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,e,..� . <br />� <br />— ,._ <br />` APPLICAT14r1 �OR CONSTRUCT�ON PERMIT �����'� <br />TO BE CCIMPLETED �N INK—PLEASE PRINT � <br />��x <br />q H <br />9HV� <br />y � �-�+ <br />� H� <br />"�G N "�A <br />VJ H <br />t�1 Q � <br />Yy <br />OH <br />H�8 <br />�Y � <br />M <br />H <br />NH <br />� <br />��N <br />HO� <br />ma Ermy,enn <br />CI1V Of <br />everett HCATINGSYSTEM: ❑GAS � ELECTRIC C_l � <br />BU�LDING DEPARTMENT � <br />259-8810 <br />r DEMOLITION � COMBINATION BUILDING MECHANICAL PLUMBING SlGN <br />OWNER MAILADDAESS GTY ZiP PHONE <br />�-f�Ni�Cr=r HroJf/1rrE /��iU3�cH L13L il�6���•f1ro .9�E fa/"•�`�7 1�,9 �lGK'i LS�'�YS� <br />tENANT MRILAD�Rc55 CITY 21{� PNONE <br />�RCHI1tGTORDESiGNER MAiLADOFESS CITY ZIP PHONE <br />. r/�l A�il (N JT. lf 1, Il // <br />GCNERALCONiRALTOR MAILADOflESS CITV ZIP P��ONE LIL[NSE• <br />r✓��Oq i, L r37 L13ti ttiGrl�� n�f C�l 2��iT �>Et�r iSt-�v5� N��A�aK+-3aci7 <br />MECNWIIGALCONiRNCTOP MAILAD�RE55 CLY 2iP PNONE LICENSE I <br />PLUMBMGCONTf1ALtOR 6NILADDR[SS CITY ZiP PM04E 4CENSE• <br />Qq✓( ni�i•-,i,r 34/1 ffl'o��t Eai`^c�T 2�ti/-2HF� <br />CLASS Of WORK . <br />i�NEW �. � ADDITION .� ALTERATION AEPAIR DEMOLITION . WOODSTOVE/FRPL INSERTn �, �. BUILDING RELOCATION <br />7(d�p,pF' c�2�S'F //�1��- �v CONiRCiPERSON4NDPHONENO. ��C-. � <br />�GONTRC�eo�v�ORK� i �5�`« �/?7.op� LFJ/,�/1Y /✓A�/' �.� 1/ L// if�+�/� <br />DESCRiBE WORK RNO SOUAPE FOOTAGE INVOLV[0 <br />COr3TR � �i Nf �' � S�'�GLG u.✓ �%- <br />PROPOSEDUSEOFpUILDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />� `rF APPLICATION AN� KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LEGGL �ESCRIPTION OF PROPtN I T 15HOWrv uuv� <br />(i� �i� �- c.c r i:: <br />LOT I�Rr� BLOCK �I f.j _ OF <br />S I�i/� /✓1GNuvh' /70Ai/ <br />PRQIECTR��RE55 <br />,%-��� ��`(7� <br />PLUMBING <br />NO. TM <br />a2.' WATER CL <br />� BATHTUB <br />a. LAVATORY <br />SHOWER <br />� KITCHEN <br />� DISHWAS <br />LAUNDRY <br />� CLOTHES <br />_ � <br />toPtes� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />'., 7RK WILL BE GOMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THF GR4Ni�ING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOH�'Y TO VIOLAiE OR CANCEL THE PROVISIONS OF ANY <br />�„�qj OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERT\' 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 />SiGNATUREOFWNTPRGTORORAUT110R2EDAGENT OATE I-G'��L <br />� -1�S v� W�usf, <br />X fie�,L T-/ 9� 3 3 <br />AP�UCRNiSWTYBU iNE55UGEN5ENO.ANOtlU51NE55NAA1E <br />PE OF FIXTURE OR ITEM FEE <br />OSET�TOILET) <br />(WASH BASIN) O �- <br />SINK 3 DISP ��_ <br />HER r ,_ <br />TRAY ' <br />WASHFR �— � , � <br />�--� <br />FLOOR DRAIN <br />BACKFIOW PREVENTERS� <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—RAR, ET0.) <br />SUBTOTAL S <br />_ � PEfiM1T S <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CN REAREETBACK / SIDF <br />� „ .. 7� <br />__� __ ,3 <br />1VPE 0� CONfS ALL01 <br />V-�/ <br />�aE uqioc 5 <br />'�� <br />OLCUPANCYLOAD <br />N�� <br />REASON FOR SPRiI <br />INTANE BY <br />IOTRR[� <br />1YPF Oi CONST ACIUAI <br />V �✓ <br />NO OF STORIES <br />� <br />FlRE SPPNNlERS REC <br />ND <br />PLANS� <br />YACANT SRG <br />0(Nf�M1Cv N� Cf�N.EI:��.GUM15 <br />Z'°°3 <br />pASEM,,,///E111yyy//qi ������ <br />�- <br />IIEIGNT LIMIiAT10N <br />!/� � <br />CITY OF EVEHETT <br />LOCAL SALES <br />TAl( CODE IS 3105 <br />OF <br />FORCED AIR SYSTEMS—U.T.U. M E.A. <br />� UNIT HEATERS—B.T.U. M �_ <br />_� CLOTHES DRYERS <br />VENTILATION FAN � <br />__ _—� <br />i onurcunnn � <br />p�RNCN[CNNOMOER roe ^� <br />'3 C-� G S� �� ,S 5 3: yo S"7 r u i <br />BUILDING � ('i ; �C% <br />PLUMBING S�� 0 VO �OL <br />—� <br />MECHANICAI (r O 'O e <br />AODITIONAL PLAN CIIECN � , j %��" <br />� <br />O7HER � <br />STATE Bl11LDING 9URCHARGE y � �C <br />Pl1BLIC WORKS �7 CJ ; o` <br />T <br />� <br />TOTAL /3� L� <br />