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� <br />l`J � � <br />p�x <br />ay� <br />y z i-�+ <br />K n <br />H 7.7 <br />'� H'i1 <br />yyC <br />Oz <br />H C7 <br />��8 <br />� . il�'1 <br />ZyH3. <br />t" y x <br />ri H <br />N <br />H <br />CC� C7 C/� <br />[�1 � Cs7 <br />y O tyi� <br />.�. , <br />APPL.ICATION FOR GONSTRUCTIUN PERMIT <br />lM1C Erp•(J•fP:� <br />GITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8870 <br />�: DEMOLITION � <br />f--- ranii�n�oon�e,.s�s� <br />� <br />A141L ApDP[55 <br />A141L R�DR[55 <br />OR <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />)N BUILDING MECHANICAL PLUMBING <br />crtr <br />� <br />QiY <br />LIiV <br />n� <br />� <br />21P <br />$IP <br />� <br />PHONE <br />�����« <br />e <br />SIGN <br />vi uuniun f.ON1RAGiOR MAR M1pOA65 CITY ZIP PMONE LICENSE I <br />� NEW ADDITION ��LTERATION <br />1[NANiRAFl10V[M[N10R�NilRIppPE^PODELON�,� JO <br />LONiRACiPRICEOFWORR: ��/ `�--� / <br />DESCRi�E\YORNANDSOU R[FOOLAGE'NVOIV[0 <br />� ,t�r-nt�iE�E����E s���rt-l� <br />FROPOSE�US[OFBUIL ING <br />O%�'L� <br />iEGAL �ESCR�PTION OF PNOPEPTV ISNOWN BELOW OR RTTRC <br />LOT _ BIOCN UF _ <br />PRpJEGTADDRE55 <br />NO. TVPE OF <br />WATER CLOSET <br />BATHTUB <br />LAVAiOPV 1�4'A51 <br />SHOWER <br />Y,ITCHEN SINK & <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASH <br />URINAL <br />DRIHKING FOUN <br />FLOOR DRAIN <br />BACKFLOW PRE <br />FEPAIR <br />DEMOLITION WOODSiOV6FflPL INSERT BUILDINCa RELOCATiON <br />I cor�rna rcnsor� nNo PHor+e r+o <br />I HEREBV CER7IFY THAT I HnVE READ AND E%AMINED THIS <br />APPLICATION AIJD KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br />covie5� PROVISIONS OF LAWS AND ORDI�ANCES GOVEtiNING THIS TVPE OF <br />WOiiK WILL BE COAIPLETED WI7H WHETHER SPECIPIED HEREIN OP <br />NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOIATE OR CANCEL THE PROVISIONS Of ANV <br />O7HER STATE OR LOCAI LAW REGULATING CONS7RUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PHO�ERTY TO PERFORM THE WORK FUR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW iB27 RCW AND 23 00 WAC. <br />SiGNni �ii -oN1anC,t0�1onAUtYOqProAr rv Dnll_ <br />%� � ,,, , .< <br />NO. TYPE <br />NC—AHNDLG <br />FORCED AIR S <br />VENTILATION FA <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLA� <br />FIREPLACEINSE <br />HEAT PUh1P <br />GAS PIPING <br />E%HAUSTFAN <br />rv5[ rv0 /��� ��S��ti65 N4N= <br />EOUIPMENT <br />f5—f1.P <br />:MS—B.T.U. M E.A. <br />�.U. M <br />8 CHIMNEV <br />'_ SUB TOTAL $ _T_ — _ SUB T( <br />PERMIT 5 PERMf <br />~' + TOTAL <br />TOTALFEE 5 <br />FRONiSEiBAGN RGRS[LpPGH S��ESEIBACN �LANC��[CNNUAIBEP ��EC <br />• I15EZONE LOTRR[A vALANTSiiE FEES VALUA <br />� VES NO OUILDIkG 1 <br />iVPEOiCOHSi.ALLOW�BIE iYPFOfCONSi�LiU0.l uCu��h:r ��oauxro�+:n�`- — ���` <br />caouo p�UMBING <br />SIZEOFOLW NOAFSTORIES BASEIAENT MECHANICAL <br />VES NO — <br />OCCUPANCYLOAp FlRESPBNNI[RSREO'0 H[IGHiLIMIIAiiOfl OTHER —__ <br />. � YES . . NO $TAT[ BUILDING SURCHARGE <br />REASON fOR SPRINNI[PS <br />STATEEN[RGYSURCHARGE <br />errucnnor+nr,c nr rinr+snrrqo or CITY OF EVERETT puoucwoaKs <br />��' LOCAL SALES <br />.0 TAX CODE IS 3105 1�TAL <br />�3 <br />FECEIPt NO <br />a � <br />