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APPLICATI�..�1 FOR CONSTRIJCT.JN PERMIT <br />Ihe Evergro¢n <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION COMBINATION � BUILDING MECHANICAL <br />OWNEN MRILADORE55 <br />.^ � / - 1 � CIiY ZIP P! <br />JLC1 � �� �N $���x 2! S � ��l61(C�������(�]( <br />�NA NT � MAIL r1DDRESS ' 1 l�P �� p` <br />C17Y <br />OP <br />21P <br />PMONE <br />i �, <br />PLUMBING <br />everett <br />e <br />SIGN <br />: -- .nvno LIGENSE � <br />PLUMBINGCONTRACTOR MAILADDRESS ��ry Z�P <br />7 PHONE LICENSE l <br />CU55OF WOPK <br />x NEW . ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT ! BUILDING RELOCATION <br />TENRNT IMPROVEMENi Op INTERIOR/�(iq�MyO,DE�L ON y �j CONiALi PERSON RND PHONE NO <br />CONTRqCT PRICE OF WORN: [�[t�.f'� ��v L'v� 5 �('��,.,I � C�� ' � �C� <br />DESCRIBE WONN AND SOWRE FOOUGE INVOLVE� <br />PROPOSED lISE OF BUILDING <br />- Gsz 5'7G1 <br />�r�tr�'rN\�IJ1 � Q9 <br />LEGAL DESCPIPTION OF PROPERTY �SHOWN BELOW OR AiIACM FOUR COPI <br />l0T BLOCN pF _ <br />�iT� F'� 5 <br />S�A /�'- �'a <br />8 <br />FLOOR DRAIN <br />BACKFLOW PF <br />ROOF DF.41NS <br />SINK ISERVICE <br />FOR OFFICE USE ONLY: <br />FNO�NT�SE7TBACN REARSEiBACK <br />GCJ �l <br />p5E{ ONE''y LOTAFEA <br />/! / <br />1YPE�fGONiSALIOWABIE IYPE.�OyF�LOH51A�L1IpnI <br />..� _� � J!. - � fli� <br />S12E AO�F ���DG NOAF SiOR!ES <br />�� 'TT/� G� <br />OCCUPANGYIO�D FlRESPFNKLERSREC <br />Yt`�� <br />REASON FOR SPRINK�EFS <br />a'-a'NA1,'C� <br />INTANEOY PLANSAPPqOVEDOV <br />$ <br />StDE SETBACN <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OfiDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HFREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUPAE TO GIVE <br />AUTIiORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THF <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIC�i <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />COIJTRACTORS LAW 1B27 RCW AND 296200 WAC. <br />SIGNAiUREOFCONTRACipqpR N EORGENT DATE <br />x • �_�.�3 <br />r1PPLICAN75 CITY BUSINESS LICENSE N0. RND BlISIN NRME <br />MECHANICAL <br />AIR SYSTEMf <br />QERS—B.T.U. <br />>DRYERS <br />WATER HEATE <br />WOODSTOVE <br />METAL FIREPLACE 8 <br />FIREPLACE INSEFT <br />FAN <br />: LAN GHECN NUIdpE�q7 <br />� r7� /.� <br />occucnicr � voc�mruuricuw�s F-oi�n.e�.�� <br />HEIGHT LIMIiAT10N <br />3 Li � <br />CITY OF EVERETT <br />LOCAL SALES <br />iAX COUE IS 3105 <br />MECHANICAL <br />'STATE BUILDING SURCHARGE <br />PUBUC WORKS <br />TOTAL <br />M E.A. <br />SUB TOTAL <br />PERMI7 <br />TOTAL FEE <br />�� i % <br />