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APPLICATI.iN FOR CONSTRUCTION PERMIT everet[ <br />�E�ro�� TO BE COMPLETED IN INK—PLEASE PRINT �� <br />' CIiV OF <br />everett HEATING SYSTEM: ❑ GAS U ELECTRIC ❑ _� <br />BUILDING DEPARTMENT <br />259•8810 <br />I J DEMOLITION I I COMBINATION i I BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br />q M�ILADDRE55 CITV ZIP PNONE <br />�ii p�1�w,.f�., 8'lG-D/yn�p�'c 6cun ,�;vt Zf9-3�/� <br />7E �N7 MRIL�DDfiESS � CITV 21P PNONE <br />�RGMITEGTOHDESIGNEN M�ILA�ORE55 CITV 21P PHONE <br />GENERAL CONTRAf.TOR �A�� �ODRE55 qTY ZIP PIIONE IICENSE II <br />MECHANIC�LGONTRRCTOR M�ILADDRESS LI7Y ZIP PHONE IICENSE� <br />N•k� f�a4�.�1«fw �� ?i���fh'/��ue fivr fYzol 1��5�33/ �oy'f�Wh i�3 /?z <br />P�UAIBING GONTRACTOH IANI ADORESS CITY 21P PNONE IICENSE I <br />i � <br />t0T <br />NEW I J ADDITION I I ALTERATION i i FEPAIR I I DEMOL�T�ON I I WOODSTOVE/FRPL INSERT 1 I BUILDING RELOCATION <br />LONTACi PERSON R1D PNONE NO <br />RRACT PRICE OF WORN /�� � <br />iCRIBE WORK AND SOU�RE TAGE INVOLVED _ <br />BIOGI( <br />flXTURE <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHEfl <br />SINK <br />_NTERS <br />FOR OFFICE USE ONLY: <br />FRONiSETB�CR RE�F: <br />USE ZONE LOT �.F <br />TYPEOFCONiS ALLiWABLE <br />SIZE OF BIDG. <br />OCW PANGY LOAO <br />RE�Sdi FOfl SPHINKLEf <br />INTAI(E BY <br />OF <br />PERMIT <br />TOTAL F <br />nPe or coNsi aci <br />NO.OF STORIES <br />FIRE SPRNKLER! <br />PUNS <br />I HEREBY CEflTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW fiEGULATING CONSTRUCTION OR THE <br />PERFOPMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEH OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTf�nCTORS LAW 1827 RCW AND 296200 WAC. `/ �/f/ <br />oIGNATUHEOFCON7P�CTOROR�UT110NIZE0�GENT D�TE / <br />X��'�. tn r 1 <br />APPLICA� CITV BU9NES5 tl ENSE NO. AND BUSINE55 Y�ME <br />NO. <br />0 <br />FORCED AIR SYSTI <br />UNIT HEATERS—B: <br />CLOTHES DRYERS <br />VENTILATION FAN <br />HEAT <br />8 CHIMIJEY <br />SIDESETBAGN PLRNCIIECNNUMBER FEE <br />VAGANT SITE FEES <br />BUILDING <br />O[CUV�H[Y N001VM�bMG11Nrt5 <br />ewouv pLU6'.OING <br />B�SEMENi MECHANICAL <br />IIEiG11T uMIT�tION ADDRIONAL PLAN CHECK <br />OTHER <br />$TATE BUILDING SURCHFRGE <br />CITY OF EVERETT rueuc wo�Ks <br />LOCIIL SALES <br />TAX CODE IS 3105 ror�� <br />a <br />N <br />;OU <br />