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�(,t�.� � /, rc� J' C'- I <br /> v-� <br /> -s � APPLICATIO�� FOR CQNSTRUCTiJN Pf�RIV11T ', <br /> ,•���<<•<< ; <br /> p�i:[�rrnn�rrr � <br /> GIIY Of <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-Bff10 <br /> DEMOLITIUN COMBINATION % BUILDING MECHANICAL PLUM�ING SIGN <br /> OV19f.11 AIAIL�Pf�lll'�'1 f,ill !�' ��"/1:1 I <br /> l��c,������x�v�s`lb �2.�. � , � . 35 3-3 s�� � <br /> � �1 va��__�.vr�ct�,1L�a.�.: <br /> muur um�eooness cirv zir� arane <br /> MGHItECTORDE9GN[R M��L�ODRESS Lrtv ZiV PHONS <br /> G'�•�ar��k Av�, 11�.ti `1�, �,i- M,.b:Skr.���„a_"r— -74z-�3-?-� -'� ...��� <br /> ��� 6Cl�LCONiMCiOR — MAILADDRcs�5 3 LI�V IIP PNO�lC 4LEf6E��. . <br /> �'CU-�� <br /> ay IIEOUtlICALCONiRAC10B I.IA�LADpRE55 CIIV DP PMONE LILENSE� <br /> A77S <br /> C H — <br /> AHN �qUiAOiNGLONtRAG10R MRiL�ODBE55 G�tY ZiP PNO�IE tiCENSE� <br /> rz <br /> � c�i nss or vronK <br /> � y� NEW X ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> � H� iE1l44iIMVf10VEMENiORIMEP10RRE�00ELONlY � � CO�RACI�PF.RSON��)DP11p11EN0 <br /> rn H Z'�T]�f/�11y1�4..__—_-�-7�=�3� <br /> cor+rnAct an¢e o�wone: <br /> � Z�i CE:f.PiBEWOHNANO50UAREFOOTAGEIIlVCIV[0 � <br /> �� <br /> �t7 =7J��K�— `—� F� n?s?:1•.•• _ — S F �• <br /> O HC� rnovoseocseooeuaou+G n I HEREBV CERTIFV 1HAT I HAVE REAU AND EXAIAINED THIS <br /> �"� m" R r C o '� n KC�^� 7 ��M� � �«� �PPLICA'ION AND KNOVJ THE SA�AE TO BE 7RUE AND CORRECT.ALL <br /> y�� n PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> lCG4LD[SCRIPLIONOFPROFEfilY15NOYlt! ELOWOR�LLACNFOIIRCOPIE51 <br /> zy� WOFiK WILI BE COMPLETED WITH VlHETHER SPECIFIED HEREIN OR <br /> � io� oiocK ov NOT. THE GRANTING OF A PER�dIT DOES NOT PP.ESUIdE TO GIVE <br /> H y AUTH091TY TO VIOLATE OR CANCEL THE PROVISIONS OF 4tJV <br /> � y �������� OTHER STPTE OR LOCAL LAW REGULATING CONSTRUCTION ON 7HE <br /> �,_, PERFOi7MANCE OF CONSTFUCTION.THA71 Ald AUTHORIZED BV 7HE <br /> C �y y OWNER OF THIS PROPERTV 70 PERFORM THE WORK FOR VJHICH <br /> Cy Cr APPLICAiIUN IS �AADE AND � COMPLY WITH THE STAiE <br /> � t��� CONTRACT(,'S IAW 1827 RGW AND 296200 WAC. <br /> x <br /> = yy S�G1i�iUREOF 9nCiORORTUt��O%U1EJ�G[tU 04iE <br /> H O V� <br /> rnOJEciAOCnE55 ��Q-��^"J — <br /> ���� �� qpqCpy�SG�}yppS�NFSSUCFSENOAM1�BUS�'�E55��<VE <br /> �(�[��L S�' <br /> PLUMOING MECHANICAL ' <br /> NO. TYPE OF FIXTUFE OR ITEM FEE NO. TYPE OF EOUIPMENi PEE <br /> / WATER CLOSET ITOILETj A�C—f.HN�LG UNITS—HP. <br /> � � <br /> I � / BA7HTUB FORCED AIR SVSTEIdS—B.fL. 1d E.A. <br /> � <br /> _L LAVATORY(WASH BASIIJI UNIT NEATERS—B.T.U. M <br /> SHOLYFP CLOTHES DRVERS __ <br /> `�� � KITCHEN SINK 8 DISP _ VENTILATION FAN _ <br /> � ' � DISHVJdSHER RANGE HOOD _ <br /> LAUNDRYTRAY WATER HEA7ER <br /> CLOTHES NIASHEq YIOOD STOVE <br /> URINAL 1dETAL FIREPLACE 8 CHIMNEY <br /> '�` �► FIREPLACE INSERT � <br /> DRINKING FOUNTA W --r— <br /> FLOOR DRAIN HEAT PUTAP <br /> ' 1�+ BACNFLOW PREVENTERS GAS PIPING <br /> -R-Y � ROOF DRAINS—RAINLEADERS ExHAUST FAN _ <br /> SINK(SERVICE—BAR,ETC.) - <br /> � � <br /> ' SUB TOTAL 5 �_ SUB 70TAL S I ;riC� <br /> (� PERMI'( S PEiiMIT 5 "� <br /> TOTALFEE 5 70TALFEE 5 ' -0 <br /> fPG'ILSEipACR REARSF1pAG✓ SDESEipAC; PLx'1C��ECK"V!�OE� �EE �� �ECEiPf�:O <br /> • " �Q Vl/ 5 �L <br /> wcza+e �oi�nen wcuasne FEES VALUATION FEE <br /> _ , vES . NO nui_�u�r� ��4�.EOc� .3n�' f.� <br /> t�YEGfCG'ISiAll0110.91F lifEGfrOq5lALIpRt M.[ueucr WUPtty�e:i:'e - - -- <br /> � , iP0.'� / — PWI.IEIING ___ IS <br /> S:IE Of Oi NU OF SiORiES &�SEMENT IAEGHANICAL ��J ; _ <br /> eve s�n°a, �- ves ,� No I <br /> GrJG3f G� � �R' �lCl4� ' � <br /> �.CU:V/HLv10�.1 RBESPRIIXIE�SPEOD MEK+NILIMIIAtiON <br /> _�� VES x NO ��I __ STATE BUILDING SUflCHAFGE __���) <br /> r��nwr�ron s anixiees <br /> STA7EEN[PGYSURCHARGE <br /> , r�nccnv rur������:�-,,run� CITYOFEVERETT auoucworiKs --- � ) ; �, <br /> �f� LOCAL SALES <br /> ! TpX CODE IS 3105 rorn� �I j a' <br /> �.j�,J�L GJMP����NC(_ <br />