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APPLICATIL��! FOR C�NSTRlDC7�';'JN r�RMlT <br />everett <br />fhe Everpreen � . <br />CIN OF <br />everett <br />BUILDING DEPARTMENT <br />259-8816 TO BE COMPLETED IN INK—PLEA E PRINT <br />❑ DEMOLITION ❑ COMBINATION I I BUILDING P ECHANICAL ❑ PLUMBING ❑ SIGN <br />ownen Mna nooness crtr zir PIIO��E 3, ' 1� <br />Zg0 �,urL (�.fl. �.t��" q�Zo3 353 ' `i <br />TENANT MAILADOflES9 CITY 21P PMONE <br />ARCNIIECiOflDE510NEN MRILAOORESS CI7Y ZIP PHONE <br />UENEBALGONTR�CTOR MpI�ADORE55 CITY ZIP PHONE UGENSc� <br />iq►5 . i �4 F�� n�ti <br />Mna nooness <br />G1A550F WOBN <br />O NEW ❑ ADDITION �iiAl'ERATION <br />TENANT IMPROYEMENT Oq �NTERI�R f1EMO0E(L �M,!1�1,Y <br />CONIMCTPPICEOFYIOfiK: IIYV� • <br />nfSc.HIPE WOFN �NO SOU�PE FOOIAGE INVOIVED <br />PROPOSEO <br />UGENS I <br />N54 soN�owrlUe.7`�; <br />ZIP <br />Cl REPAIR L I DEMOLITION ❑ WOODSTOVE/FRPL INSEFT ❑ BUILDING FiELOCATION <br />cor+rncr rensou n��o Pr�orie r+o. <br />1 <br />tE�AL DESCNIPTION O° PHO�E ITY �SHCNsN BEIOW O(1 A1�I�CH F W H COPIES� <br />LOT BLOCK OF <br />: [- PROIEC� <br />ill <br />i <br />I PLU <br />NU. <br />i - <br />WHTER CI <br />BATH�UB <br />6 <br />I <br />I�' FROIItSE7B�CN <br />�W1,�f.� � �.�.7VvV� <br />lii�;���3�� <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />PERR SEIBACK SIOE SElO�CK <br />USEIONE — I LOT�REA <br />lYVEOffAvSI.ALLOWABLE � 1YPEOftON51.AGWQ <br />S�ZE OF BlDO. <br />I . occurnr+cr4o�o <br />�r--- <br />PEASON FOfl J.^RINKLERS <br />APPUGAIION ACC. OY <br />NO.OF S10NE5 <br />FIRE SPRNNlERS RE00 <br />❑ YES ❑ NO <br />VAC�NT $IIE <br />I:l YES 17 NO <br />acur�xcr xnav.vuuxai <br />t�wr <br />ORSEMENi <br />L] YES I] NO <br />MEIGHT UMITATIOH <br />PUNSAPCROVEDBV I CITY OF EVEFlETT <br />LOf.AL SALES <br />TAX COUE IS 310F <br />I HEREBY CcRTIFY THAT I HAVE fiEAD AND EXAMINED 7HI5 <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. ALL <br />PROVISIONS OF IAWS AIJD ORDIN�NGES GOVERNING 7HIS TYPE OF <br />WORK WILL BE COMPLETED W�TH WHETHER SPECIFIED HEREIN OR <br />NOT. TNE GRANTING OF A PEf�M1T DOES NOT PRESUME TO GIVE <br />AUTFIORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />F'ERFORMANCE Of CONSTRUCTIUN. THAT 1 AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PEHFORM THE WOFiK FOR WHIC1i <br />APPLICATION IS MADE AND I COAiPLY WITH THE STATE <br />CONI"RACTCRS LAW 10.27 RCW AND 296200 WAC. <br />S�GNqUflEOFCONI174CTORORAUi1/0R12E0AGENT D�TE • <br />b,;.G� OZ-n03�12� �(j <br />pPPLICq1�I5CITYBUS�S�ICENSENo.�NDBU5�NE55N�� �� <br />NC—A/HNDLG UNITS—H.P. <br />FORCED AIH SYSTEMS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />CLOTHES URYEHS <br />VENTILATION FAN <br />RANGEHOOD _ <br />WATER HEATER _ <br />WOODSTOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />IiEAT PUMP <br />PLAN G41ECK NUMBEfI <br />FEES <br />BUILDIIIG . <br />PLUMeINO <br />MECHANICAL <br />OTHER <br />S7ATE �UILDING SUPCHAf1GE <br />STATE ENE(iGY SURCHARGE <br />PUOLIC WOfiKS <br />r,:*a� <br />SUBTOT�L S <br />PEF� 5 � 1!1 <br />tOTAL FEE S 'OO <br />FEE PECE�PTNC. <br />VALUATION FEE _ <br />