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�;}�� ;. <br />APPL,ICATIO�N"FOR CONSTRUCTIVN PERMIT CVe«�t '. <br />TO BE COMPLFTED IN INK—PLEASE PRINT � ! <br />INe Evorgraon " <br />CIN OF <br />everett �EATINGSYSTEM: GAS I]ELECTRIC U <br />2UILDING DEPARTMENT <br />259•8810 <br />I J DEMOLITION I I COMBINATION I I BUILDING I I MEC'HANICAL I I PLUMBING I I SIGN <br />OWNEA AIRILAUOfiE55 CITY 21P PIIONE <br />°C36e-'�' E� �iUi Z <br />JIlRN� `7`YU1�j�i/" /I�OI <br />ARCkIITECTOR0E51GNEfl \iAILhD�RE55 <br />GENEfiAICONTRACfOR MAILAOOPE55 <br />MELHANICAICONiRACTOR M ILA ORESS <br />IS� ��h C�. <br />PLUMOINGCONTRACTOH MNI,ppOPE55 <br />LITY ^`/ Z7-IP <br />' W/� 7 C <br />CITY ZIP <br />CITV ZIP <br />C� <br />� � ►�uw� <br />CITV ZIP <br />PIIONE <br />PHO E � <br />PHONE LICENSE 1 <br />P 1011 LI NSE 1 <br />� -� LSaI <br />PI NE LICENSEM <br />n <br />17 NEWnVnI 1 ADDITION �ALTERATION I � REPAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT 17 BUILDINGRELOCAT�ON � <br />/��`P _ __ . �CONTAGTPERSONhi10l������ � , 1 �. <br />CONTFlACTPpICEOFWORK D �j i� rwc.i�% : <br />DESCRIBE WORK ANU SOUARE FOOTAGE INVOLVEO � <br />�O O..Q_2lYLQ �i � I�k1YL.t�.� ' i <br />PROPOSEOUSE DUILONG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br />�L APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL ` <br />LEGALDESCRIPTIONOFPROPERTV�SHOWNOELOY/ORATfACHFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF � <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�or e�aK oF — NOT. THE GfiANTING OF A PERM�T 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 AUTHORIZED BY THE �- <br />OWNER OF THIS PROPERTY TO PEFiFORM THE WORK FOR WHICH <br />APPIICATION IS MADE :.ND I COMPLY WITH THE STATE <br />CONTRACTORS W 1 27 RCW AND 296.200 WAC. <br />SIGNr1TU OF ONT CTO UflAUTHJNI2EDAGENT �ATE ' <br />PqOJECTADDRE55 , ,/ n� � � ' �I I <br />71D G� �/1//t aPP�I ANTSCITVBI151NE55LICENSEN ANDBUSINE55NAME �' <br />N0. <br />WATER CLOSET <br />BATHTUB <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNORYTFlAY <br />CLOTHES WASHER <br />FOR OFFICE USE ONLY: <br />USE ZONE <br />ivPE OF CONTS. ALLOWABIE <br />SIZE OF BLUG. <br />f1EA50N FOp SPFINKLERS <br />INTAKE BY <br />PERMIT $ <br />TOTAL FEE $ <br />LOT AREA <br />TYPE OF L@I5T AC1U�l <br />I10. OF STORIES <br />PLANS APPROVED BY <br />�� <br />FORCED AIR SYSTEMS—B <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />WATER HEATE <br />WOOD STOVE <br />"�TAL FIREPL <br />EPLACEIN <br />EAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PIAN LMECN NUAI9EB <br />Bl11LDMG <br />OCCuv�Ntv NO OfOWF14NL11N115 <br />cenur PLUMBING <br />oaSEMENT MECHANICAL <br />HEIGMTLIAIITATION AODITIONALPWNCHECK <br />OTNER <br />STATE BUILDING Sl1RCHARGE <br />CITY Of IVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX COOE IS 3105 TOTAL <br />TOTAL FEE <br />` <br />