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APPLICATIOht FOR CONSTRUCTItiN PERMIT <br />ma E�rere,�� <br />cirv oF <br />everett <br />BUILDING DEPARTMENT TO SE COMPLETED IN INK—PLEASE PRINT <br />259-88 S 0 <br />21 DEMOLITION 1 COMBINATION j( BUILDING MECHANICAL PLUMBING <br />LIY ^^ ^ YHUNt <br />everett <br />e <br />C7 SIGN <br />TENAHT'' I Q MFII.ADDRESS CI7Y ZIP PHONE <br />4v /T� <br />qqCHITECTORDESIGNER MAILADDRESS CITV 21P 'MONE 9&((,J� <br />t��P�gr�'c�7ur.�9� ��r.�-�, �ows,rc�P,�c� ! o. ra�x e 9zoca BFrl�vu� �5/ -BG9�, <br />GENER4LCONTRALTOR MAILAUDiiES� CITY ZIP PNONE LICENSE� <br />��.;�i'� ;c�rs i�c9 T�vc /�a ?�X�i�s �SccFr,ec F 9,Fco9 �'-za5�; �, +:.,=,ePrs� <br />MECHANICALCONTRACTOfl MiILADDRF.SS CITV ZIP � PMONE UCENSER <br />PWMBIVGCONiRACTOR 1.'41LADDRE55 CITY 21P PNONE LICENSEI <br />CLASS OF WORH <br />'! NEW L.'. ADDITION �',-1 ALTERATION .-! REPAIR �. �. ����MOLITION <br />TENr1N' IMPROVEMF ' OR INTERIOR REMODELONLV � p� C� �_ I CONTAC' <br />DESCFI'oE N' .^.aK AND SOUARE <br />_'� �L_:tl �d` <br />PROPOSED L'+E OF BUILDIIIG <br />Shl2 <br />LEGAL UESGRIPTION OF PFiOPI <br />LOT._ __ BLOCK <br />BELOW Oq ATTACN FOUR <br />OF <br />PPQIECTAODFE55 <br />�� � �Q�� �� <br />PLUMBING <br />N0. TYPE OF FI%TURE OR ITI <br />WATER CLOSET (TOILET) <br />7j BATHTUB <br />LAVATORY(WASH BASIN) <br />'fj SHOWER <br />KITCHEN �INK 8 DISP <br />D�SHWASHER <br />/ LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTA�N _ <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />7 SINK (SERVICE—BAR, ETC.) <br />FRONT�SETTBACK <br />C� <br />USEZO� I <br />�Z� <br />1 i°E OF LONST ALLOWABIE <br />d- .�_ <br />srzeoF.�oc. <br />59NG - f f <br />l3vl SF G4K <br />OCCUPANCV L��\0 <br />u�� �_�. <br />REASON FOR S�RN'(LERS <br />+�� <br />=tifa�e: <br />SUB TOTAL 5 <br />PERMIT S <br />TOTAL FEE $ <br />REAR SETDACK I SIDE <br />LOT AREA <br />7VPE Oi CONS7 ACiOAI <br />4-N <br />NO. OF STORIES <br />FIRE SPRN�EFS RE00 <br />❑ YES SC NO <br />r'LANS APP� ED �V <br />9 <br />��. . WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />iO/N AND nPHONE NO �/�. I' <br />T JJ�nain/'-71.�—o�`1,S- <br />I HEREBY CERTIFY TH,�T I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 7HE SAME TO BE TRU= AND CORRECT. ALL <br />PROVISIONS OF I.AWS AND ORDINANCFS GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEflE.�J 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 Ofi LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br />APPLICATI' N IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTGriS LAW 18.27 RCW AND 296.200 WAC. �//U/G� <br />SIGNATUflEOFCONTPACTORORAIJTHORIZEDAGENT UATE � <br />X /�r �1 ;�fs.`+�T� -f��!�,.iQe . <br />� [/. P. <br />APP ANTSCITYBU51 ESSLI NSENO.ANDBUSINESSNAME <br />MECHANICAL <br />V0. TYPE OF EQUIPMENT FEE <br />A/C—NHNDLf3 UNITS—H.P. I � <br />FORCED AiR SYSTEMS—li.I.U.� <br />UNIT HEATtRS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER I �EATER <br />WOOD S�:OVE <br />METAL FIF;EPLACE 8 CHIMNEY <br />� FIREPLACc IN: <br />�� — HEAT PUIv7:' <br />; ,j GAS PIPIN:.� <br />� E%HAUST FAN <br />�� <br />VACANT SITE <br />l-. YES I. NO <br />oeeuvexee x�aownuruxns <br />B0.5EMENT <br />y� YES '�. 1 NO <br />HEIGNT LIMITATION <br />CITY OF EYEHETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER Q� � <br />STATE �UILDING S�IRCHARGE <br />STAIEENEBCISURCHARGE <br />PUBLIC WORNS <br />TOTAL <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTAL FEE 5 <br />Y_/_ A/a RECEIPTNO. <br />� <br />f�2 ;r0 <br />i <br />—;— <br />s�;� <br />� <br />y S� <br />i <br />i <br />i <br />ao ;oo <br />�-G 9 3 <br />