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pppLlCl�lT10N FOR CONSTRUCT14r�1 PERNi1T <br />m� e��.a,�„� <br />cirv oF <br />everett <br />BUI�DING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-8810 X BUILDING MECHANICAL <br />DEMOLITION COMBINATION p„QN` <br />OWNER AIAILNO�R[55 <br />CIiV 21C <br />�cNFaac c'oP7S2RUCTION INC. 111 S.E. EVERETT MALL WAY, D201� EVERETTP �WA <br />ARCMITECTOROESIGNER MAItADORE55 <br />GENERALGOHTRALTaR MRiIADDA[55 <br />CIiY <br />G1Y <br />PLUMBING <br />PHONE UCENSE� <br />. WA 98208 347-E <br />�� <br />evere[t <br />e <br />SIGN <br />ESHEARS CONSTRUCTION INC. 111 S.E. E6�.......c'rv-- -- z�, —vHor+e LICENSE• <br />MEGHANIL�LCONiNACiO� IARILAODAE55 <br />TO BE DETERMINED ��tY „a rHone uccr+se. <br />PLUA�AINGCbNTR�GTOR MARADDRE55 —__ <br />TO 8E DETERMINED <br />cussoFwoeK SVOOD9TOVE/FRPLINSERT ��� BUILDINGRELOCAT10�� <br />X NEW � ADDITION � ALTERATION REPAIR . DEMOLITION _ <br />' CONTAGT PERSCN AND PHONE NO <br />TENANT IMPHOVEMENT OA INTENOA �E�ODEL ONLV <br />GONTP Li fiCEOFYIOpN• �Q ifC `/y�0 ' -- <br />DESCRiBF WOFK �NO SOU�NE FOOi�GE iNVOIVED <br />PFOPOSED USE O% <br />LEG�L UESC�IPTqN OF PROPERTY ISHOWN 0[lOW Oi1 ATTAGI roJn wrm oi <br />�or 5 eiocK 3 oFSMYTH LA6ID COPiFANY� <br />2ND. ADDITION 'R� E�'EREZT, ACCCRDING TO THE PLAT <br />THEREOF RECORDF.D IN VOLUME 4 OF PLATS PAGE 25, <br />RECORpS OF SNOf1tY'1I3fi CO•�WA% THETICE EAST 93.00 <br />THENCE SOIII'H�Q� 57' 14" EAST FOR 7"s.25 FEET� 'I <br />SOUTH LINE OF LOT 13, BLOCK 3, OF SAID PLAT; TF <br />� m�- gg�52 10 L''F.ST pI ��' `��TH LINB OF $pID [ <br />& THE WESTERLY PRQTECTICk1 THEREOF�cE�JRr118T02 E <br />SINK <br />FRONTSETBAGK <br />USE <br />ryPE OF LO �twwn <br />S12EOFBlOG � � <br />nccua CvlonD <br />qtASpNFORSPNINNLERS <br />�PPLIC�TION ALC BY <br />n <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 TYPE OF <br />WORK WILL BE COMPLETEO WITH WNETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOGAI LAW REGOLATING CONSTFUCTION OR THE <br />, PERFORMANCE OF GONSTHUCTION. THAT I AM AUTHORR�D BY THE <br />' OWNER OF TH15 PFiOP[RTY TO PERFORM THE WORK FOR WHICH <br />EqppLIGATION IS MADE AND I COMPLY WITH iHE STATE <br />CONTRACTORS LAW 1927 RCW AND 296200 WAC. <br />os�f.NAtUFEOFLONiRACTORORAt1TNORPEOAG[Ni �AT� <br />BE1ES�inARS rrv�c�rrttu�mriw rnu� rFpl-125-91fl-- <br />AYMIC�NiS CIl\ 01151NE551 CENSE NO �D BUSM[55 NAME <br />NO. �irc��.. <br />,� p�C—NHNDLG UNITS—H.P. <br />— FORCED AIR SVSTEMS—B.T.U. M <br />— UNIT HEATERS—B.T.U. M _ <br />CIOTHESDRVEflS <br />�r VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER _ <br />� WOOD STOVE <br />METAI FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />y GAS PIPING <br />FxNAUSTFAN ._ <br />TOTAL FEE S " <br />REARSETBRCR SIOES BACN <br />ZO <br />lOTAPEA V4CRNTSIiE <br />2 .' YES - � NO <br />___'___......... orcuvux�v I noo-Mi�o�.ai <br />NO OF <br />FlFESPRNNlEA5RE0D <br />. . YES '. � NO <br />SAqp_PR�OVE�OV <br />" ,1 � <br />9ASEMENT <br />. � YES '.' NO <br />HEIGHT llAll^pTION <br />� i <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />;K MJMBER <br />a /'P 9 <br />BUIL�ING , <br />PLUMB�NG <br />l.tECHANICAL <br />OTHER <br />STATE BUILOING SURCHARGE <br />$7ATEENERGVSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />5 <br />FEE RECEiPT NO <br />vsas.c. 3g 5''' <br />