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,w <br />APPLICATI�1 FOR CONSTRUC �ON PERMIT EVefP1 <br />� TO BE COMPLETED IN INK—PLEASE PRINT � <br />tne Emry�ean <br />CIN OF <br />everett HEATING SYSTEM: O GAS ❑ ELECTR�C ❑ � <br />BUILDING DEPARTMENT <br />259-8810 <br />' DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />TENRNT <br />MAtL ADDRE55 � <br />M41L AO�RE55 <br />OROES�GNER MMLPpORE55 <br />zir <br />ZIP PNONE <br />GENERALGONiHRCT00 MBILqDDRE55 QTY 21P PI'ONE � LICENSE/ <br />MECNPNIG�LGONiPACTOR MRIIRODRESS CITV 21P FNONE IICENSE• <br />PIUMBiNGCONTR/.JTOR MMLADDHESS CIiY 71P PHONE LICENSE� <br />�. NEW �.� I ADDITION . ALIERATION �. REPAIR <br />CONTRAGTPRiCEOFWORK �`�I���O <br />OESCRIBE WORN �ND SOURRE FO0OiA�,GE iNVOLVED <br />�/1 � � �dI/ ��-La� <br />PR POS USEOFBUI�NG � <br />LEGRL DESCflIPTION OF PROV[RtY ISHOWN BELOW OR ATTRCM FOUF COPIES� <br />�or e�acK oF <br />FOUNTAIN <br />FOR OFFICE USE ONLY: <br />FFONT SETBACK RERR 5[TBACK <br />USEZONE IOiARE� <br />iVPC Oi [OM115 dIIOWABIF IYPf OF CONSr ALI <br />SIZEOFBLDG NO.OFSTORIES <br />OCGUPANCVIOAD F��ESPRNKLER: <br />RE�SON FOfl SPRINNLERS <br />iNLRKEaV � PLFNSAPPPOV[DBY <br />5 <br />FEE <br />� <br />DEMOLITION .� WOODSTOVE/FRPL INSERT �..1 BUILDING RELOCATION <br />CONTALT PERSON AND PHONE NO <br />I HEREBV CEfiTIFV 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 TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />1PPLICATION IS MADE AND I COMPLV WITH THE STATE <br />JONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />9GNAtUR/EO\FCONTR�CTOROR�UiNOH12E0�GENT OATE <br />X \ // � ,�i1 / / � � \ l �A�Q � <br />�PPUC� CITYBPSINESSLICENSENO.ANpBUSME59NAME <br />FORCED AIR S`.'STEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CIOTHES DRVEFS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATEF <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SETBRCK � PIRNLHECKNUMBER � FEE <br />VACANT SITE FEES <br />BUILDING <br />{'(N1'ANCV NO O�OAIl11NGllYi[t <br />49�P PLUMDING <br />6ASEMENT MECHANICAL <br />MEiGHr uMrtnnoN FDDITIONAL PLAN CMECK <br />OTHER <br />STATE DUILDING SURCNARGE <br />CITY OF EVEREiT PU�LIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 Tor�� <br />3 <br />�;. <br />1; <br />