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������� APP�ICATIOW FOR CONSTRUCT t'�TI PERNII'T ��'�'���' <br />meevo�g�een TO BE COMPLETED IN INK—PLEASE PRINT � <br />urv oF <br />everett HEATING SYSTEM: GAS _1 ELECTRIC CI <br />BUILDING DEPARTMENT - <br />2�9-8810 <br />DEMOLITION COMBINATION <br />OWNER / MRILADDR[55 <br />OR�ESIGNER MARADDRESS <br />P W MOiNG CONiRRGTOR <br />ClA$S OF WORK <br />� NEW � ADDITION <br />LONTRALi PRiCE OF W09N <br />PROPOSED USE Jf PUILOING ( <br />LEGAL DESCFiPTION OF PACPI <br />lOi BLOLK <br />MA�L ADDRESS <br />MNL ADORESS <br />� HLItH <br />�C�U,(� <br />TRG(INVOLVED � <br />��,r <br />(SNOWN 9ELOW OR AT' <br />OF <br />REPAIR <br />COPIES) <br />BUILDING XMECHI <br />�- I,U�S��i � z��� T <br />GiV PP <br />CrtV IIP <br />�� /P/ � <br />�,.Y U�� l <br />Cltt ZiP <br />PHONE <br />PMONE <br />�N�; rs <br />PHONE <br />PLUMBING SIGN <br />>-�S�1��0 <br />I <br />�� <br />DEMOLITION WOODSTOVE/FRPL INSEflT �. � BUILDING RELOCATION <br />I CONTACT PERSON RND PIIONE NO <br />J <br />raaecr aooaess ���� ��� J���� A �� <br />I�'` <br />OR ITEM <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTFAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENrERS <br />ROOF ORAWS—RAINLEADERS <br />SINK ISERVICE—BAR, ETC.� <br />PERMIT 5 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />fRONTS[TBACK RCAN 5[ipACK <br />16[ZaNE �OinRCA <br />Yn9 01 CONTS ALLOWABtF iMPEOf CONSi.AL1VAl <br />SVfOfBIDG. NO.OFSTOAIES <br />OC�URnNGYLOAD FlRESPNYNIERSREOD <br />I�EeSGN FOR SPR�'MLCRS <br />v,iq..C�ry I PIqNSPPPFOVEDBY <br />I HEPEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO B[ TRUE hND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPL[TED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GI\'E <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHEfl STATE OR LOC�L LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIIZED BV THE <br />OWNEfl OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THF STATE <br />COWTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />9GNATUREOFCONtq6CTOROR/UtHONIZEDAGENT �ATC <br />X �( tU�- ���.Li'�C��C� <br />� Q� <br />!SE N0. AND BUSINE55 NRM[ <br />:OUIPMENT FEE <br />S—H.P. <br />MS—B.T.LL EA. <br />U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATEF HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIqEPLACE INSEFT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SOESETB4CK PUNCHECKNUMBER <br />�y <br />S <br />vncaNT si�E FEES <br />BUILOING <br />On'.�WNLY NOMUW[1liNt�NitS <br />�"aP PWMBING <br />BaSEMENT MECNANICAL <br />M[IGI+t LIUITqi1oN ADDITIONAL PLAN CHECK <br />OTMEA <br />STATE BUILDING SURCHAFGE <br />CITY OF EVERETT AUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL g �n ; — <br />PEFMIT $ /5 � — <br />TOTAL FEE 5 r'— <br />R[ Cf mT NO <br />VALUATION FEE <br />� <br />� <br />0 <br />0 <br />