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APPLICATIOlN FOR CONSTRUCTIOnI PERMIT <br />everett <br />rnc E,�o,u,��on � <br />1:111' Of <br />everett <br />BUILDING DEF/1R fMENT <br />: 59-8810 TO BE COMI'I ETED IP!'P!h—PLEASE PRINT <br />i I DEMOLITION I i COMBRJATION BUILDING MECHANICAL i' PLUMBlNG I I SIGN <br />owr+en nuannnnF;s � c�rv - . r ruor+e <br />�j,��}Q—�►'�NIeJ�ica�v G3Q�l RocKs�f_'_alel,Pl��� -- ��3�Z�2 <br />,:nu.anrn�ess cnv 7iN mior�e <br />�fiCN,'cCTOBDE51fiNFR MqIADDRESS CIIY ZIP PIIONF. <br />GFN[FaLCONiMCTOR MnIL�PD9L55 <br />an <br />LIL[NSE I <br />MEUANCAI C�/hi11ACTOR MAM1 ADDRE55 CI(Y IIP PIION- I IGLNSE � <br />QLs�4ui7�en-6�tVl` _ ?/r0__f%iLl -lN�e - - EU� --- -�"-'-�- �-- - 0?���1—t�.j��aZ�.—!.�`�� <br />PICMF.NGGCNI%7eC7011 A1�Il.i.L'M�.tiS CIIY ZiP 'l1pNE LICBISEY <br />CUSS OF IYORK <br />I ] NEW !jLADDITION �, ��� ALTERATION . REPAIR <br />TEN�NT 14PROVEMENT OR IN7ER�OR REMODEI. JNIY <br />CONTR�CT PRICE OF WORM: I�CY] <br />PROPOSE� USE OF <br />IEGQ <br />LOi <br />iNvo� �-in <br />oF rRoremv �sr�awrv actov, oN ni <br />BIOCK _ OP _ _ _ <br />PLUMBING <br />O. TYPE OF <br />WATER CLOSET <br />SHOWEF; <br />KITCHEN SINK 8 DISP <br />DISHWASHEF <br />LAUNDRYTRAY <br />URINAL <br />DP.INKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW �REVENTERS <br />FEE <br />ETC.) <br />--� <br />SUD TOTAL $ <br />---i <br />PGRMIT $ � <br />FRONTSETBACN � 11EARSETOr1LN � SIOES@�OnCF <br />USE20NE � LOT AREA <br />7VPE Of LON51. FI IOWABtf I 1YPE OF WNSI �GNAL <br />512E OF Bl D(i <br />occurnrvcviono <br />REA:AN FOR SPRINNLEHS <br />APPLICATION r1CC. OY <br />NO. OF STORIES <br />FIRE SPPNHI.EPS R�iO'D <br />I I YES I I NO <br />I DEMOLITION '� '� WOODSTO`✓E�FRPL INSERT '. I �JILi>ING RELOCATION <br />VALPNi SIIC <br />I I YES I i NO <br />oG�.ur�qtr HaaU'.vtiuSGurWS <br />UASEI.IE!!T <br />ilYES iINO <br />IIEIGIIT lllAliRTION <br />PI�NSAPPBOVGODV CIT'fOFEVERETT <br />LOCAL SALES <br />TAX CO�E IS 3105 <br />GONiACI PENiUN AH� PIIONG NO <br />I I-IEFiEBY CERTIFV THAT I HAVE READ AND E7(AMINED THIS <br />/1PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES COVEFNING THIS TVPE OF <br />WOFK WILL BE COMPLETED WITH WNETHER SPECIFIED HEREIN OR <br />IJOT. THE GRANTING OF A PC•RMIT DOES NOT FRESUME TO GIVE <br />AUTHORITY TO VIOLATE OFi CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR I.00AL LAW REGULATING COIJSTRUCTION OR THE <br />PEHFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER qF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 hCW AND 296200 WAC. <br />51611RTUREOFGONTFiACfONOAAUT110R12E0RGENT �RTE <br />Xn/ , � <br />/,q/ P-6'-90 <br />APPLIC TSCIIVI11151�SlICEN NOr1N0BUSINESSNAME <br />EOUIPMENT <br />FORCEU AIR SYSTEMS—B <br />UNIT IIC-ATERS—B.T.U. M <br />CLOTHES DRYERS <br />RANGEHOOU _ <br />W�TEF IIEAT[R <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />H[AT PUA <br />GAS PIPIP <br />EXHAUST <br />Ilr1NC1�LCN1lUM1ItlLR I FGG <br />eui�niNc __ <br />PLUMAING <br />MECHANICAL <br />OTHER <br />SiATE BUILDING Sl1RCI�IFRGE <br />SIATE EN[RGY SIiRCHARGE <br />PUHIIC WURKS <br />1JfAL <br />M E.A. <br />SUO TOTAL $ <br />PERA7IT $ <br />TOTALFEE S <br />RE;.EIPT NO <br />FEE <br />ca� <br />n <br />� <br />H <br />