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�.� <br />APPLiCi�►'�f10N FOa COiVSTR�t�TION <br />PERMAT <br />(he BerBrean <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />everett <br />e <br />259•Beto TO BE COMPLETED IN INK— PLEASE PRINT <br />owr+en ` Maiuooneas cnr � ar nuor+e <br />TO/�� Gi-I ! l� �3a -./Y6�'rr srv y��,�,w�od 98036 7 7S — 7 S 3 5 <br />TENRNi MAILRODRESS CI1Y Zip PNONE <br />�RCMItEQOf10E51GNFR M�ILADORESS , CI1V ZIP 1•HONE <br />0 <br />T <br />:, <br />� NEW ❑ AODITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSiOVFJFRPLINSERT L BUILOINGRELOCATION <br />/A/sT�c l� ri; :. < <br />PHOPOSED VSEOF BUILUIN, <br />LOT� BLOGK� OF _%-�.T /c Y". �� I,�� u I <br />PLUMBINO <br />TYPE OF <br />WATER CLOSEf (TI <br />BATHTUB <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />`�1 SUBTOTAL 5 <br />dt PERMIT $ <br />�`� TOTALFEE $ <br />•. � <br />��j FPONTSETB�CN PEARSETBACK SIpESET6FGK <br />..� <br />�� <br />l� !15ElONE LOTAFCq VACANTSIIE <br />�� <br />O YE7 ❑ NO <br />I?� TYPEOFCONSi. OCCUFRNCYGflOU' NO-0FOWELLV <br />ALLOWABLE/AL7UAL <br />�.`t <br />'�J SREOFBL�O. NO.OFSfOflIES &SMt. OCGLOAD <br />uv <br />;� o N <br />i: � HEIGNT LIMITFTI <br />.i <br />�� FIflE SPPINNLEP9 REOUIRED O YES ❑ NO <br />i� <br />�', <br />�'- 11PPLICAiIONRGGOY PLRNSRPPR.BY <br />t• <br />`: I <br />� <br />:� _ <br />3 6 i�-35 3 4 <br />1 HEf7EBY CERTIFY THAT I HAVE READ AIJD EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED K'ITH <br />WHEiHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERhAIT DOES NOT <br />PRESUME TO GIVE AUTHOFiIN TO VIOLATE OR CANCEL iHE PROVIS�ONS OF <br />AN1'OTHER STATE OR LOCAL LAW R[GULATING CONSTRUCTION OF THE PER• <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIZFD BY THE'JWNER OF <br />THIS PROPERNTO PERFCRM THE WORK FOR WHICH APPUCATION IS MADE <br />AND I COMPLY WITH THE STATE CONTpACTORS LAW 1827 RCW AND <br />29820C WAC. <br />SIGNRiURE OF CONTRACiOB OF 4UTHOR12E� �GENI ORTE <br />X %�i'--�-�.��-�- �� �' i 8 9 <br />APFLICRNTSpTY8U51NE55UGENSEN0.RN0U051NE5SNRME � <br />MECHANICAL <br />FEE NO. TYPEOFEOUIPMENi <br />A/C — A/HNDLG UNITS — H.P. <br />� FORCED AIR SYSTEMS— B.T.UTJp'M EA <br />UNIT HEATERS— B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />METAL FIREFLACE 8 CHIMNEV <br />FIREPLACEINSERT _ <br />11EAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STAtEENEFGYSURCHARGE <br />PUBLIC WORKS <br />TOTA: <br />SUBTOTAL S � <br />PERAIIT 5 <br />70TA1 FEE S �I � <br />