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. .♦ . .` �aY �r' �a3e.:t�r.�i��4i :i�i.�t:�llLf•' • .K�. L-. '.�.YtiJCYi1�Gi1K•�CAT'�a9lJ.AY� Yl:%S' .•. <br />APPLICA�N FOR CONSTRU��ION PERMIT everett ; <br />fhsEvsqresn TO BE COMPLETED IN INK—PLEASE PRINT .�:I <br />everett � �- � <br />BUILDING DEPARTMENT <br />259•8810 <br />�.] DEMOLITION . ❑ COMBINATION <br />OWNER MAIL�DDflESS <br />�oN�6LD t �Oy1C `%l�S/�1 <br />�€ <br />MAIL ADDRESS <br />MAiI ADDRE55 <br />. 6 yoy <br />HEATING SYSTEM: ❑ GAS 0 ELECTRIC O <br />L3�BUILDING O MECHANICAL <br />GTV ZIP <br />��i`� °f 8203 <br />CITY 21P <br />GITY 21P <br />CITV 21P <br />E✓dlt.F� q��o3 <br />GITV ZIP <br />❑ PLUMBIN(i <br />PHONE <br />3�'3-S �� <br />PNONE <br />PIIONE <br />35�" <br />PIIONE <br />� mo �a.�t� :� �,�akC �:: <br />LICENSE 1 . � tcj�. �. <br />� . . . �.i'i.', . tif��m.,.. <br />PLUMlRqCANTMCTOfl tUILADDHE65 CITY ZIP PIIONE . UCEN5EI , .p <br />i:a} <br />l ,r;� <br />CLABEOF1VdiN .. .. �.� �•�� . `^ <br />� NEW O ADDITION ❑ ALTERATION (SYFiEPA1R ❑ DEMOLITION ❑ WOODSTOVEIFRPL INSERT. ,, � BUILOINO RELOCATI01 <br />CONT�CT PERSON AND PXONE NO. ' <br />�.���,,,� �y a�r 3, ' <br />DEBCNlE WORK �ND 60U�RE FOOTA6E INVOIVEC <br />r� <br />PlqPO6EDUSE BUILDMKl <br />� �f �. <br />IEML DE6CRIPTION OF PROPERTV �SHONT! BELOV <br />LOT BLOCK OF <br />...�.,. <br />�.r. • <br />M . . . <br />I �qU'crt:�•, . � .. <br />Y <br />, .s.rnoxcr�ooaess <br />I ,'� "7ilil �n.��a..i /A <br />� <br />� <br />� <br />UHINAL <br />DRINKINO FOl <br />FLOOR DRAIN <br />BACKFIOW PF <br />ROOF DRAINS <br />FOR OFFlCE USE ONLY: <br />FflONTSETBACN REARSETBACK <br />USE20NE LOTAREA <br />� <br />1YPEOFCONTS.ALLOWABIE TYPFOFCON5T.7�LN�l <br />IOCGUPANCYLOAD FIRE <br />FOR SPRINKLEPS <br />BY <br />S <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAM�NED��THI3';; ; <br />APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL't:: �` <br />PROVISIONS OF LAWS AND OPDINANCE3 dOVERNINO iH18 TVPE QF�� �• <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR.� �� <br />NOL THE 6RANTINQ OF A PERMIT DOES NOT PRESUME-TO OIVE :�" <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION8AF•ANV�1 �;;, <br />OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION' OR hl8'.��°� �. <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THEi?lf,j.'� <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH� j:.; <br />APPLICATION IS MAOE AND 1 COMPLY WITH THE STATB ' <br />CONTRACTORS LAW 1827 FCW AND 298.200 WAC. <br />SqNATUREOFCONTMCTORq1AUTH0111ZED�0EM D�TE � ���i � <br />�' r <br />:', r� <br />x��.� , , <br />• a, � <br />APPLICANfSCITYBUSINESSLICEN6 .NIDPUStt1E85NAME �;.x,�-. <br />METAL FIRE <br />FIREPLACE <br />HEAT PUMF <br />QAS PIPING <br />EXHAUSTF <br />i <br />.. <br />SUB TOTAL S ' � . '�"i:; <br />PEPMIT E � <br />TOTAL FEE S ; :�•� : � <br />NUMBEfl FEE RELEIPTNO. <br />BUILDINO <br />aeuv.wcr ra.amvewxauxm <br />GR0°P PLUMBINa <br />BnSeuEN7 MECHANICAL <br />MEI6HTLIMITATION ADDITIONAL PUN CHECK <br />OTHER <br />STATE BUILDINO SURCHAR�E <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAI <br />