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y,, �ip.� � � <br />AiPPLICATIO� FOR CONSTRUCTI N PERMI'1'Tr'��i'-�-�' <br />everett <br />�E� e <br />GTV OF <br />everett <br />BUILDING DEPART:uiENT TO BE COMPLETED IN INK—PIEASE PRINT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ;�ECHANICAL � PLUMBING ❑ SI(iN <br />/ �� N C MAILADD�E/1 .%�n �A..w'� �Iry��� `�i� IP.O/1 ... i.i�l��rii��% !l� J�����liti� <br />r <br />•I.!.1'i� <br />7EqNJi 1ANIOVEMENT OR <br />�pr e�oac ov <br />F110Ni BETB�CK <br />UBE ZONE <br />1YPEOF WfqT./LLLOWABLE <br />61ZEOFBLW. <br />OCCUPANCYLOAO <br />RE�BON FOR SPRMNLERS <br />APPLIC�TIpN �LC. BY <br />PEARfiET&1GK <br />l0T �RE� <br />iYPE Oi CONST. ACN�L <br />NO.OF StORIES <br />FIRE SPRNKLENS REO'D <br />O YES ❑ NO <br />CITV =�P <br />CITY ZIP <br />CITV <br />CITV <br />PXONE <br />PHONE <br />❑ flEPA1R ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDINQ RELOCATION <br />a ; <br />a � <br />S ' <br />61DE SETBACK <br />VAGANT SITE <br />❑ YES ❑ NO <br />occuo�w.r xoaow[uiwi <br />anpw <br />B�SEMENT <br />O YES ❑ NO <br />HEI6HT IIMITATION <br />PUNS APPROVED BV I CITY OF EYEREIT <br />LOCALSALES <br />TAX CODE IS 3105 <br />CpNTACT PERSON AND PMONE NO. <br />I HEREBY CEHTIFV THAT I HAVE READ ANO EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF UWS AND ORDINANCES OOVERNINO THI`3 TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVI810N8 OF ANY <br />OTHER STATE OR LOCAL LAW REODUTINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE 8TATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />SIONATURE OF CONTMCTOR � RED M3ENT DI1TE <br />�,�x. • `��� <br />APPLIGINTB CITY BUSIN LICENSE �. 0 BUSiNESS N�ME <br />FOflCEO AIR SYSTE <br />UNIT HEATERS—B.l <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANOEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE ! <br />FIREPLACE INSERT <br />HEAT PUMP <br />OAS PIPING <br />PIAN CHECK NUMBER <br />BUILDING <br />PLUMBINO <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORNS <br />T0Tl1l <br />E.A. <br />TOTAL <br />NIT <br />1L FEE <br />FEE I NECEIPTNO. <br />•-�.;�•.Y, n,v <br />� <br />•. <br />