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8lo"`�C <br />APPLICATIOIr FOR CONSTRUCTIL.�1 PERMIT everett <br />� E��� TO BE COMPLETED IN INK—PLEASE PRINT �,7 - 7f � <br />CITV OF }} <br />eVerell HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259•8870 <br />❑ DEMOLITION ❑ COMBINATION <br />I.I BUILDING xl MECHANICAL ❑ PLUMBING ❑ SIGN <br />CITV <br />PHONE <br />TENµT MAILAUDPESS CITV ZIP PHONE <br />�RLHITECTOflOESIGNER AIAILADORE55 CITY ZIP PHONE <br />6ENEIW.CONTRACTOR MpILADDflE55 CITY 21P PHONE :ICENSE� <br />� ar/oJl�wl c . <br />❑ NEW ❑ ADDITION UO ALTERATION <br />___.___. �a z�0�.— <br />DESCRIBE <br />LEOAL DE9CRIPTION OF PROPF <br />LOT BLOCK <br />PROJECTADONE55 <br />/ zi� <br />PLUMBINO <br />� Np, TYPE OF <br />� WATER CLOSET <br />BATHTUB <br />i �.AVATORV (WASI <br />� SHOWER <br />KITCHEN SINK 8 <br />' DISHWASHER <br />LAUNDRVTRAY <br />. CLOTHES WASH <br />URINAL <br />. DRINKIN6 FOUN <br />,� FLOOR DRAIN <br />. BACKFLOW PRE <br />ROOF DRAINS— <br />SINK (SERVICE- <br />CITY Zir <br />l .J//_ <br />ZIP PHONE <br />uccnx. <br />. _ / <br />� <br />I I REPAIR I.I DEMOLITION I_I WOODSTOVEIFRPLINSERT ❑ BUILDINORELOCATION <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />.OW OR ATTACN FOUfl COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVEiiNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />oF NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <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 PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SIGNATURE OF GONTRACTOR 011 AUTHORIZEO A(3ENT DATE (�—� ��y � <br />X i'��,�< �� Fca�,EidA.✓ <br />� MPLIC�NTS CITY BUSWE55 LICENSE NO. AND BUSINESS NAME <br />FOR OFFICE USE ONLY: <br />FflONT6ETBACK RERBSETBAGN <br />USEZONE LOTAFEA <br />OGCUPNICY <br />INT�NE BY <br />OF <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />RANGEHOOD <br />WATEfi HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT S <br />SIOESETBAGN I PLANCHECKNUMBEfl I FEE <br />VAGANTSIfE FEES __ <br />BUILDING <br />TVPEOFCONST.ACiIIAL OCcuv�xcr xowowEwNGUNitS <br />GPMP PLUMBING <br />NO.OFSTORIES BASEMENT MECHANICAL <br />FIRESPflNKLER5RE0'D HEIGNTLIMITATION AD�ITIONALPIANCHECK <br />OTHER <br />STATE BUILO�NG SUflCHARGE <br />PLANSAPPROYEDBY CITY OF EYEflETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAL 31 CdJ i�. <br />� <br />/ <br />