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F,�`7 � <br />�tPH <br />r � ;.n �e <br />N fn <br />y�H <br />tG C] <br />H A1 <br />��-0Hh] <br />VJ H <br />H�G <br />lT1 O <br />H t7 <br />OH <br />�/��g <br />y�V C] <br />H <br />r H <br />ha H <br />g `° <br />C� Cy fn <br />y <br />�h <br />x�acn <br />H O (n <br />t , ' <br />APPLICA,7'1�1e�6 P'OE3 COIdSiRl��T1Jf�9 �EidlVa!'�` <br />everett <br />m�, <<-:���r,�� ,: � <br />cirv or <br />F'VeY'E'�� <br />E3UILDING DEPAFTME�:T <br />'�59-8810 TO BE C.`.MPLETED IN INK—PLEASE PRINT <br />�� DEMOLITION ' J COMOINATION �rBUILDING i J MECHANICAL PLUMDING SIGN <br />/OilNc� h!NLAOORE55 CITV ZIP PMON[ <br />JT''r'-tc�S' E"..� �c't/4�Z /S'7/.:l _i4iH�. 7,Gl1 ;�C-7.t%TLt�/J� �%Gi/(,G.%292�9/ � — <br />tENAN: AIqILPDDRESS CIT\' 21P PHON[ <br />t;_/-���..� �-, ; L i� '// so L:t r.o .�.s " <br />A4CHRBCTCBDESIGNcR M�ILROpPESS LITY ZIP PNONE <br />i'i %t,'r3L,� �, coli,l,�s�: LL ,��/� �Oc;i�' ih,:= � CZ,E7'E.-17- l„A �j�%qo/ (�G / ��r� -//// <br />GEN[MI.CJNiR4CtOR MARF�DPE55 CITY Z'P PHONE L�^.[NSE� <br />/J�d�IF� <br />UECHNi1CA�GONTRACTOR IAAIL��ORESS CITV 2ir PHOtI[ LICENSE� <br />C-O/�i�'_ ,��,eiG, C;�, Cc �.��,vir.m'r —�:�C- !-�� <br />PWI.NIYGCONTRACTOR M�'1A00RE55 ��ITY ZIP PMONE IICENSEY <br />I.! NEW i_i ALiDI;IG>� <br />TEIUNTIf,''+qOVEMENTG31N�E1 <br />OESCPIBE WORN AND SOUni�^ t <br />�✓�U i /�%/�%.=/C/= <br />PFOPWED 45E OF BO LUMG <br />LEGAL OESCPIPTION OF PROPE <br />LOT 9lOCK <br />i�LTERATION <br />__ GF <br />% <br />! FlEPAIR <br />PRQIEGTAODRE55 l p�y%i��L� <br />.�r` NO. <br />i <br />�` — <br />TYPF OF FIXTURE OR ITEM <br />WNTER CLOSET (T�ILET� <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />6AC�:FLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FRONTSETNACK _ <br />USE ZONE <br />ttrE or cor�� <br />SIZE OF ULD6. <br />�� � � <br />OCGUPANCYIORD <br />nenso� Fo� <br />APPLICNION FCC. DY <br />TOTAL <br />REARSET�ACH <br />ur S' � 7tiI c <br />LOTFFEA <br />ivPE OF LONSi A:itlaL <br />.� � <br />�[ : h _ <br />N0. OF STORIES <br />! <br />FIRE SPFIMLBRS R[0'[1 <br />VES xN0 <br />PlANSFPPR� <br />0 <br />5 _ <br />SIOE SETDaCH <br />VAC�NT S�i (E <br />'_ YF3 �' NO <br />ttcuru.n rmoro�n.un�cme�s <br />cerniv �- <br />rt � <br />=� ��s hNo <br />CITY OF EVEfiETT <br />�ocn� sa�es <br />TAX COUE IS 3105 <br />ILITION �_i WOODSTOV:IFRPL INSERT '._! BUILGING RELOCATION <br />f.ONTACT PERSON ANO PH011[ N0, <br />�v,� ,n�� n�= . Ci3�:r,r1.Sr� i_ 2-) s//// <br />I HEF7EBY CERTIFY THAT I HAVE flEAD AND EXAMINED THIS <br />APPLICATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT. R,LL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEHNING TFIIS TYPE CF <br />WORK WILL BE COMPLETED WITH WHETHER SPECiFIED HEREIN OR <br />NOT. THE GRANTING OF A PERA7IT DOES IJVT PRESUME TO GIVE <br />AUTHORiTV TO VIOLATE OR CANCEL THE PFOVISIONS CF ANY <br />OTHFR STATE OR LOCAL LAW REGULP.TWG CONSTRUCTION OR THE <br />PERFORIdANCE Or CONSTRUCTION. THAT i AM AUTNORIZED BY THE <br />OWNEH OF THIS PROPERN TO PERFORM1I THE W��RK FOFl WH�CH <br />APPLICATION IS MADE AND I GUM�'LY WITH THE STATE <br />CONTRPC70RS LAW 18.D RCW AND 296.'t! U WAC. <br />SIGNATURE�)fCOHIRACTORORFUT1�ARiZEDAGENT 04TE <br />X ' <br />e—� � C� i�/�/9� <br /><,FPLI(. ITV BlI5R1E55 LICENSE N0. M1D BL :�NESS NAAIE <br />MECHA JICAL <br />�O. TYPE OF EOUIPMFN7 PEE <br />A�C--NHNDLG UNITS—H.P. I <br />FOFCED AIR SYSTEMS—B.LU. M E.A. I <br />UNiT HEATERS—B.T.U. M - � <br />CLOTHES DRYERS _ � <br />VENTILATION FAN ' <br />RANGEHO00 —� <br />WATER HEATER _ _ <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT I <br />HEAT PUMP I <br />GAS PIPING ' I <br />EXHAUSTFAN � <br />� <br />i I <br />SUBTOTAL S ; I <br />PIAN CNECH NUhIBER <br />9 ?Go <br />FEES <br />DUILDING <br />PLUMBING <br />M1:FCHANICAI <br />OTHER <br />S7ATE BUILDMG SURCHAFC�E <br />STATEENERGVSURCHARGE <br />PU�LIC YlORKS <br />TOTAL <br />F:E <br />7�.c% 5� <br />VALUATION <br />� <br />�_ <br />flECEIPT NO. <br />yi9� <br />S� i <br />E <br />