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.. _. , <br />APPLICATIVrI FOR CONSTRUCi .ON PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />fhe Evergraen <br />CITV OF <br />everett � <br />BUILDING DEPARTMENT <br />259-8810 <br />-i DEMOLITION I-i COMBINATION <br />TENRNT <br />GENERFLCONTRACTOR <br />MECHANICRICONTRRCTOH <br />PLUMBING CONTPALTOF <br />!.� NEW <br />� <br />3.�e� <br />rnoroseo use oF <br />�r �5 <br />IEGAI DES�C1RIPTq <br />LOT T. l <br />MAIL AJDRESS <br />MAIL ADDRE55 <br />owne�`' <br />MAIL ADDRESS <br />fI �. 1 �n .J /' <br />HEATING SYSTEM: <br />BUILDING <br />�� CITV <br />t� <br />CITV <br />cin <br />CITV <br />❑ ELECTRIC ❑ <br />- MECHANICAL �(PLUMBING SIGN <br />21P PNONE <br />r11�1.� �S3✓ U62� <br />ZIP PHONE <br />Zlp PHONE <br />Z�p PHONE LICENSE� <br />CITY ZIP PHONE LIGENSE t <br />CITV ZIP PHIXJE IICENSE• <br />�u7h e r- <br />r <br />ADDITION .-' ALTERATION .-. REPAIF ��. i DEMOLITION �' WOODSTOVE/FRPLINSERT �.-i BWLDINGRELOCATION <br />� � O CONTACT SONANDP ONE � � m <br />f,�,�,K est, Ma+e � 0 e.r�, 5 � <br />10 SIXIARE FOOT�GE INVd.VEO O S A '� I� CL i� <br />.L� (;.. 7 �� <br />�� � <br />eua�NGl I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />� �o� G`C APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />V OF PROPERTY (SHOWN BELOW OR ATT�CH FWR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />e�aK oF E� �ua�e �,,,, WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />y. ` AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />' IL�\ {'CCO ('�P9 `l�. � OTHER STATE OR LOCAL LAW REGULATI4G CONSTRUCTION OR THE <br />PERFOFMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />; q+ ��q � q� reCJ� 1 p� OWNER OF THIS PPOPERTY TO PERFORM THE WORK FOR WHICH <br />YS APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />i � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />� � ' Si� „ .{/� SIGNANREOFCONTRACTONORAUTNORIZEDAGENT ��TE <br />� ah0�0«� S� G o� �0.S � I�� O I/� D_ �� �--�� <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ETC <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK � REARSETBACK <br />S Z5� <br />USE ZONE LOT AREA <br />-S � � a7o <br />ttPFOiCONTS.AILOWABIE TVPEOfCON51.AL7URL <br />SIZE OF BLDG. NO. OF STORIES <br />REASON FOR SPRINKLERS <br />INTANE BY ` <br />FIRE SPRNNLERS REO'D <br />N� <br />PLANS <br />3 �3 <br />� <br />FEE <br />�PPLICANTS <br />NO. <br />TYPE OF EOUIPMENT <br />A/C—NHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STQVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDE SETBACK� Y�nn ����� n�mo=^ <br />r7.s y� 2 G 5"'3/ <br />VAC�,,NIT SITE FEES <br />N� BUILDING <br />OCNF�MY N001UM1ilUNGUM�iS <br />f}a� / PLUMBING <br />��_ <br />B�SEMEN7 �.1cCHANICAL <br />O <br />HEIGNTIIMIT�TION ADDITIONA�PLANCHECK <br />OTHER <br />STATE BUILDING SURCHAHGE <br />CITY OF EYERETT PUBLIC WORKS <br />LOCAL SALES <br />r�Y r.nnF ic s�ns TOTAL <br />TOTAL S f ' <br />MIT $ � <br />\LFEE $ /� '' <br />RECEIPT NO. <br />�c� s-�ay <br />JATION FEE <br />av 63 � u6 <br />� <br />/�OC <br />i <br />' d <br />i <br />� <br />� <br />� <br />T <br />y �5� <br />i <br />i <br />� <br />9� �s <br />