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APPLICATIOr�I FOR CONSTRUCT�ON PERIIl41T �Ve�P« <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />me eve,g�een — � <br />CITV OF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ � <br />- BUILDING DEPARTMENT <br />259-8810 �/ / <br />1 DEMOLITION COMBINATION BUILDING YMECHANICAL PLUMBING : SIGN <br />OWNEP MAILAODflE55 GiTY 21P PHONE <br />�"cNN dvr,-��s 5/3J Nr�ea���,�ur� ��Z-, 93lzo� 3Y�-/ 9v3 <br />TENRNT MAILA9DRESS CITY 21P PNONE <br />�F�A0.c,..r,y � i�55�c. /SY315� SL�oOR _C�Ai..qw�ns �R�-, 9%O/s i' �3)GSZ-1 R o8 <br />ARCHitELTOPp SIGN[R MAILAOORESS ,{� dTY 21P PN IE ) ��' p�-y� �/ <br />01}�� I�dwScw I��S� //-�ARh �R11.P ��r. IS�-o3 /-S /-�- / J �//%%N�L'�v3Yi�gZ <br />� �GENEFMCONiRRGiOR �AARPODRESS Cltt ZIP PNONE LIGENSE• <br />MECNRNICALCONTR4CTOR MAILRDDRESS CrtY ZiP PNON[ LICENSE/ <br />�BINGCONTPACTOH MAILRDDRESS Ciiv ZIP PMONE LIGENSE� <br />cus woaK <br />� NEW '. . ADDITION .�� ALTERATION . � REPAIR �. . DEMOLITION �. � WOODSTOV6FRPLINSERT �. -� BUILDINGRELOCATION <br />� _ _(J CONTACiPER50NAN�PMpNENO. <br />DESCRIBE WOPN �ND SOU�RE FOOTAGE INVOLVEO <br />�� ��i - <br />PROPOSED USE OF BUILOING <br />LE .A(. f ESCRiPTpN OF PROPERTY ISMOWN BELON <br />ior e�ocn _ __ oF <br />PNQIECT�D�RESS <br />PLUMBING <br />N0. TYPE OF FI%TURE O <br />WATER CLOSET�TOILET) <br />BATHTUB <br />LAVATOFV�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DFAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADE <br />SINK 1SEFVICE-6AR, ET0.) <br />FOR OFFICE USE ONLY: <br />USEZONE <br />SRE OFBIDG. <br />OLCUPANCYLOPO <br />MT�RE BY <br />I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS � <br />APPLICATION AND KNOW THE SAME TO BE TRt1E AND CORRECT. ALL <br />ATTACNFOUNCOPIESI PROVISIONS OF LAWS AND ORDINANCES GOVcRNIP'3 THIS NPE OF . <br />WORK WILL BE COMPLETED WITH WHETHER SFECIFIED HEREIN OR �� <br />NOT. THE GRANTING OF A PERMIT DOES NOT PflESUME TO GIVE . <br />AUTHORITY TO VIOLATE OR CANCEL THE PPOVISIONS OF ANY �I <br />OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE . <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE I <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTR! CTORS LAW 1827 RCW AND 296.200 WAC. <br />SIGNAiU��OFCONTP ORORRUtNO 12�DAGENT OATE <br />�^� � �,. �j/ Q u/� � <br />X„ /i � .� <br />!3o?c. �A�N�Ns��, r �sz�.. o�, µ�, <br />APGUCAhf 5 CITV 0U5ME55lICENSE N0 ANO DUSINESS NPME <br />ITEM <br />LOT aliEA <br />iYPFOfLONSi.PLtURI <br />NO.OF STONIES <br />TOTAL S <br />NIT 5 <br />1L FEE S <br />SiDE SEtBRCK <br />V�CPNT SITE <br />OCCUv�4tv MU OfVN[lliNGUNi15 <br />LPWV <br />FIpESPRNNLEPSPE00 I HEIGMTIiMIipTiON <br />rur+snrrnoveoor CITYOFEVEREIT <br />LOCAL SALES <br />TAX COUE IS 3105 <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYEFS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL 3 <br />PERMIT $ <br />TOTAL FEE $ <br />PUN CHECN NUMOER <br />Bl11LDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECN <br />OTHE(i <br />STATE BUIIDiNG SURCHARGE <br />PUBLIC WORKS <br />TOTRL <br />FEE I AECEIPiNO. <br />