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QPPLICATiON FOR CONSTRU�TIvN PERMIT <br />�rvoren <br />um f vamraen � <br />CITV OF <br />everett <br />BUILDI DEPARTMENT <br />259- 0 TO BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION COMBINATIC�N BUILDING MECHANIC4L PLUh1BING i i SIGN <br />OWNEfl MFIIFDOqE55��-'"� . ..�"-����CIIY � fli•" -'-���- "PIIOIJk-��'--�_ <br />Pt\Lf.IL'RS 4 x 4 710 S.l._}iVlil;l'i]"1'_�Ll._�;Y�ilil:l`,'_,-1VL1._.�+2n$—�9�r�R42_ <br />TEIIAN7 e�nu nnnness r.irr z�❑ rnou� <br />ARCIIITECTOR[1[SIGNER MAILAD�RC55 f.liY ZIP PIIONE <br />f.ENLRAIC�O��Ni/flACTOR h1All RpDf1GSS GIV ZIP PIIOIlB LILENSEI <br />'1.._�w •�-L9—_—_-_--"_—_.._._.__". .. ._......_...._ _.._"__. __— <br />M11Ff.lUNICAI LflllifiPf.iOR IAAII AOf1fiL55 G111' ZIP I'110NL IIC[HSE 1 <br />'-_ .-_--_..._'_'-'___._. .._."_._ . _._-"__--____-____. <br />PLIIIAOIHGCON1MC1011 IAAII �I)OI11.S5 . .. f.li1' . .. JII' PIIOHL IILCNSEI <br />CLASS OF WONK <br />I I NEW I I ADDITION I I AI.TERATION <br />IENRNT IMPROVGMUIT O(11N1EPi0R N[IAODEI ONIY <br />CONIPRGT PRICE CF WOPK: <br />CESfR18E WORN qY0 SOJIAqE Ft�TAG[ iNVOIVLO <br />REPAIR X� DEMULITION I WOODSTOVE/FRPL �NSERT i I BUILDING RELOCATICN <br />� CONiAGI PGRSON ANO PIION[ NO <br />� — <br />i�c�t oescn�ou or rnorenrv isr�owrv oeiow in nrrac�+ roun coricsi <br />ior��g��_ e�ocH 1(1101 oF 4th AVL. W�__ <br />l-f1RVl:LJ L�V1J 111Yli L�VLY LIA.!\llil� \/1\ llll: <br />L•AST SInIi UP 4th AVP.. W. APPRUXIMATLLT <br />2uo e•�r:T r.cmT�i ur• Tiu, i�a�r�nsLc7iurt or <br />4th AVL'. lV. AND 1:V1;1LETT nIALI, I�AY <br />rno�ECTaooaess —___ ___...._.— <br />iotoi atr� AV£•.. IV. Lv�::^r•r, �•�n, <�azoa <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSGT (TOILET) �— <br />— .— — __—. .___. . ____ __. _ <br />BATHTU6 ;_ <br />LAVATORY (WASfi BASIN) � <br />SHOW[R <br />KITCHEN SINI( 8 DISP <br />DISHWASI�IER <br />LAUNDRVTRAY � <br />DRINKING fOUNTAIN <br />�LOOR DRAIN <br />B�CKFLOW PREVENTERS <br />ROOF DRAINS—RAWLEADE <br />SINK (SERVICE—BAR, [TC.) <br />FRDHi5E1RACN <br />USIi ZONE <br />i VPE OF LON57. Al10WABlE <br />SIZE OF BI.OG. <br />OCCUPRNCVLOAD <br />RE�SON FOR SPNINNI ERS <br />APPLILhTION FLC. UV <br />_ ' _ _.___'�.___. <br />—_ —i_— <br />_ .__.. __�__ <br />I HCREOY CERTIFV THAl 1 HAVL- READ AND EXAFA;NED THIS <br />APPI.ICAiION AND KNOW iHE SAA1E TO BE TRUE AND CORRECT. ALl- <br />PHOVISIONS OF LAWS APlU ORDINANCES GOVERNING THIS TYPE OF <br />WORK kVILL �E COMPLETED WITII WIIETHEP, SPECIFIED H6REIN OP <br />NOL THE GRANTING OF A PFRMIi DOES NOT PRESUME TO GIVE <br />AUTIIORITV 70 VIOI ATE OR CANCEL THE PROVISIONS OF ANV <br />OTHEfl STAT[ OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFOR6IANC[ OF CONSTRUCTION. THAT I AM Al1THORIZED BY THE <br />OWN[R OF TNIS PROPEHTY TO PERFORM THE WORK FOR WHICH <br />APPLICATI0IJ IS MAD[ AND I COMPLV WITII THE STATE <br />COMFACTORS LAW 1827 RCW AND 296.200 WAC. <br />sr,�mniia.ora�unincroi�onnnuwi�iu.uaceur nnte <br />X ��'�� _ __- <br />nri°ucnr sc.nr�ni;mi.ssnr,i�si.�nn�� nusrt��ssr�n��,e <br />MEGNl1f'IGAI. <br />110. TVPE OF E�UIPC7ENT <br />A�C- AIINDIGUNITS HP. <br />FORCED AIR SVSTEMS �S.U. r1 EA <br />IINIT I-IEATERS— B.TU. M <br />CLOTHES DRYFRS <br />VENTII.AIION FAtJ <br />__.____ .__..__ _.-.___._—_______ <br />RANG[ H�IOD <br />WATEH IIEATER -- �_�—�-- <br />WOO� S70VF <br />IdETAL FIREPLACE 8 CNIMNEY <br />RREPIACEINSERT <br />HEAT PUMP <br />GAS FIPMG <br />EI(IIAUST FAN <br />.__._—..I ._ _ .' _ I_ � _ I _ . __ _-_.._— <br />SIIt3 TfI1:11 $ <br />P[RA411 $ <br />ioini r i_�. b <br />isnns�iunck � sm�wunr.n <br />IOiAREA <br />IYPC 0! L01lSi AGIIUL <br />1!O OF SIORiLS <br />RRC SVRt1NLEH5 REOD <br />I I YES i�� NO <br />w.nrvs nrrnoveo iir <br />1'I i.�! i 111 I.h. Ii11Chl II � 1 �I <br />vacnr�r srte FEES <br />I YES I I NO �3tIII.UtlJG <br />lLY�III'/111:Y TI M111 III UINIIINIiIiI� �i'� .. <br />b11Uli� I <br />PI IR.1l31NG <br />_--"_J'_— _ _...— <br />IiAstUun �dLf.HANICAI. <br />— __ .' YES , NO . _ . . . _. <br />_ . —'___.___ - _ <br />❑Ei6117111A11A710H CJIIII.H <br />_"_. —__-__ '__'"_._ <br />__— __ __-__ _ -_—_ S1AltiliUlIUINGSURCHARGE <br />SiME 6NkRGY SURCIIAHGE <br />I CITY OF EVERETT i�ui3i ic wuiixs <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />T <br />--�r— <br />i <br />Stlf3 T(1TAI R <br />1'LIlMII 5 <br />ioini ri_i_ h — <br />I11 1 1 II'1 !!�1 <br />VALUATIOt7 <br />