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APPLICATIGN FOR CONSTRUC7 rON PERMIT <br />Ifre Everpreen <br />CITY OF <br />everett <br />BUILDINr DEPARTMENT <br />259-881Q TO BE COMPLETED IN INK—PLEASE PRINT <br />I J DEMOLITION I I COMBINATION _� BUILDING i I MECHANICAL <br />u�a �ooness <br />M�IL <br />cm p nr r�ar+e <br />:Jt'rc'/! l.�n. `I.f'a� i (/':,��II"Ji�i <br />dTY T� 21P PHONE <br />everett <br />e <br />i I PLUMBING I I SION <br />O W �1! ✓ <br />ApGNITECTORDE5IGNER /AAILADONESS CITV ZIP PIIONE <br />FrHhi 1��� r��wyN, 3�07 �n�2� /��.. �.utrrft lJ.�. `/J�;�c'� -,�sY-3.�1.�.� <br />GENER�LCONTfl�CTOR UII.ADDRESS � CIfY � 21P PIIONE IICEN5E1 <br />A�e�.. u rN c.• ,.� r�.�� r <br />MEGIIA'N/ICALCONTfl�CTOR AIAILMDRESS CIIY zlP PIIONE IICENSE� <br />/vC ll -1 <br />CIIY <br />�'i:l �- <br />CU SOFWORK <br />P�NEW fl ADDITION I 1 ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVElFRPL INSERT I I BUILDING RELOCATION <br />1 cNANT IMPHOVEMEN� OR �NTERIOfl REMODEL ONLY <br />..,,...e.,..seN�..���. S.r. /. y -ni' <br />/00 /i�e, / !�% re1'n; <br />PROPOSED 115E OF BUILDIN6 <br />il�e b/�� ;..�:i�Y�� <br />LEDILL DESCRIPT OF PpOPERTV (SHOWN BEL01 <br />g i <br />LOT .�) BLOCK,�,f_OF <br />iecr wone:s / <br />DC 7 ��y���/.✓ �)�1.� <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHEFi <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />FPONTSET&\LK <br />USE ZONE � <br />T` <br />iYPE OF CONST �IlOWA9tE <br />SIZEOFBLIIG 'Zr� <br />l21�1 K� �,�/, <br />OCCIIP�NCY LO <br />PEASON FO� PHINNLEF <br />APPLh:ATIONACC BY <br />CONf�CT PERSON AIID PHONE NO <br />llr.vi:c fi�<�, trr., - /�Jt4� e:�7/•J:� <br />Jr L:��.. .�i.l.Ti.� �.bnr .I.�.�.L.. <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 OR�INANCES GOVcRNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEHMIT DOES NOT PRESUME TO QIVE <br />AUTHOpITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PFfiFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />'.�NER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 FiCW AND 296 200 WAC. <br />SIGN�IDPEOFLON1fl�GTORONAUI110qRE0AGEN1 DATE <br />�/ I/� � <br />Xi;.�,•,..+'(i 1���,-�f..- �1�/'l/1.,.X� <br />�PPI.tf.1NI5dTV0u51NC5511CFNSENO NlOOU ESSNWE <br />MEGHIINIGJIL <br />FEE NO. TYPE OF EOUIPMENT <br />A1C—A/HNDLG UNITS—H.P. <br />; FORCEO AIR SYSTEMS—B.T.U. <br />�— UNIT HEATERS—B.T.U. M <br />� RANGEHOOD <br />' WATER HEATER <br />— �— WOOD STOVE <br />� METAL FIREPLACE � <br />� FIREPL4CE INSERT <br />HEAT PUMP <br />� GAS PIPING <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />RE�RSET9ALK <br />► <br />LOTANE� <br />ttPEOf CONSf ALIDAI <br />�� <br />NO. OF STORIES <br />� <br />FIqE SPONKlEFS flE0 D <br />I I YES I I NO <br />� <br />S <br />$ <br />S�OE SETO�CR <br />VACANT S�tE <br />I I YES i I NO <br />aavucr xoaowt-iiwi <br />��=` I <br />BASEIAEN7 <br />iIYES !I NO <br />IIEIGIITIIMIT�71ON <br />_�.. // <br />PIANSIPPNOVEDBY I CITYOF <br />TAX <br />,t(.*s� : Sp��.a•- <br />P1UNL��ECHNI) 8� FEE �7=7 RECF, TNO <br />� 7" �'_ <br />! / <br />t J' � <br />�-�.' r t � .T- ~ — t'1��� <br />FEES VALUATION FEE <br />BUIIDING , �� � - �� , �/� <br />PLUM6ING 8 i <br />MECHANICAL � <br />� <br />o,ia� � LL �' k f �' <br />SfA7Ee ILDINGSURCIIARGE -'� � <br />S7ATEENERGYSURCHARGE ; <br />PUBL�C WOFNS � � ' <br />TOTAL <br />� ,�@7�ldee�O <br />�6 7 t� y! Z �� <br />