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A�; <br />Aa <br />APPLICATIO FOR CONSTRU PE <br />2 2 1990 everett <br />ow.......... <br />e <br />CITY °B" CITY OF EVERET'C <br />CITY OF Public Walt♦ Dept, <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK —PLEASE PRINT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING 14 SIGN <br />CITY � / PHONE <br />OWNER - MAIL ADDR SS , 7 6 -/S&>2 ' <br />�' ,VeSf nTell+ � I' 0 130?t 338 C—c9 m c]r ciS l UV� 91oa o <br />CITY ZIP PHONE 35 <br />MAIL AODPESS 1 vevF� ��//I )3- bi %)� <br />j "jU,PLJ 1)e 3711 Mt kj jieo (3�l/c� C n A Cor,ir <br />ARCNRECT OR E6KiNER MAIL ADDRESS <br />CITY 21P PHONE 54 <br />1 ' T <br />N11� ICENSEW <br />TOR MAIL ADDRESS CITYo1� zIP 4s •3zm PHONE �. L <br />\ � S <br />TY�C. �US qYv\ 11'1 ICI J (!T <br />MECHANICAL CQNTT TOR MAR ADDRESS <br />CITY ZIP PHONE UCENSEA <br />.�•�usiunr MAIL ADDRESS <br />CITY ZIP PHONE LICENSE <br />MACTOR <br />CtlT <br />❑ NEW 'M ADDITIO ❑ ALTERATION Cl REPAIR ❑DEMOLITION I- i WOODSTOVE/FRPL INSERT ❑BUILDING RELOCATION <br />W6 <br />CONTACT PERSON�{I{maI1D PHONEj1Q. �/ L/S/ jZO0 <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />�r •, •y Y,'y p NI <br />U <br />BLOCK — OF <br />'iA SHOWER <br />KITCHEN SINK & <br />DISHWASHER <br />TOTAL <br />TOTAL FEE <br />$ <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />p <br />E t>f <br />LOT AREA <br />CD`USE <br />VACANT SITE <br />❑ YES <br />ZOiI <br />r 1 <br />l <br />JPA0 <br />.S, TYPE OF CONST. ALLOWABLE <br />I YPE OF CONST. ACTUAL <br />pp(J KY WINMVRuxc UNI <br />BRplr <br />/ <br />BASEMENT <br />SIZE OF BLDG. <br />NO, OF STORIES <br />❑ YES ❑ NO <br />OCCUPANCYLOAD FIRE SPRNKLERS REO'D <br />HEIGHT LIMITATION <br />❑ YES ❑ NO <br />REASON FOR SPRINKLERS <br />CITY OF EV" TT <br />APPLICATION ACC. BY <br />PLANS AP ED OY <br />LOCAL SALES <br />TAX CODE IS 3105 <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 ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN 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 OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />XX Q�FGr��gJ/ OC�— <br />APPLICANTS CITY BUSINE LICENSE NO. AND BUSINESS NAME <br />'ORCED AIR SYSTE <br />JNIT HEATERS—B.T <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE I <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER K <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />H <br />____.,.......r.�..i.aa�•. :ss:AS.a'.IAA?i`Ri°:iF✓'::S`. <�»I«-r^.•r.TT.`<:fjUr:l\ Tl ;ice+%'-'H.�•.i«�L.`:1�1 w'4i:ii; <br />