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� APPLICATiC J FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �— <br />259-8810 <br />DEMOLITION ' � COMBINATION <br />OYyMER M�IL ADDRE55 <br />" BUILDING �''�uIECHANICAL I!'PLUMBING I ' SIGN <br />CITV IIP PHONE <br />��nAn� MRi�qDOFE55 GTV IIP PHONE � <br />ARCNITECT OR DESIGNE MAIL ADDRESS CITY ZIP PNONE <br />����t'i�Pw.) QDI�Sr` ��L�� �i.i'f(/6:.ti• .51� ���FG�� �'f&61� 7SJ��yJ'j'� LvirNe��oy�o2 <br />GENEHAL CONTRACTOR MAIL ADDRESS CITV ZIP PHONE STA7E I.iCE65E � <br />�•� � � l 1 / I , <br />MEGHIWIGILCONTRACTOR MAiL�DDRESS <br />*if'+'.e I�1�C81Li4i� <br />PLUMBINO CpNTR�CTORD MAIL ADDRESS <br />e d� t� / �uM���.S <br />CLAS�S OF WORK <br />[��NEW I l ADDITION ! I ALTERATION <br />ci—n,�—r— <br />�17eKk S uM, <br />CITY <br />ZIP <br />ZIP <br />PMONE STRE LICENSE N <br />tit- 5GhL. <br />PHONE STATE LICENSE 1 <br />i-1 REPAIR i�: DEMOLITION '�,-' WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />CONTACT PERSON �•ID P�'JN E NO. <br />�.IAL. ii�i'RLIIa1 �liS��:ICY"'st! <br />DESGRIBE WORN �1ND SOUANE FOOTA3E INVd.VED ��) � S <br />J 2 7Y f�° °S� `�70 6Q�u.� �7 <br />PROPoSED I�SE OF BUILDING <br />.s/ujle F4,h Il�[� . <br />LE�3Al DESCRIPTION OF PROPERTY �SHOYM BELOW OR 2ATfA��CH FWR COi <br />LOT _ 1 o BLOCK �_ OF W�+�GL��J � <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY (WA^,H BA: <br />SHOWER <br />KITCHEN SINK �i DISP <br />DISHWASHER <br />URINAL <br />; DRINKIN6 FOLINTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADEi;S <br />SUB TUTAL <br />FOR OFFICE USE ONLY: <br />fRONTSETBA�K REARS':TBACK <br />-'� II 2 7 <br />TYPEOFCONiS.AIIOWAPIE TVPEOFLON5T.6f.70pL <br />� <br />� A / I �-., t <br />,� sF �'1— <br />OCCUPANCVLWD FINESPRNI(IERSREOD <br />N/A No <br />PLANS APPROVED BV <br />FEE <br />SIOE <br />i HEREBY CERTIFV THAT I HAVE fiEAD 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 />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS lAW 7827 RCW AND 296.200 WAC. <br />x ��c � � �_2�; -�L <br />Sb � OATE <br />FORCED AIR SYSTEM�B.LU. M E.A. <br />UNIT HEATERS--B.T.U. M <br />RANGEHOOD <br />WATER HEATER <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />PUN CHECK NUMBER <br />_�,.�-r _.� <br />BUILDING <br />OCCUPAMY NJGIGWE4WGUHIIS <br />�p °� / PLUMBING � <br />_�— <br />BASEMENT MECHANICAL <br />Mv --- <br />NEIGNT LIMITATION ADDITIJNAL PLAN CH%�K <br />'9PRNMttER `h�ir.�id <br />,UU <br />STATE KUILDING SURCHARGE <br />CITY OF EVERETT PUBIIC WORKS <br />LOCAL SALES <br />TAl( CODE IS 3105 TOTAL <br />FEE _� Og <br />\% � <br />� <br />L- o . <br />� <br />� <br />