REAO AND EXAMINED THIS <br /> E F ES f G C APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> LEG/�L OESCRIVTqNOF PqOPHiTY�SHOWN BELPN OR RTfRCH FOUF COPIES� PROVISION3 OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OA <br /> �or 1 7�I 1� e�ocK /Zz oF A U 1 NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � �� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OP CONSTRUCTION.THAT 1 AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FO'ri WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THc STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNATUREOFCONTRACTORORRUTHOR12EDAGENT DATE <br /> A <br /> fROJECTAODRE�yS�S <br /> '/��O I �'T �S E• G� �' �PP�ICANTS CITV BUSINE55 LICEI SE N0. BU IE55 NMIE <br /> PLUM8ING MECHANICAL <br /> Np. TVPE OF FlXTUHE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER Cl0.SET(TOILET) A/CrA/HNOLG UNIT�H.P. i <br /> BATHTUB FORCED AIR S`.'STEM�B.T.U. M E.A. <br /> LAVATOHV(WASH BASIN) UNIT HEATEfiS—B.T.U. M uq � <br /> SHOWEF CLOTHES DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TFAV WATER HEATER <br /> CLOTHES WASHER i WOOD STOVE i <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> OFINKING FOUNTAIN i FIREPLACE INSERT <br /> fLOOR 6RAIN HEAT PUMP <br /> BACKFLOW P ENTERS GAS PIPINCa <br /> ROOF DRA RAINLEADERS � EXHAUST FAN <br /> SINK(S VICE—BAR,ETC.) <br /> SUB TOTAL $ SUB TOTAL $ / ' ' <br /> PERMIT $ PERMIT $ <br /> TOTALFEE $ TOTALFEE S <br /> FOR OFFlCE USE ONLY: <br /> FRONiSETB�CR � FE�NSETBACK SIOESETBhC�K FLANCHECKNUMBER FEE RECEIPiNO. <br /> zo 2� � s qi a� s�rY ;os-so 3a <br /> USE ZON�_ � LOT RREA� VACNNT� �E� VAIUATION �E <br /> v euaou+c <br /> "3" /!oa � Or_� <br /> iYPE Of COMiS.AIIOWABLE TVVE Of CON51�LiUpL acuasxCv rq Or pw[wxc uxrt5 <br /> txouv / PLUMBING <br /> 'l�/ — <br /> SRE OF BLOA NO.Of STORIES BASEMENT MECNANICRI – <br /> 32�i st q o <br /> S� <br /> OCCUP�NCV LORO FIqE SPRNKl,ERS HEO'D HEIGHT LiMITqT10N ADDITION/1L PLAN CMECN — <br /> 7�7 i <br /> �/a NJ w OtHER <br /> REASON FOIi SiRINNLEFS � <br /> STRTE BUILDING SURCHAHGE �U <br /> iNi�KE B�' PUNS RPFROVED BY CITY OF EVERETT PUBLIC WORKS -- <br /> ^� /J�� LOCAL SALES <br /> i �7 Q b TAX CODE IS 3105 roT�� ��� ;�J I <br /> J <br />