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�1 � <br />H <br />t" 'yt�C y <br />H`�� <br />��� <br />C! <br />Ci1 z^S � <br />O M h <br />n <br />��,8 <br />t"y� <br />Ny <br />gy <br />H <br />C7�N <br />�Oy <br />APPLICATIG.+1 FOR CONSTRUCT ON PERMIT <br />rtre Evergreen <br />CI7V OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259•8B1G <br />i DEMOLITION f' COMBINATION X BUILDING ` 1 MECHANICAL _ pLUMBING <br />! NEW <br />TENr1NTIM <br />MAIL AODFlE55 <br />Ha lle� � �(o �t/,' <br />MAII RDDRESS <br />R DESIGNEH MAIL AODRESS <br />�- <br />JTRRGTOR MAILADDR 55 <br />f.c�rscn �n31' rn� <br />CONTPRCtOR MAILADDRE55 <br />INiRACTOR MAILADDRE55 <br />OF WpRN: <br />lOT :�/ ��` ��` BLOCN <br />PRGCCT <br />FPONTSETBACh <br />ZO' <br />USE 20N� E r <br />ttPE 0( WpSi. tLLOWABIE <br />��-� <br />SIZE OF BLDG <br />5�6�`' _ <br />OGCUPANCYLORD <br />Nii <br />P[ASON FOR SPRINNLEflS <br />�PVLIGATION ACC. BY <br />��� <br />8 DISP <br />Cltt ZIP <br />Q � <br />GIT� <br />CITY ZIP <br />' �C� � (K,i S� � ZIP <br />K � �+� y9d <br />, ��n z�P <br />ZIP <br />PHONE <br />PHONE <br />PH� <br />PMONE <br />LICENSE � <br />uc�Aa <br />LICENSE I <br />everett <br />� <br />! : SIGN <br />ALTERATION ._'. REPAIR ❑ DEMOLITION �'�. 5 WOODSTOVE/FRPL INSERT � I BUILDING RELOCATION <br />ODEIONLY %R �V CONiACTPF.R50NANDPHONENO. <br />. i�. �L _ " � ��.�..... Z/ R�� U%U� <br />I HEREBY CERTIFV THAT 1 HAVE RFAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />.OW OR RTTII6MFOURCOPIES� /1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />,/ �/I WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />oF r � 1� NOT. THE GR�NTING OF A PERMIT DOES N0T PflESUME TO GIVE <br />i � AUTHORITY TO VIOLATE OH CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SIGNAiUP[OFCONTPAGTOR011RI1TMOFREDAGENT DFiE <br />X �+�+ �/i:G�.a.w.� <br />.l hPPLICANTSCITVBU51NE55UG NSENO.ANDOUSW[SSNAME <br />ITEM <br />REAPSEiBA;K <br />2.0 <br />LOTAREA <br />i PE Of GONSi. RCt Al <br />��-/� <br />N0. OF STORIES <br />FIRE SPRNNLERS REOD <br />I 1 YES ri NO <br />PlANS �PPROVED OV <br />97r <br />AIR SYSTEMS—B.T.U. M E.A <br />WOOD <br />_� 5 <br />SIDESETBACK� PWNC�CI 1UMOEf�� <br />5 9 ��� 3 y <br />VRCANT SITE FEES <br />❑ YES � - NO BUILDING <br />JLCUMHCv NO [MlliHuN.115 <br />LP0°' PWMBING <br />�— <br />BnSEMENi MECHANICAL <br />� YES x No <br />IIEIGHiIIMITATION OTHER <br />��' _ STATE6UILDINGSURCHARGE <br />SIATEENERGYSURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX �ODE IS 3105 TOTAL <br />FEE �� <br />TOTAL <br />S <br />� i;a,s� <br />