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�� ' �1 <br />APPLICATI� FOR CONSTRUC�N PERMIT everett <br />? e; �E� TO BE COMPLETED IN INK—PLEASE PRINT <br />F� crtvoF <br />{� everett � <br />`� BUILDING DEPARTMENT <br />' 259-8810 <br />❑ DEMOLITION I I COMBINATION <br />''� �yy��p �� M��` AOORE55 <br />1� TAn � I e� lgc <br />r� �C3 <br />��T IMRADDRE55 <br />HEATING SYSTEM: U GAS U ELECTRIC U <br />i I BUILDING I I MECHANICAL I 1 PLUMBING I I SIaN <br />11RCNITECTORUESIGNER MMLAUDRE55 "'^ "' -'-- � <br />pE1/Ep11�CpNTR�CTOR MAIL�OORESS CITY ZIP PMONE LICENSEI <br />MECHANIC�LGONTRACTON MNLAODRESS CITY 21P PNONE LICENSEt <br />���wnf`11NiMCTOR M�RAUDRE55 CIiY ZIP PHONE LICENSEI <br />77 <br />��� �� i I DEMOLITION I I WOODSTOVE/FRPL INSERT ❑ BUILDINQ RELOCATION j( <br />❑ NEW f�I ADDITION i I ALTERATION I I REPAIR <br />CCNUCT PEPSON AND PHONE NO. ' � <br />CONTMCT %110E OF WOF�K . <br />LEpµ pE9CPIPTION OF PPOPERTY ISHONM BELOW <br />LOT BLOCK � <br />SINK 6 <br />URINAL <br />!: SINK (SERVICE-BAR, ETCJ <br />{� <br />i <br />" SUB <br />{;' PER <br />TOTi <br />y FOR OFFICE USE ONLY: <br />� FqpNt 5E1gACK flEl1fl SE7BAGI( <br />uee erwc LOT ARE� <br />� 612E OF BlOa. <br />OCCUPANCYLOAO <br />� REASONFORSPRINKLEHS <br />. INTIUCE BY <br />ACIDAI <br />FINE SPqNKLERS REO'D <br />PIANS APPROVEO 8Y <br />I HEREBV CERTIFV THAT I HAVE REAC AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL � <br />roun coeies� PROVISIONS OF LAWS AND ORDINANCES 130VERNINCi THIS TVPE OF ' <br />WORK WILL BE COMPLETED WItH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE � <br />AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY i <br />OTHER STATE OR LOCAL LAW REOULATIN(3 CONSTRUCTION OR TME � <br />PERFORMANCE OF CONSTHUCTION. THAT I AM AUTHORIZED BV 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 />SH3N�TUREOiCONTR�GTORORAUT110RIZEDA6ENT O�TE <br />X�c.3=��� � u� <br />�PVLICANTBCITYBUSNlE9SLICE � � N� <br />` MECHANICAL � <br />. •ur�w�R R! '. <br />��_��-'•,-11 <br />��_� <br />�—� <br />WATER <br />i <br />O�iw�Q <br />�i��ji� <br />DRYERS <br />ON FAN <br />FAN <br />SIDE SETB�CK PUN CHECN NUMBER <br />V�CANT SITE FEES <br />BUILDING <br />p[�yru�cr xoaowl�uMcuM�is <br />GPO�P PLUMBINO <br />PnSEMENT MECHANICAL <br />NEIl3HT LIMITAiION ADDITIONAL PLAN CHEGK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBIIC WORNS <br />LOCAL 8ALE3 <br />TAX CODE I8 3105 �T�� <br />•..,... ,.�.,..y....u'•' •..r,n, <br />M <br />PERMIT <br />TOTAL FEE <br />n <br />H <br />