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���tl <br />b� <br />��u`W� <br />� 1"1 � <br />��� <br />x <br />o� <br />�� <br />Q�1r <br />Zs �"I <br />t" y <br />M <br />CA <br />H <br />�� <br />6 � <br />APPLICATIO�: FOR CONSTRUCTC'�N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />t�e Eveipreen <br />aTv oF <br />everett HEATING SYSTEM: O GAS O ELECTRIC ❑ <br />_., BUILDING DEPARTMENT <br />259•8810 <br />!] DEMOLITION COMBINATION x BUILDING i.l MECHANICAL i: PLUMBING SIGN <br />nwuFR MMLA9DRESS _ Cltt IIP PHONE <br />TENANT <br />OROESIGNEH MpIL <br />ADUPE55 <br />cm <br />21P <br />PHONE <br />GENEMLCONTP�GTOR MAILADDRESS CITY 21P PHONE I�CENSE• <br />MECHANIC�LCONTR�CTOH MRILAD�RESS CItV 21P PHOYE 4CENSE• <br />PLUMBINGCONTRRCTOH MAILApDPESS CITY 21P PHONE LIGENSEI <br />cuss oF wonK <br />❑ NEW ❑ ADDITION G ALTERATION <br />'PRICEOFWORN �Y� <br />V/ONK �ND SOU�RE FOOTAGE <br />C..r/tCNEfF. � �i�K/ <br />IEG�IDE CRIPTIONOFPFOPERTY�SMOWN <br />LOT� BLOCK �� <br />LAUNDRY <br />FOUNTAIN <br />SINK <br />FOR OFFICE USE ONLY: <br />FRONTSETB�LK REAR: <br />USEZONE I LOTAREA <br />SRC OF BLOG. <br />PEASpNFORSPRINNlERS <br />REPAIR :�. DEMOL�TION �. �. WOODSTOVFJFRPL INSERT ;� BUILDING RELOCATION <br />GONUCT PEPSON AN� FNONE N0. <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />;� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY 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 AUTHOR12ED BY 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 />51GN�TUFEOFCQ4TRACTORORAUTHORREO�GENT DATE <br />x�.r inw�� 91 <br />PPLICANTSCI BUSINE554CENSE .MlDBUSMESSNAME <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />SIpE SETB�CK <br />1YPE OF CONSf. PCiWI <br />NO. OF STORIGS <br />FIPE SPRNNLERS REO D <br />Pi RNS APPROVEO BY <br />IYa1:l <br />METAL FIREPLACE 8 <br />IYd.I <br />FEE <br />T.U. M E.A. <br />$ <br />V�CANTSrtE FEES VNLUNIIVI'1 �cc <br />6l1ILDING � � � <br />«n.qr.xn xoau+rtii�ncurrts i <br />GBp1° PLU;.t9ING i <br />BASEMEr+i IAECHANICAL ' <br />HEIGNTLIMITATION AODITIONALPLANCHECK <br />OTHER <br />STATE BUILDING SURCHARGE i S O <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES , <br />TI1X CODE IS 3105 TOTAL ��;�.� <br />