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APPLICATIO.i FOR CONSTRUCT..iN PERMIT <br />tr�e erery�een TO BE CUMPLETED IN INK—PLEASE PRINT <br />CITV OF <br />everetY <br />BUILDING DEPAFiTMENT <br />259-8810 <br />❑ DEMOLITION COM3INATION <br />OWNER , M�ILAO['.ESS <br />z <br />HEATING S1�STriA_ <br />Ol _cCTRIC ❑ <br />everett <br />e <br />�� BUILDING ' MECHANICAL = FLUMBING � SIGN <br />nr rnon[ <br />' ' � n �__. <br />TENANT AIIADDNE55 / CITY ZIP PNONE <br />��nu 1� <br />RRCHITECTCR DESIGNEP MAII �DORE55 GITV 21P PNONE <br />GENEf4LLCONTRAC�TyOR M�ILFDDRE55 CITY 21P PHONE LICENSEI <br />�/ L�l <br />MECH IC�ICONTMCTOR MRILAO�RE55 GITY 21P PHONE 4CENSEI <br />PLUMBINGC[NTR�CTON IMLL�DDRE55 Gltt ZIP PHONE 4CENSE• <br />CLASS OF WORK <br />:� NEW ❑ ADDITION ❑ ALTERATION <br />CONTRACT <br />LE(3AL OESCRIPTqN OF PROPF <br />LOT BLOCK <br />v <br />OF <br />� <br />Yi:/\1 <br />DISP <br />FOR OFFICE USE ONLY: <br />USE 20NE <br />SIZE OF BIOG. <br />• '�SON FOR SPPINNLEPS <br />IOTAFEA <br />NO OF STOHiES <br />PUNS RPPROVED BY <br />��.; REPAIR <br />� <br />� <br />FEE <br />WCRNT SITE <br />L DEMOLITION C�! WOODSTOVE/FRPLINSERT � BUILDING.9ELOCATION <br />GONT4CT PERSON AND PHONE NO. <br />aao.rcr noamvmixcunrts <br />GNav <br />BASEMENT <br />CITY OF EVEHETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />I HE�iEBY CERTIFV THAT I HAVE READ hND EXAMINED THIS <br />APPLICATiON AND KNOW THE SAME TO BE TRUE AND CJRRECT. ALL <br />PROVISICNS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV 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 DV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />SiGN�TUREOFCONTRACTORORAUTMORIZEDAGENT DATE <br />x �'�- i�c.��_ 9-a�-5� <br />APPLICANTS GITY BUSMESS UGENSE N0. �dD BUSINESS NAME <br />UNIT HEATERS--B.T.U. <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 C <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PU1N CHECK <br />OTMER <br />STATE BUILDIN� Sl1RCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />FEE <br />IHSVil� <br />8 <br />FEE <br />