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r-- <br />� <br />�� <br />� � <br />H <br />>Hp�VHi <br />Hz� <br />�a��a <br />� <br />% <br />H <br />��b <br />��g <br />�w n <br />t"y� <br />Hy <br />g �' <br />C9�tA <br />� � � <br />,-., ,.:, <br />APPLICATIG� FOR CONSTRUCT.JN PERMIT �`'"`'" <br />m�� e�erqmen TO BE COMPLETED IN INK—PLEASE PRINT � <br />cm or <br />everett HEATING SYSTEM: � GAS ❑ ELECTRIC J <br />BUILDING DEPARTM`NT <br />� 259-8810 <br />DEMOLITION X COMBINATION BUILDING MECHANICAL ! PLUMBING SIGN <br />01VNER I.UiLRDDRE55 CrtV ZIP PNONE <br />�lll@RLIL F DA�IS 4��`� N�,r�xcl d�� �vucyl 9bdL� 3S3?�31 <br />iENANT M1ln'LAODRE55 CIiY ZIP PNONE <br />�RCHREGTOIiUESiGNER M\ILADOFE55 GITY ur 'n�nc <br />6NHlD r- l'4A1N�t� a�a�a cu�[�'�I Fve.�e� 9� ao� asa-lill <br />GFNERAICONTRAGTOR AIAILAODRESS CITY 21P PHONE LICENSE• <br />MECNANICALCONTR�CTOR MAILADOflESS CITY 21P PHONE IICENSE• <br />PLU�IOINGCONTRPCTOR MAILAOORE55 <br />NEW i( ADDIIION � ALTERATION - REFAIR <br />�,'1,C��UUU V'�� <br />�.�.,..ve���..�,.,..o. AOPf[Y' rl_�.h ni <br />cm nr <br />DEMOLITION . WOODSTOVF�FRPL INSERT <br />... I CONTACTPERSONANDPNONEN�. <br />MA1E��i� }�.t�X�s4irnp K�Id�v.n �.P��ihrocnn ��c�:l�.if� <br />PROPOSEO USE OF BUILOING <br />N�mF S f'f� <br />LEGRI OESCRIPTION OF PROPERTV ISHO�YN BELOW OR ATTACII GOUF GOVIESI <br />LOT BLOCN . OF <br />U[CTR�DRESS <br />�I �i � 8' Alo � 6�(� /�ci p. <br />PLUMBING <br />O. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASNER <br />LAUNDRYTRAV <br />CLOTHES N'�SHER <br />URINAL <br />DRINKING FOUVTAIN <br />FLOOF DRAIN <br />BACKFLOW PREVENTERS <br />flOOF DRAINS—RAINLEADERS <br />SINK �SERVICE—BAR, ETC.) <br />SUB TOTAL 5 <br />PERMIT 5 <br />FOR OFFICE USE ONLY: <br />FHONTSETBACN REARSEiBACK SI�ESETBACN <br />:ON[ I LOiARE� I �'ACRNTSHE <br />iYPEOFLONfS PILOWABLC <br />�-u <br />512E OF pIDG <br />3?G sa n�o� <br />OCCUPANCVlORO <br />_� <br />PtAEOY FON SPRINKLERS <br />c <br />BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES G7V�FNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR12E0 BY THE <br />OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY N'ITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SiGNRiUREOFCONif1ACTORORAUTHONiZE�RGEN� OAT[ <br />X �/�cLai4CLr���o�.l <br />APPIICANTS CITV BUSiNdSS LICEYSE NO RNO BUSINE55 NR�1E <br />FOPC <br />— UNIT I <br />CLOii <br />— VcNT <br />— RANG <br />WATE <br />W 001 <br />META <br />FIflEF <br />HEAT <br />iEH^ -L.T.U. <br />DRYERS <br />FIREPLACE! <br />ACEINSERT <br />L�J <br />E%HAUSTFAN <br />� SUB TOTAL S <br />PERMIT S <br />� TOTA�FEE S <br />/f`��-J� <br />PLANCMEC NUAIpER �EE — RECEiPiNO <br />a 5 �-°� P' �li 7 a� <br />FFFC ve—f �uarioN' FEE <br />�s[�cNAt arw�•.:r uuorcwnu`�cuu�s <br />Leo� e <br />ORiES BASEMENT <br />Ao�« N <br />0 <br />IKLERSREOD HEIGHTUTAItAT10N <br />u� <br />naanovEooY CITY OF EVERE7T <br />�J LOCALSALES <br />`i' ��, TAX COUE IS 3105 <br />BUILDING � <br />PLUAIBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK � <br />orHeR <br />STATE BWLDING SURCMARGE <br />PUBLIC WORKS <br />TOTAL <br />--�— <br />� �7 <br />