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APPLICATI� FOR CONSTRUCT��N PERMIT everett <br />�E��� TO BE COMPLETED IN INK—PLEASE PRINT � <br />cirv oF }} <br />eVerel• HEATINGSYSTEM: ❑GAS �ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION LI COMBINATION ya BUILDING I I MECHANICAL L] PLUMBING i J SIGN <br />pyypQp MMLAODNESS CITV ZIP PIIONE <br />R/CAROO P. GABoaR ��/S �ROi4aWq> E✓EREi T W/� 9P2o3 355-.5 /$SL ' <br />TENIINT M��I.ADURESS CITY 21P PNONE <br />,9ANE i!s IlBa/� <br />�RGMITECTOi1DE510NEN MAILADDRE65 GTY ZIP PNONE <br />OENEML CONTPIICTOH MAIL ADDRE65 GTY ZIP PHONE IICENSE / <br />MECNAHIC�LCONTR�Gv �TOH— M�ILADORE55 CITY 21P FMONE UCENSE� <br />RUMBINOCOHTR�CTOR MAILADDRE55 CITY 21P PHONE LICENSE� <br />NA <br />ClAR50F WORK <br />�1i NEW SZADD�TION I_I ALTERATION I I REPAIR f I DEMOLITION I_1 WOOOSTOVE/FRPLINSERi f.J BUILDINGRELOCATION <br />DEBCR9E <br />I �m <br />� <br />CONT�CT PERSON ANO PNONE NO. <br />wonK N R/cA�.Jv /'� dA�6�NN 355-5'i8f/ <br />$OUAREFOOTAGEINVOLVED j s� w <br />�o� rG�. ,cf. <br />'PROPEPTVI6HOWN <br />e�ocK <br />SINK 8 DISP <br />HER <br />'TRAV <br />WASHER <br />iFOUNTAIN <br />9AIN <br />W PREVENTERS <br />1 HEREBV CERI'IFY THAT I HAVE READ AND EXAMINED ',-H�5 <br />� a� R.GC_ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LOWONATiACHiWRCOPIES� PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TfPE OF <br />WORK WILL BE COMPLETED W�TH WHETHER SPECIFIED HEFEIN OR <br />oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PRC''EHTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS �IADE AND � COMPLV WITH THE STATE <br />CONTRACTOFS LAW 18.27 RCW AND 296200 WAC. <br />SIGNATUREOFCONTRRCTORORAUINOR12EDROENT OniE <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT6ETBACK RERRSETBACK <br />USEZONE IOTRRE� <br />iYPEOiCONiS.AILUW�BtE TYPEOFCON51./iLTUAL <br />BIZE OF B100. NO.OF STORIES <br />OCCUPANCV LOAD FlRE SPRNKLEHS REO'0 <br />BY � PUNS <br />SETBACN <br />oxw.xc. I rro a <br />GRWI <br />rax cooe is a�os <br />X <br />FORCED AIF SYSTE� <br />UNIT NEATERS —B.T.' <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 <br />FIREPLACE �NSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />BUILDIN3 <br />PLUMBING <br />MECHANICAI <br />ADDITION L PLAN GMECK <br />OTHER <br />STATE BUII�ING SURCHAHGE <br />PUBLIC WORNS <br />TOTAL <br />NRME <br />M E.A. <br />SU� TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FEE RECEIPT NO. <br />VALUATION FEE <br />/ YD-� � 3 f <br />�L <br />