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ppPLICATIO� FOR CONSTRUC�N PERMI'i' <br />rne �veroreen <br />CITV OF <br />everett <br />6UILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259•8810 <br />❑ DEMOLITION f_1 COMBINATIUN I"1 BUILUING I' MECHANICAL L 1 PLUMBING <br />Q�E�y MAILADORE55 CITY ZIP pPpMONE /1p <br />1L�'J ... /_...f �r i�n f�nY (A/'19.1'� .CC/'�7i�E.. w!�. 70%6�'�v7�� <br />everett <br />e <br />❑ SIGN <br />TEN�i MAILA�ORE55 "••. <br />��n, Z�p PHONE <br />ARCMI7EGTORDESIC.NER MAILADORE55 <br />PLUMBINOCOPoTNACTOR MAILADORE55 CIIY 21P PNONE LIGENSE• <br />CLASS OF WORH <br />I-1 tiFW ❑ ADDITION I.�i ALTERATION I�PAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT f I BUILDINGRELOCATION <br />TEN�NTIMPRO�EMENtORINTEiilO MOOELONIY <br />--..__._._�,��„�w„��. �c�SoU• c� U <br />�oi o�ocK oF <br />i �_ <br />FRONTSETBACN <br />1 <br />USE 20NE <br />t <br />r <br />iVPE OF CONSC ALIUWABLE <br />srzeoFe�oo. <br />OCCUPANCYLOA� <br />� REASONPORSPRINKLERS <br />APPLICATION AGC. B <br />� i <br />�� <br />SUB <br />REARSEi04GN <br />IOTAREA <br />7VPEOiCON57 AC1UAl <br />� <br />hJ. OF Si0RIE5 <br />FlRE SPPNNLEf15 FEO9 <br />I.] YES IIi1Q6 <br />PLANSAPPROVEOBY <br />FOUR <br />CONI�GT PERSOrv miu rnune n�. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS j <br />APPLICATION AND KNUW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES (iOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GI4E I <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br />OTHEN STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOFiS LAW 1827 RCW AND 296200 WAC. <br />SIGNAT' OFCONiRnCi URGU7110RIZEOAGENi DR1E I <br />X%� �'��- - -- <br />AP � CAN75 CITY OlI51NES5 LICENSE NO. ANO BUSINE53 NPME <br />ANICAL ' <br />TYPE OF EOUIPMENT <br />NC—NHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTIIATION FAN <br />RANGEIi00D <br />W�TER HEATER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN _ <br />$ —� <br />5 <br />SI�ESETpACN PIAIICNECNNUM9ER <br />VACANT SIiE FEES <br />I� ] YES I 1 NO OUILDING <br />acurnea noaow�gixcuxns <br />mj0 1 PLUMOING <br />oASEM�[r+ MECHANICAL <br />1/yE$ I I NO <br />NGGIITLIMIiFTION OTHLR <br />STATE BUILDING SURCNARG[ <br />STATE ENERGY SUf1CNARGE <br />CITY OF EVEPcTf PUBLIC WORK$ <br />LOCAL SI!LES <br />TAX CODF IS 3105 TOTAL <br />� <br />TOTAL <br />FEE <br />� <br />�$ <br />RECEIPT NO. <br />