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� y <br />Q�H <br />�HV� <br />H�� <br />R1H� <br />N <br />Hx <br />O H b <br />n <br />��,g <br />t"y� <br />HH <br />gy <br />� <br />n�y <br />�H� <br />HOC/� <br />� �'" <br />APPLICA'TION FOR CONSTRUCT�aN PERMIT <br />evemtt <br />��oE��,�� e <br />CIN OF <br />everett <br />BUILDING DEP�RTMENT <br />259•8810 TO BE COMPLETED IN INK-PLEASE PRINT <br />; DEMOLITION ! COMBINATION BUILDING MECHANICAL PLUMBING � SIGN <br />OWNER L ��AILA��RESS CITY Z�P PHONE <br />�% l -y� 1''. I.CJC C � =� � C <br />eL� l.l��� I ��''i V C•C��X Y7� G � Gc� � �SS / I� <br />TENANT MrtiLA00RE5S CITY 21P PHONE <br />� �� i. .i �� <br />ARCHITECTO(�flD�E51GHER MAILRD�RE55 CITY ZIP PHONE <br />• xl � �\ l/_/ <br />GENERALCONiRACTOR MRILADDflESS CITV ZIP PHONE LICENSE9 <br />�;.l,l; � �� y ��l T�L . .�=�t�e�l S���C'� 'i� � -7`�// ,�i�0� �C�-r.l?E.l�`S <br />IAECHANICALCONTRACTOR MAI'�ADDRESS I:ITY ZIP PMONE UCENSE• <br />PLUAIBINGCONTPRCTON MAILADDRE55 <br />f: NEW I i ADDITION '..� ALTEflATION <br />TENRNT ItAPROVEMENT OR INTERIOR REMODEL QCtFY <br />PROPOSEDUSE <br />LOT <br />PF0.IECT <br />(ct5� <br />BLOCN OF <br />691J:f.3 <br />TRAY <br />FRONT 5'_�BRCN <br />�.� / <br />��ZON�� I"'/ <br />Vt CE Of CONSi AIIOW�BIF <br />SRE OF BIDG! <br />� ^'%v+ <br />CLC. <br />OCCUPANCYLORD <br />REASON FOR SPPINKL[RS <br />APPLIGATICN ACC. BY <br />�c7 <br />CIiY <br />PHONE LILENSE t <br />FlEPAIR �. �, DEMOLITION �, � WOODSTOVE/FRPL INSERT '.. I BUILDING RELOCATION <br />� CONT4LT PERS N AND PHONC N � � <br />— �Te tc.��,:�—IE `'SS'�=75�/ <br />'fii��� <br />�TfAGN FOUR COPIES) <br />PERMIT <br />REARSEiOACN <br />/ <br />-�%�1 � <br />LOTABEF <br />jEE�O� <br />iYPE OF L NSi. ACNAI <br />���� 1 �awlz- <br />NO.OF STORIES <br />fIRE SPRNNLERS RE�'D <br />i �. YES . '� NO <br />PL�NSAPPpOVEO BY <br />1` <br />SiDE SEtBACN <br />Ll <br />VACRNT SITE <br />I'� VES �_� NO <br />MSiVAt'LV I M1O VNfII�YGI <br />BRSEMENT <br />I�� YES j� NO <br />CITY OF EVERETT <br />LOCRL SALES <br />TAX CODE IS 3105 <br />I HEREBY CEFTIFY THAT I HAVE READ AN� EXAMINED THIS <br />APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />INORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br />NOT. THE GFlANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTH0.71TY TO VIOLATE OR CANCEL THE PROVISIONS UF ANY <br />OTHER STATF OR LOCAL LAW f±EGULATING CONSTRUCTION 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 HE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />S�GNAi 'OfG 4TRACTOF�ORFI1l10 ZEDAGENT OATE � 6 �� <br />/ \ <br />X �7z%�- ' <br />i ` G/ <br />iVLICANiS CITY BlI51NE55 LIGENSE N0. AND BUSME55 NAME <br />FORCED AIR SYSTEM; <br />UNIT HEATERS-B.T.U. <br />RANGEHOOD <br />WATER HEATE <br />METAL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAT PUM� <br />GAS PIPING <br />SUB <br />S <br />TOTAL FEE £ <br />PLFNCMECKNUMBER FEE RECEIPTNO. <br />Bl11LDING -�Q�T S ` <br />PLUM6ING i <br />MECHANICAL <br />OTHER <br />STATE B W LDING SURCH0.RGE � S a <br />STAiEENERGVSURCHARGE � <br />PUBUC WORHS <br />TOTAL S �' : � <br />! <br />