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xr7 <br />�>H <br />,o�x <br />ayv~i <br />rma <br />H ZH <br />K n <br />H �1 <br />� N'U <br />CR H <br />xz <br />t�1 y � <br />oH <br />��g <br />G]. C] <br />ay� <br />r H F? <br />8 �' <br />hi <br />c� G fn <br />��� <br />Z H :n <br />H O fn <br />� e <br />'a ` <br />'�°� r <br />APPLICA'TIG.� FOR CONSTRUCT�_.1N PE�iMI'T <br />�,,���« <br />mr Emrgrroa � <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OR'NEfl I.�AILAOORE55 CITY ZIP PIIONE <br />DAv.oG.NlauScw �OS�Y N,}'nev.0�� [�;.;r %B zo3 :zS�-J-J�� <br />i[NANT MA�LADDRE55 GITY ZiP PMONE <br />AfiCHRECTOR0E5�GN[R MAILADDRE55 CITV 21P PHONE <br />QvN N1ra����.. ►v�+�ays G �'9 - �y S7 <br />G[IJERALCONTFACTOR MAILR�ORE55 CItY ➢P PNONE LICENSE� <br />p�u� I�Iv�Nscw (•1L3c+u� f/�a71s����-3z4� 3'Z <br />6iEC11ANICAIGONTRACTOP RIAtLADORESS UiY ZiP PHCNE LICENSE• <br />E�c�.��,�� � ���r��. G. F��r. �-s2-�iiy <br />PlUMBiNGCO TAACiOR MAilA00FE55 piY ZIP PHONE LICENSE� <br />,; / %� <br />nS50F/NORK <br />NEW �. _ ADDITION � ALTERATION <br />CONiqACT PRILE OF WORK: <br />D[SCRIBE WOFK AND SOUARE FOOTAGE INVOLVED <br />ikon�Y�ok ro�x�s�, s.r, <br />PROPOSED USE OF OViLOMG <br />� _ C . <br />IEGAL �ESCRiPtiON OF PROPERTV <br />IOT�_ O�OCN _ <br />N�a Rt� a R u�� <br />� � �-., a tz � �• <br />OG <br />riaaec* eooaess <br />/c�s v N. PnRK 0 <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITE <br />WATEP CLOSET (TOILETI _ <br />BATHTUB <br />LAVATORVIWASFiBASIN� <br />SHOWER <br />KIT�HEN SINK 8 DISP <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAI <br />FLOOR DRAIN <br />BACKFLOW PREVEI <br />ROOF DRAINS—RAI <br />SINK (SERVICE—BA <br />lRONTSETOACN <br />20' <br />�5� R� t <br />� <br />ir�t(lf[ONSI.ALLOWABLE <br />S�-u <br />:9ZE OF BIDG <br />S94 SF RcnU <br />OCGUP�A�N�CY�LOAp <br />-�— <br />i�[ASON FOR SPNNKLERS <br />nrrucnnor�ncc ttv <br />TOTAL 5 <br />NIT 5 <br />1L FEE 5 <br />RE�RSFtO�[H 9D[SF.1��FK <br />ZU� 5 � <br />wr nnr:a \'AC�Ni SIiE <br />Zg� YES � NO [7UILDING <br />iVPEOfLOB51ACt l a.c.��+�.cr qocr�muun:u�.�s _. <br />P�ma <br />�J, 3 PLUMBING <br />N� OFSTORIFS OASEMENT MECHANICAL <br />YES J( NO <br />FIl1ESVRNNI[RSREOD MHGI11lIMIiAiION OTNEfl <br />�. � YES �( NO Zg� STATEBUILD�NGSURCHAFGE <br />STPTE ENENGY Sl1FCHARG[ <br />CITY OF EVERETT auoucwor�Hs <br />LOCALSALES <br />TAX COOE IS 3105 TOTAI <br />-�a-u�- �►,�� �I-e� <br />FEPAIR <br />�.Ciai C,.�ny� � <br />lG,. 15< <br />OEMOLITION - WOODSTOVEiFRPL INSERT �' BUILDING RELOCATION <br />394 � <br />COPIE51 <br />FEE <br />C01liFCT PERSON PN� PNOYE NO. <br />Q �� �, a� G. I-I r1 iv s� w 2 S'�i - 2R �—b <br />I HEREBV CERTIFY THAT I H�VE READ AND EXAMINED THIS <br />APPLICATION AND KNOV! THE SAME TO BE TFUE AND CORREGT. ALL <br />PROVISIONS OF LAWS AND ORDINANCFa" GOVERNING THIS h'PE OF <br />WORK WILL BE COh1PLETED WIThI WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFI2ED BY THE <br />OWNER OF THIS PROPEFiTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV VJITH THE STATE <br />CONTRACTORS LAW iB27 RCW AND 296,20C WAC. <br />$IUtiAiUFE � CO'iiRAGiOliORAUiMOPREDAGEI'i bdiL <br />X ` (Lv—z�)—LY_�'t�<� <br />nr.r�.cnu-s r�i . r�.n �.: 55 i cv�se n�o nr�o ousiness unue <br />mc <br />NO. <br />AG-A HNDLG UNITS—H.P <br />� FORCED AIR SYS7EMS—B.T.U. M E.A. <br />UPIIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGENOOD <br />WATER HEATER <br />� / WOOD STOVE <br />ri nN <br />IiEAT PUMP <br />GAS PIPING <br />E%IiAUST FAN <br />pipr+s ni�rnoveo nr <br />,lf''�r <br />�� <br />F3N:��IJ�1 <br />PERMIT <br />TOTALFEE <br />r�i <br />//%`—` <br />dVALUATION <br />J II i�:4 <br />3 <br />r�o <br />� <br />FEE <br />a <br />