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�"�' <br />H <br />�HC~i� <br />� <br />�H� <br />�yR�Hz <br />O H d <br />��g <br />�I:Y (�] <br />t"y� <br />H+ y <br />gy <br />H <br />n�� <br />�H(n <br />HOtn <br />/�PPLICATION FQE� CONSTRUCTI`.N PERMIT �'`'�'�c" <br />TO BE COMPLETED IN INK—PLEASE PRINT G � <br />«� �,e.9,�.� %jlw� <br />CITV OF <br />eve rett HEATING SYSTEM: ❑ GAS � ELECTRIC U _ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION �c BUILDING MECHANICAL PLUMBING SIGN <br />OWNER � �'1pILA0�D-R}E55 �. . Cltt� �' PHONE <br />� �(( f S t� �ICv�-z� LYlC,CSGI�I �vT✓ �;�(I'] <br />rer+nr�r ��v�ess�/SI�IC C /Cl!cm��i.V�z�eL�c:= vnor+e <br />� n <br />MCj�TECTORDE5IGNE MRiLA RE Cltt ZiP PHONE <br />�-��i . � . �Q�.Q,v � �r �� lrc� c..�1�5 �I SG.,s� _ <br />�ENERRLC��TRA�G(/ �✓) � AILA�S � � /�(. /� ✓�(l�Cl `i/t'�I ZI � O�G� O� S� `I �7, LICENSEt <br />I.IELHRNICRLCONiFAGTOR MRILADDRESS GtY ZIP PI/ONE UCENSE� <br />i�C,m , A� �r�{,vr <br />PLUMB�NGCONIRRCTOR MAILP�ORE:S CITY ZIP PHO�� � LiCENSE� <br />NEW X ADDITION � ALTERATION . REPAIR DEMOLITION <br />:» <br />FOOTAGE INV V f' <br />.• .d _ r �/Ch2. <br />LEGAL DESCR/IP'TION OF PpOPERTV �SNOWN BEl05Y OR ATTqCl <br />LOT � k'J BLOCN OF <br />/—l�G� ������ F��,s <br />/V L /L� � � � � <br />- /� �/� Lr,f �� <br />/ <br />� <br />PRQIEf.T ADDRES <br />�7U `1 Nr G r� Lfl.ulD lZ . <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM FE <br />LAVATORV�WAS <br />SHOWER <br />KITCHEN SINK 8 <br />�:F1:1�: <br />FLCOR <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONTSET�ACN RERRSEiB�1GH <br />, �, <br />US[2GNE �OiRRER <br />� ' <br />P�C[O�CONiS>ILOWABIE t1'PEOF[ONSC�CNAI <br />-N "ti� <br />SiLEOFOLDG NOAFSTOPIES <br />3`�L X AoJN � <br />OCCUPANCVLOAD FIRESPPNNIERSREO'D <br />u� <br />PGAWN POF SPRINNLER$ <br />PlANS APPROVED CY <br />tiL q�- 41 <br />WOODSTOVE/FRPL INSERT . � BUILDING RELOCATION <br />nruol nE�(lI'!� �.Sr�—�S� 7 <br />I HEREBV CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS NPE 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 PROVIS�ONS OF ANY <br />OTHEq 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 />APPLICATION IS MADE C.ND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 ACW AND 296200 WAC. <br />SIGNqTpqEOFCONTRAGiOflOflRUi�i R AGENt DATE <br />� � o ,�� y � � <br />X , <br />APPLICANTS CIiV HUSIYESS LIGE . NO AND BUSINE55 NAME <br />:G7�ii!•1��77 <br />M <br />UNITHEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />5 <br />PERMIT <br />TOTAL FEE <br />PtANC��ECICJUMpER (EE�L.Zu'f�s AECE�PTN` <br />RI L � Sy' `��� <br />Vr1CANT5ITE FEES VALUATION F <br />DUILDING , ,� �7n �1�. g �p � <br />CLCUMVCY NOC[pAllliHv'US'!5 <br />°R�� PWM�ING <br />( <br />BRSEMENT MECHANICAL <br />N� <br />HEIGNTIiAIITATION �DDITIONALPLANCHECK <br />28 ' OTHER <br />STATE BWLDING SUfiCHAFG[ <br />CITY OF EVERETT PUBIIC WORKS <br />LOCALSALES <br />TAR CODEIS 3105 rora� <br />