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. . . . � . . .. .._.1... . .... . . . . . . . ... <br />APPLICQ►T10�1 FOR CONSTRUCT�ON PERMIT <br />1ha 6rem..reen <br />CIN OF <br />everett <br />everett <br />e <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-8810 <br />L I DEMOUTION I 1 COMBINATION i I BUILDING �.MECHANICAL � I PLUMBING I I SIGN <br />OWNER <br />MAILAD�R[SS CITY ZIP PIIONE <br />nrUi �� �/N �/600 �•C/ ni �- L'l/i- •�STi-5 �>?93 <br />IENANi <br />MAILADOR[SS CIIV 21P PHONE <br />ARCMITEGTOR�ESIGNEfl IAAILROORE55 dTY ZIP PMOHE <br />GENER�IGONTRACTCR MRILADDRESS G7Y ZIP PHOKE LILENSEY <br />MECHANICALCONTFRCTOR MAILAD�FE55 dTY IIP PI10NE LIGENSE/ <br />�. _ .,,.1.,� i�f�� ��.,� -� u;, tliii ��r.l' � Uf `��n,9Ub d5y -533/ Ne�1-L r�l� 13�IG� <br />MAIL <br />CITY 21P <br />r��orve <br />CLASS OF WORK�'�• <br />I�-I NEW y-«DDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I J BUILDING RELOCATION <br />TENANT IMPROVEMEN70R INTERIOR PEMOD� ONIY__ �� I CONTACT PGRSON AND PI�ONE HO <br />�ESGRIOE WORK PNO SOU�Ht twinoe inv�ivcv <br />-n�ct,�,.i� Ql1S C�✓fl{EIZ f�V1''�� <br />PROPOSEO USE OF OUI:OING <br />�� / P� � <br />LFGRLDESCR�PiJ NOFPRO .P.TYISHOWN�ORRTTAGHFOUfiG( <br />�pT BLOCK Of <br />WATER CL <br />BATHTUB <br />LAVATORY <br />CLOTHES <br />SINK <br />FRONTSETBACK <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />RERR SETBPCK I SI�E SETUACK <br />USEZONE I IOTAREA <br />1VPEOFCONS7.AlLOWA6lE I rY�EOiWNSf.ACIDAL <br />52E OF BIOG. <br />OCGUPANCYLOAU <br />REASON FOR 5'NINKLEAS <br />RPPLICATION ACG BV <br />NO.OF SiORIES <br />FIRE SPRNKI[f15 REO'� <br />I7 YES I:I NO <br />PLANSAPPPOVEDOY <br />VRCANT SITE <br />I� I YES l 1 NO <br />rcrureNcr xnamvuuxc� <br />BASEMENT <br />I I YES Il NO <br />HEiGMT UMIIATION <br />CITY OF EVERETT <br />LOCAL SRLES <br />TAX CODE IS 3105 <br />1 HEREBY CERTIFY THAT I HAVE READ AND E%AAIINED IHIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINC THIS TVPE OF <br />WORK WILL BE COMPLETED VJITH WHETHER SPcCIFIED HEREIN OR <br />IJOT. TI1E GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEHFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 flCW AND 296.200 WAC. <br />SIGNAIIIRE Oi CONI RAGtON OR A111110RILF.0 AGENI OATE <br />X �',� � ������.Lla�--- <br />AP LiC� 75CI1VOUSM[SSIICENSENOAN ❑SINESSNAME <br />:ED AIR SYSTEMS—B.T.U. M E.A. <br />HEATERS—B.T.U. M <br />ATION FAN <br />HOOD <br />HEATER <br />STOVE <br />I1EAT <br />8 <br />SUB TOTAL $ <br />— PERMIT $ <br />— TOTALFEE S <br />PLANCHECKNUMBER FEE FECEIPiNO. <br />BUILDING <br />PLUId01NG ' <br />i <br />i <br />MECHANICAL <br />OTHER � <br />i <br />STATE DUILDING SURCHARGE �� <br />� <br />STATEENERGVSURCHARGE <br />— i <br />PUBLIC WORKS � <br />rorn� �' <br />