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,.�.v.. r.. _ ..._ � ... .. _ .' .._.... . •.s. ,..� ,.. �... •1._ _J_ <br />. .. �__ .. .S _ _. L'_..,c le: � ¢ ... ._ . . . .. .. ».. .]6 til.. ::�:: .� , . �. .. . _ .�1"^:ixJ_ Y�.1CF:L]'Y.'rt�:t91L) <br />� <br />APPLI�A.ION FOR CONSTRU�TION <br />PERMIT . <br />M� Ewrproen everett � , <br />C'TY OF <br />everett <br />BUILDING DEPARTMENT <br />259•BB10 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNEp M�IIADOflE55 LIiY ZIP PNONE <br />b�,41v DR-u�y�vt3auc3�-! �/ZDS GQAtiI� RUE �1�7 98za3 ZSZ-�ZS! <br />.�...... MAIL�DDHE55 dTY ZIP PHONE <br />�� <br />ARCHITEROROE910NER M�IL�DDRESS GITY ZIP PMONE <br />'iHNv StrrAN q29 N.13ork•Svi�reB, SGr.�Q7Tt�, w,a.�YB/33 362-.Sfl2S <br />�E�����pp M�IL�ODRE55 CITY 21P FHONE 36ZS_OZS �ICENSE• <br />(�LP�N� (�i�JSTOM t3w�Dw�S, L72g rv.l3o�; S�krrcC, i-✓�•�'8�33 ALP�rvc�IS/M9 <br />MECMIINIGLLCONTF�GTON M�ILAODFE55 CITY SIP PMONE LICEN9E• <br />PLUM&NOCONiRACTOR M11lAD�PE59 GITY ZIP PHONE LICEN9E• <br />Jal NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ tUIL01N0 RELOCATION <br />TEN�NT IMPROVEM[tl I Un In Icmv(�n now.iva vn�. <br />� CONTMCTPRICEOFN'ORK � i. JS / � <br />i p[SCMlEWORMAND90U�REF00 A EINVOIVED <br />, GAr2.�►G.E � �l-loP <br />PIpPOlEO U8E OF BU�lDINO <br />�EE BLuE PQtaT <br />, LEW DEBCRIPfIONOFPROPENTY�SHOWNBELOWOR�T1 <br />' LOT lLOCN OF <br />S�n Gf(�,�1�� <br />, <br />� rnaecr�ooness � <br />N2A� GfQnd �V �G <br />PLUMlINO <br />Np, IYPE OF FI%TUHE OR ITEM <br />� WATERCLOSETITOILE7) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />3HOWER <br />� KITCHEN SINK6 DISP. <br />DRAINS — <br />b <br />'-r <br />DNST. <br />�L�� <br />oc+. <br />99Z <br />iKLERS PEW IRED <br />DN AGG 11Y�'A <br />�!til " <br />� <br />N /Z,�ZZ. <br />�W <br />',S ' Y1LS I Lln .T -'1�1- � GIJC GJOR.K <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED TH�S APPLICATION AND <br />KNOW THE 3AME TO BE TRUE AND CORRECT. ALL PROVISION9 OF UN/8 AND <br />ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br />WH ETHER SPECIFI ED H EREI N OR NOT. THE ORANTI NQ OF A PERMR DOES NOT <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVI310N3 OF <br />ANY OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE PEFF <br />FORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORI2ED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM TNE WORK FOR WHICH APPLICATION 19 MADE <br />AND I COMPLV WI7H THE STATE CONTRACTORS LAW 1827 RCW AND <br />298200 WAC. <br />SIUN� FEOFCONT TOROH�UTNOi1RED�0ENT D�TE <br />X� 0 � � � _ _, y/�d9 <br />0 <br />MECHANICAL <br />NO. TYPE OF EOl <br />A/C — A/HNDL6 UNITS — <br />FORCED AIR SYSTEMS— <br />UNIT MEATERS— B.T.U. <br />CLOTHESORVERS <br />a <br />E <br />S <br />SIDESETBAGK � PUN( <br />/O �C B' <br />WC�NT SITE <br />❑ YES D/NO <br />�S <br />� <br />WOOD STOVE <br />METAL FIREPLACE 6 <br />FIREPLACEINSERT <br />SUB <br />BU�LDING y gZ X� � <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHPRGE <br />STATE ENERGV SURCHAR�E <br />PUBLIC WORKS <br />TOTAL <br />M EA <br />fOTAL S i <br />AIT S � <br />i <br />LFEE S I <br />II[C[IPf N0. <br />76 = ��s r � <br />VALUATION FEE <br />'��� a � <br />i <br />o'� � <br />