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��x <br />�Ht~i� <br />H�� <br />K n <br />oH�G hl <br />'il H � tl <br />� <br />xp <br />H <br />OHd <br />��g <br />�Y (] <br />t"y� <br />HH <br />gy <br />��N <br />HOCn <br />APPLICATIOI:�''FOR CONSTRUCTI'�N PERMIT ���''« <br />tnee�e�g��� TO BE COMPLETED IN INK—PLEASE PRINT � <br />CITV OF <br />everett HEATWG SYSTEM: GAS i� ELECTRIC U_ � <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION �"�UILDING MEC (�A-qNICAL PLUMBING SI"N <br />h1A�+/f? UNEyS ^,, �pj CITV IP ,e` ,Y//O/ PM N,E1� �� <br />01VNER� ! /!/ // (' i �/ /l�/ %i / 7.VI�J /.%f�A//%L� �V � � iiWlC/�C �•6C %� •l f_— . - - <br />MAit 4DDRE55 <br />4 <br />,� NEW � � ADDITION ALTERATION <br />"ONTR�CTPRCEOFWOPN GI.�G�{J' I"•%� <br />DESCRIB[ WORN AND SOIIRRE FOOTRG[' INV V <br />n �/ . / Pl .__ <br />ov oui�oirvc <br />ior iiY% __ e�ocK '�� ov <br />BATHTUB <br />TRAY <br />TOT�L <br />FOR OFFICE USE ONLY: <br />�RONiSETOACK REAH SETdACM <br />2�� 5 � <br />u5[]ON[ lOT/RER <br />R•1 /3 _ <br />ivP[Oif.ONiS RllOW4BlF iYC[ Oi LON'1 AC <br />_ _�_� ' <br />SiZr UF BLDti NO OF STORIES <br />��� SF <br />OCCUPANCYLOAG FlRESPRNKLCR <br />CITV <br />CrtY <br />� PNONE <br />i P �MONE <br />� PHONE <br />ZIP PNOVE <br />ZIP PNON[ <br />: <br />I <br />REPAIR DEMOLITION . WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BL COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIJLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STAT[ OR LOCAL LAW REGULATMG CONSI'RUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 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 1827 RCW AND 296200 WAC. <br />SIGNAIUREOFLONTRAqORORAUTNORiZEDAGENT DATE <br />/A' <br />X /Lf�}��,(,(,� �i�l C��GU7l.P�� <br />APvIICA TS LITY I E55 LIC� SE NO RND BUSMESS NRMP <br />TYPE OF EOUIPMen i <br />NC-NHNDLG UNITS-H.P. <br />FORCEG AIR SYSTEMS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />FIREPLACEIN: <br />HEAT PUMP <br />GAS PIPING <br />f_%HAL15T FAN <br />$ <br />� � " l.2 � <br />vncnNrsrtE FEE <br />� BUILDING <br />���.v.. ��of�.��,,,���,_ <br />�B°�" PLUMBING <br />B45EMENT MECHANICAL <br />UMItpTION <br />N�J ��/ OTHER <br />REAS NFOR51'FMKLERS <br />STFiE BUILDING SUPCHARCE <br />nnnKc or v�nr+snvaaovm er CITY OF EVERETT PUBLIC WORKS <br />'//'- � LOCAL SALES <br />7� s/3� TAX CODEIS 3105 TOTAL <br />8 <br />F�E <br />SUBTOTAL S <br />PERMIT S <br />70TALFEE $ <br />c�ao <br />FEE r <br />i�r�no <br />