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APPLICATIO►. FOR CONSTRUCTi..N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />the Everyreen <br />CIN OF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 '�/ <br />�l DEMOUTION i-i COMBINATION X BUILDING Ci MECHANICAL �� PLUMBING L SIGN <br />OWNER �ILADDRE55 CITV ZIP PHONE <br />a Paw�- o� t��� Qo,� s�r �..�,� s�aoi a.rs-���s. <br />TEN�NT MAILADURESS CIN ZIP PMONE <br />OC ki4rbo,- (�larina INoLWf'ra.i,tVicwA^ fvr.�d- rif2�l ds"5-�o'►/r <br />ARCNITEGTORDESIGNER MAILADDRESS CITV Z�P FMONE <br />GENER4GONTRAGTOR AUILRDDRE55 CITV ZIP PHONE IILENSE� <br />�,cIAN r <br />CM�NICAL CONTRACTOR MAIL AUDRESS CITV 21P PHONE UCENSE t <br />PLUMBING CONTRACiOR <br />CLASS OF WORK <br />❑ NEW I7 ADDITION ❑ ALTERATION <br />OESCRIBE WOfiN AND <br />� ,L <br />I.EGAL 6ESCRIPTION OF PROPE 1TY (SHOMm 9ELOY <br />� LOT BLOCK OF <br />� <br />' PRQIECTADDPESS <br />oc �yoz LV /�'%RH� <br />�4� PLUMBIN6 <br />�, NO. TYPE OF FlXTI <br />� WATER CLOSET (TOIC <br />y BATHTUB <br />LAVATORY(WASH BA: <br />SHOWER <br />�� KITCHEN SINK 8 DISP <br />� DISHWASHER <br />'� LAUNDRYTRAV <br />CLOTHES WASHER <br />UFlINAL <br />t <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />. BACKFLOW PREVENT <br />ROOF DRAINS—RAINI <br />' SINK (SERVICe—BAR, <br />FOR OFFlCE USE ONLY: <br />FRONTSETBACN REARSET� <br />� � <br />USE20NE � LOTAREA <br />i <br />1VffOFLONTS.ALI(IW�BIE TVPEOFL01 <br />CITV <br />PHONE LICENSEI <br />P' REPAIR -J DEMOLITION �_: WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO. <br />Ui'�ti 11 ri� <br />'!:: <br />PERMIT $ <br />TOTAL FEE $ <br />SREOFBLOG. kO.OFSTORIES <br />�o78yF T • I . f <br />OCCUPANCV LOAD FIRE SPRNKLERS REO'D <br />�9e /,iWf4Y_ 1�10 <br />SIDE SETBRGK <br />V�CANT SITE <br />I HEREBY CERTIFY THAT 1 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 TVPE OF <br />WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTIN�3 OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.� ��/��/G/ <br />� '�GN�TUREOFGONTRpCiOBORAUTNORRED�O T . / <br />�; � ' ca-�., <br />�PPLM.AN SCI�BUSNESSLILENSENO.AN�4 E�HAFIAE�AHNe <br />� <br />N�A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS--B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOODSTOVE <br />FIREPLACE <br />HEAT PUMP <br />GAS PIPING <br />8 CHIMNEY <br />NV BUILDING Sy.O � �'O� <br />OCCUP�NCV MOdDNTIUNGtINRS <br />GNWP PLUMBING <br />B�SEMENT MECHANICAL <br />/� <br />HEIGHT LIMITATION ADDITIONAL PLAN CHECK <br />OTHEFi <br />STATE BUILDING SURCHARGE <br />CITY OF EVEREIT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 ror�� <br />PERMIT <br />TOTALFEE <br />FEE <br />�"8 SO <br />H <br />_ � <br />—� <br />� <br />3S`t�< <br />