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,;. ���1 <br />APPLICATI ,� FOR CONSTRUC7"1�ON PERMIT <br />IfN E�wprn <br />cm oF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION �BUILDINQ ❑ MECHANICAL <br />pW��p MA0./�DDRE55 CITY 21P P/ <br />cm <br />PNONE <br />everett <br />e <br />❑ PLUMBINO ❑ SIGN <br />�,g t1--'t`^ t'' l�2 rJluu�►e+� QfLz7S 3s'3os5 Z <br />�pqpTEl:lO`1�6��uNEp MALADDRE55 CITV ZIP PlIONE <br />pQNEpILLCp�(�qhCTOR WILADORESS CITY ZIP PNONE LICENSE� <br />CITV 21P <br />CITV 21P <br />PHONE LICENSE/ <br />PHONE <br />T8 PyG ASS �c, he � C.kc� 2 <br />or woa¢ <br />� NEW ❑ ADDiTION ❑ ALiEqATION f 1 REPAIR f l DEMOIITION I 1 WOODSTOVE/FRPL INSEHT ❑ BUILDINO RELOCATION <br />i[W1NT MPIIOVEMENTOp INTEHIOR REMODEL ONIY <br />K canrawr rn� oF wa�c: 101 .,cnt� <br />oeecaw� wowc uio sowne Faor� rcrvaveo <br />� 9� ...� c� O.. o. �.i <br />�� <br />: i:,m..^ra <br />AL DE8Ci11PT10N OF <br />�— ' <br />QK Q <br />BELJW OR <br />oF F <br />GONT�CT PERSON AND 1'!qNE NO. <br />I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br />coriesl PROVISIONS OF U1WS AND ORDINANCES (iOVERNINO THIS 7VPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br />� NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO �IVE <br />AUTHORITY TO VIOLATE OH CANCEL THE PROVI810NS OF ANY <br />(�L OTHER STATE OR LOCAL LAW RE6ULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICFi <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS UW 1827 RCW AND 298.200 WAC. <br />SICLUNREOFCONT1UCTqiORAUTHORIIED/WENT OATE <br />�haWlr�/b� X�✓LC�.- G��� <br />�, APMICANT9CITYBUSINESSLIGENSE .N/UBUSME63I�PE <br />uenu�uu.0 . <br />PERMIT S � <br />TOTALFEE S <br />F1qNTBE7BhCK � 11FANSETBACN � SIDESETBACK � <br />' ?A ' 20 '-oc, (o <br />U9EIONE LOT/�REA VACMITSITE <br />R� Z � SO � 1 '6.9 YES Cl NO <br />1YPEOiCOMST.ALLOWMIE lYPF0iWN5I.ACTUAI on.vwxn Noaow[uiwcu <br />GRdW <br />_� Z <br />��tLR�OF_BIDp* NO.OFS ORIE9 MSEIAENT <br />G°�sf ❑ YES ��NO <br />.�G' 4i Sf GAIt Z <br />OCCUPANCYIOAD FIRESPRNKLERSREO'D NEIOHTLIMIT/TION <br />❑ YES � NO � <br />REA$ON Fqi SPRRlKLENS <br />APPLICATION ACC. BY PIANS APPqQVEp BY <br />/(ill� <br />�� <br />CITY OF EVEHETT <br />LOCAL SALEB <br />TAX CODE 18 3105 <br />BUILDINQ <br />PLUMBIN� <br />MECHANICAL <br />OTHER n��.� ca,�r� <br />STATE BUILDING SUHCHAROE <br />STATEENERGVSURCHARGE <br />PUB�n: WORKS <br />TOTAL <br />FEE" � <br />N <br />O <br />