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1� <br />� APPLICATIG.� FOR CONSTRUC7`�'JN PERMIT eVefP« <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />��x <br />�Ht~i� <br />H�� <br />4Cu{,� <br />� M � <br />y <br />�'x� <br />� � d <br />��g <br />� Y (� <br />Cy� <br />HH <br />g �' <br />e] C7 cn <br />��� <br />HOCn <br />the Evergrean <br />CITY OF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />' 259-8810 <br />DEMOUTION COMBINATION <br />OWNER MRILADORE55 <br />�j��diNr7'N'� 6/ Sa�(� <br />T�NNNT I.UILADORE55 <br />�7i� �'�� !+ c�fi7 �ai <br />PRCMILECT OR OESIGNER MAIL RDORESS <br />BUILDING ' MECHANICAL <br />CITY ZIP PHONE <br />�y�RtTT f�o a � s�y � � <br />CiTy 21P PIIONE <br />ZiP rn�ne <br />-' PLUMBING i SIGN <br />GENERALLONTRACTOF MFILPDDRESS CITV ZiP PNONE UCENSE� <br />��ti � <br />MECIIANIC�ICONTRACTOP MAILAOORE55 CITV ZIP PHONE LICENSE <br />PWdUMGGONTRACTOi� MM�RDDRESS CITY 21P PMONE LIGENSEt <br />C1A530i WJNK <br />.l NEW �i A�MTIUU I�LIERATIUN <br />CONTR�GTPRICEOFWORK.� ['Q <br />DESCRiBE WORN PND 50U�RE FOOTAGE INVOLVED � <br />,�, �h.r„-�f` � 7 20 -z� <br />PROPOSEOUS URD� <br />LE WL OESCflIPiION OF PROPERtt �SHOYM BELOW OR A' <br />ior e�aK oF _ <br />PRQIEGT A�I <br />Z �Q <br />8 <br />FOR OFFICE USE ONLY: <br />FRONTSETORCK RERNSETI <br />��E20NE LOTAREA <br />iYPEOfLONiS.dIIOWABIF iYPE0iC01 <br />92EOFOLOG. NO.OFST <br />IYi�LI <br />DEMOLITION ��. ��. WOODSTOV6FRPL INSERT .-' BUILDING RELOCATIUN <br />CONTALTPENSONAN�PHONENO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br />FOURCOVIES� PROVISIONS OF LFWS 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 />AUTHOHITY TO VIOLATE OR CANCEL THE PROV�SIONS OF ANV <br />OTHFq STATE OR LOCAI LAW REGLILATING CONSTRUCTION OR TNE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPE97Y TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW :8.27 RCW AND 296.200 WAC. � <br />SIGNPTl1RE Of GONTFRGTOFl OR AUTNOHREO RGEhi DATE <br />X �� ��� /�(� f'-� 9/ <br />_ _ � A�LI ANTSCITVBl15�1+ SSLICENSEH .AND�USME55 <br />TOTAL FEE 5 � <br />SI�E SETBAC <br />VPCANT SITE <br />AGIWI occuo�NCv xoIXVnRun4uNu5 <br />GNWP <br />ES B0.5EMENT <br />JCCUPANCVLOAO fIF1E5PRNNlEP5PE0� HE��miinu�n <br />REASON FOR SPRINKLERS <br />INIANEDY PL�NSI.PPROVEOOY CITYOFEVERE7T <br />LOCALSALES <br />TAX C�DE IS 3105 <br />AIR SYSTEMS—B.T.U. M <br />UNIT <br />METAL FIREPLACE 6 <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />BWLDING <br />PLUMEING <br />MECHANICAL <br />A�DITIONAL PLAN CHECK <br />OTfiER <br />SiATE BUILDING SURCHAqGE <br />PUDLIC WORHS <br />TOTAL <br />i <br />�J) <br />s-b <br />.s� <br />