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. -_. �., <br />APPLICATIUN F�DR �ON�TRUC'� rAN <br />�nne�-r.gmr� TO BE COMPLETED IN INK—PLEASE PRlNT <br />cirr or <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />i i DEMOLITION I I COMBINATION <br />ov+wen Mni�nooness „ <br />lAAIL <br />4RCHITECT OR �ESIGNEF MAIL �ODRE55 <br />f.l ll��N.f.OR1O4C10(�ii. r MAILAOOfI[55 <br />ldAIL �U�RESS <br />ri.uinemc corn nncmn <br />� <br />HEATING SYSTEM: U GAS ❑ ELECTHIC ❑ <br />PERMIT <br />everett <br />� <br />I I BUILDING I i MECHANICAL I i PLUMBING ! I SIGN <br />cirv zm vi�or+e <br />�UP�Cf/ 1��a-o/ 3�/� aSf/7 <br />ciTv zm r�+oNe <br />anss oF wom� <br />I� NEW I I AODITION � ALTERATION I I REPAIR <br />coi+innctvnicForw� d O <br />ocscraoe wonK nr:o sounne Fannc� irrvoiveo <br />, �-- <br />f'PJ�air ,/or✓orti.e ��e.� �,rrh/n, <br />rnoroytn use or euaoi�+c <br />—,i,'CY <br />ie�n� oes:niarior+�.r rnaa�nn �si�owri oe�owon <br />� �ot o�ocK or _ <br />� rr.o�tcr <br />NO. <br />WATEfl CLOSET (TOIL <br />BATH7V3 <br />LAVATGRY (WASH BA: <br />SHOWER <br />K'TCHEN SINK 8 DISP <br />UISHWASHER <br />LAUNDRYTRAY <br />CLUTHES WASHER <br />ROO� <br />SINK ( <br />FOR OFFICF USE ONLY: <br />fRONf5ET04CH RE4RSETBAC <br />2v` 2v <br />U:-�E Z�nNE LOt �flE4 <br />„� � <br />IYPEOfCONtS PIIOWPBIE TYPEOFGONSi. <br />-N II-,� <br />SIZE OF �LOG. NO.OF SIOPi <br />�' s � <br />ocr.urnr�cviono Finesrnr+Ku <br />l.l N <br />��ensor+Fon srnmkicns <br />iuinerm---- � riar�snrrne <br />OR ITEM <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />� sioe sernnc� <br />/ � <br />�����,r,�,� <br />�� <br />GIiY ZIP <br />nr runrir ncrr+se. <br />%�ti �/ � �% 1- 7-Sy-�--_ <br />TiP PH011E UCEN� � <br />nr runur iirri�sr� <br />I I DEMOLITION I I WOODSTOVEiFRPL INSEFS �� BUILDING RELOCATION <br />-- cori�ncrrenso������rr�oC��'.V�S�Jl�- �5�� — <br />.l1 <br />��i <br />� s>N - C.v�v- 35� -7�7u <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE 1"RUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITIi WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEflMIT DOES NOT PRcSUME TO GIVE <br />AUTH'JRITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER ST�TE OR LOCAI LAW REGULATING CONSTRUCTIOW OR THE <br />PERFORM�NCE OF CONSTRUCTION. ThAT I AM AUTHOfiIZED BY THE <br />OWNEri OF THIS PROPERTY TU PERFORM THE WORK FOfl WHICH <br />APPLICATION IS M�DE AND I COMPLY WITH TFIE STATE <br />CONTflACTO�iS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATUREOfCONif1�CTOROR4UT110PIZEDAGENT DNE <br />��� _ �- ��,� <br />�PPLIC�NiS GITV �US W E55 LIC -NSE t 0. AND BUSINE55 NA61E <br />MEChIANICAL <br />NO. TYPF OF E�UIPMENT FEE <br />� NC—A/HNDLG UNITS—h P. � <br />� FORCED AIR SYSTEMS—B.T.�. M E_n ! <br />—T— UNR HEATERS—B.T.U. M ; <br />�— <br />� CLOTHES DRYERS , <br />�CCIIMI�CY 110 OfpWfIII11G1:N115 <br />cnour <br />E,.�1>k. <br />13ASEMENT <br />�N/a <br />�,E����, ���a�,�,�o�, <br />CITY OF EVEflETT <br />LOCAI SALES <br />�,�Z TAX CODE IS 3105 <br />R�NGEHOOD � <br />WATER HEATEfl <br />WOODSTOVE i <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLAC[ INSERT ' <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSiFAN � <br />BUILUING <br />PLUMOING <br />MECHpNICAL <br />ori{�� <br />STATE BUILDING SURCHARGE <br />ruAuc wo�Ks <br />TOTAL <br />SUB WTAL 5 <br />PERMIT S <br />TOTAL FEE S _y <br />J�9i <br />F�c \ nec�iaT��o �7 <br />!�� 1 �� li <br />