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� � <br />��� <br />� � <br />� <br />R�� <br />�u� <br />� <br />O� <br />t" H <br />�"f <br />W <br />A � <br />O� <br />APPLICATIO�� FOR CONSTRUCT��I�i PERMIT ���'�" <br />ihe Everpnren TO BE COMPLETED IN INK—PLEASE PRINT ��� G G � <br />CITY OF C/ <br />eve rett HEATWG SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDIN3 DEPARTMENT <br />259-B810 1 <br />DEMOLITIOJ� ��v�COMBINATION �CBUILDING �MECHANICAL �PLUMBING SIGN <br />O ER MAtLA�ORESS CILV ZIP PHON[ <br />`"7 � ��i„� r� „ �1 ._ /, _._., rC�I��P 9lc/_ ii�n[� <br />ueu.aoonE55 I� <br />E� <br />MAIL AOOF,€55 <br />� <br />zm <br />��-SO� <br />LIqENSE • <br />' � l �'J U(O �'�// Gui 5 ' )- - -rt� G��ri r �o '. <br />ME �IANI LCONiN�CT R 1AAllA0�RE55 L,j�� l� ��TY Z�P PlIpNE UCENSE• <br />4 � � 3�jJl � ��r ` (,-" Z_ -L� ��i�C,N�Z�o9�' ,u� '' <br />PLUTABINGCONiRACiOR MAILA ORE55 Cliv � ZIP PNO-NJ[ IICFNSE• I <br />r � �' / '�i <br />�, � rx a��,h,��o s� s� -- �� <br />LLA55Of WORN , <br />�NEW : � ADDITION . . ALTERATION ; REPAIR . '� DEMOLITION . � WOODSTOVE/FRPL INSERT , . BUILDING RFLO�ATION , <br />� A� — CONTRGT PERSpN AHO PlIONE <br />�. G J � � 1��-. �� � <br />CONiPnCT PPiCE OF WORK � <br />DESGRiBEWORKAN�50UA FOOiAG V LVE� <br />� � . S <br />PROPOseouseocovaoir �L I HEREBY CERTIFV THAT I HAVE READ AND ERAMINED THIS , <br />S i�' � APPLICATION AND KNOW THE SAME TO 8E TRUE AND CCFiAECT. ALL � <br />LEGRLOESCRiPt10NOFPPOPENttISNOWNBELO\YORRTT�LMFOUNCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGT'�iISTYPEOf <br />p WORK WILL BE COMPLETED WITH WHETHER SPECIFIE�� HEREIN OR � <br />ioT I'� o�ocK ov NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE ��, <br />S� P�� 70 Q�7V7O � AUTHORITY TO VIOLATE OR CANCEL TNE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUf,TION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE �. <br />— OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />Pi APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.209 WAC. � <br />SIGNAiOREOFCONTPACiOROR�UTNORIZI?DAGENT DATE <br />X� , InAc I.fr�.,.�— <br />ADDRE55 <br />BATHTUB <br />I:NZ�77 <br />a <br />fY�1�Pi►:11�. <br />ETC. <br />� �� <br />ITEM <br />NO. TYPEOFEOUIPMEN� <br />A/C—NHNDLG UNITS—H.P. <br />- FORCED AIR SYSTEMS—B.T.U. <br />- UNIT HEATERS—B.T.U. M <br />- CLOTHES ORVERS <br />- VENTILATION FAN <br />- RANGEHOOD <br />METAL FIFEPL <br />FIREPLACE IN: <br />HEAT PUMP <br />G�S PIPING <br />EXHAUSTFAN <br />� <br />FERh11T 5 � rcnmii <br />TOTAL PEE $ (,-i ��' - TOTAL FEc <br />FOR OFFICE USE ONLY: `� ` . �`_ <br />FRONTS[iBAGK �EAflSETBACK SIOESEiORCN PLANCNELNNIIMOER F[E <br />r / � � <br />�, � Z� � � 7 �, 3•,5C <br />usezo LOTRREA VAUNTSIT[ FEES yVALUATION <br />— I /C� �) y� BWLDING 1' <br />IVPCOtCONiSRIlOWABLE lYPEOiCONSi.AC1UAI IXLv�Ax.r xonw:ui�4.uxn5 O�l <br />rnwv � p�UM01NG <br />—nl — (� •3 <br />5R[OFOts('F r No.0i5TONES BASEMENT MECHANICAL <br />1773 �� O <br />qi� 5'r �+AR AOOITIONALPLANCNECK <br />OCCUPANCYLOAD FlRESPPNrcLER5BE0D NEtG��1liMIt�TION <br />or <br />/ <br />Np OTHER <br />STAiE BUILDING SUflCHARGE <br />�,nvrRoveoor CITY OF EVERETT PUBIIC WORNS <br />�LOCAL SALES <br />i���d TAJ( CODE IS 3105 TOTAL <br />J �' ` <br />/'%; � , <br />,� <br />