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g <br />C'! i�i � <br />[A."�H <br />a rx3 cn <br />H Z� <br />� H� <br />"�C H � <br />Hrp� y C~" <br />C'l Q � <br />H C7 <br />OH <br />�/��g <br />y� V C� <br />7y.N3 <br />Cy2 <br />HH <br />8 �' <br />C� C �n <br />��Cr+7 <br />2 H tn <br />H O (A <br />� � <br />r ,� <br />,.,;� .-, <br />APPLICATIt�N FOR CONSTRUG'i.�N PERMIT <br />the Eve�gree� <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />25g-gg10 <br />DEMOLITION <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />COMBINATION BUILDING MECHANICAL <br />ApDFEES GiY ZIP ^�� <br />PLUMBING <br />everett I <br />e�� <br />SIGN I <br />_ i <br />TENRNT MAILADDRE55 fITV 2iP PHONE <br />nRCMTECTORDE5IGNER IAAIIF��RE55 GTY ZiP PMONE <br />G[NEPRLCONiHRGT�R IAARADDPE55 CITY 21P PHONE IICENSE� <br />!A[CNPNiCPLCONTRRGTOR MAiLRDDRE55 CITY 2iP PNONE LICENSEt <br />v 3iio Nit< � <tr! �06 �r9-s��i�r �a�6�tliL�� <br />�I.�.1 tO�ll7 t�j�'� LICENSE• <br />.•�. "_ � .. _______ niv ZIP PNONE <br />NEW ADDITION ALTERATION <br />-ENANT IAIPROVEMENT 0� IMERIOR REAIODEI ONLY <br />CpNTRALTPRICEOFWOHN: n�0� <br />pESCRIBE WORN AND SOUARE i00IDGE INVOIVED <br />ioi oiocK <br />REPAIR DEMOLITION . WOODSTOVEiFRPL WSERT BUILDING RELOCATION <br />I LONtAGTPERSpNANDPHONENO. <br />� I HEREBV CERTIFY THAT I HAVE REA� AND EXAMINED THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LOW OR ATTRCNFOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS TVPE OF <br />WORK WILL �E COMPLETED WITN WHETHER SPECIFIED HEREIN OR <br />oF NOT. 1HE GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PfiOVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. TH�T I AM AUTNORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERF05M THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE S7ATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SiGNAiUFEOFCONiP4CTORORAUTHOPiZEDAGENi DAi[ <br />._./ i� e/ � ., . . <br />NO. TYPE OF FI%TURE OR <br />WATER CLOSET(TOILET) <br />BATHTUB <br />LAVATORV(WASHBASIN) <br />SHOWER <br />KITCHEN SINK L DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FI.00R DRAIN <br />lROM SEIDRCN <br />W G 20N[ <br />ivP[ Of CONSi ALLOW�BI[ <br />SIZE OF �IDG <br />OCCUPANCYIORD <br />RGSON FOR SPRiNKLERS <br />nrrnr,nnor�ncc, ur <br />�Yt1:i <br />REAR SETBACK <br />LOT�REA <br />iYPE Of CON9 �L1UAL <br />NO O: STORiES <br />VIRC SPRNKLEf15 REO'0 <br />VES NO <br />pi nr�s nrrnovr n or <br />FEE 51 <br />SiDE SETOACN <br />VTCPNT SITE <br />.NiS CITY OlI5ME55 LILENSE NO� BUSINE55 NAME <br />ANICAL <br />TYPE OF EOUIPMENT <br />A C—A�HNDLG UNITS—H.P. <br />FORCEDAIRSYSIEMS—B.TU. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />_� PERMIT 5 / <br />TOTALFEE 5 5 <br />PLA�GMECKNUld�CR FEE RECE�PTNO <br />YES � N� BWl.DING <br />aav�sc. r,00�owiuixcu�.iis <br />cawv p�UM�ING <br />o�SEMEt+T MECHANICAL <br />VES NO <br />NlIGMLIIMrtATION OTHER <br />_ STATEOUILDINGSURCHARGE <br />STAi[ENERGVSURCMARGE <br />CITY OF EVERETT PUDIIC WORNS <br />LOCAL SALES <br />TAX CODEIS 3105 Tora_ _ <br />