Laserfiche WebLink
AF�PLICATIOrI FOR CONSTRUCT ON PERMIT <br />rr� e�ro�� <br />cirv oc <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />❑ DEMOUTION ❑ COMBINATION O BUILDING �MECHANICAL <br />�� �\��'�-t'�`� i�l�o Jne��-U 8 l�l1fl-I n°i �-f-- �. {i v � UCJd� ( K <br />�ti�uin MA0.�DDRE55 CITV 21P PHONE <br />♦RLNITECTOROESIGNER M�I��DDRESS CITV 21F PHONE <br />❑ PLUMBING <br />everett <br />e <br />❑ SIGN <br />ClASS O: �'/OnR � <br />❑ NEW ❑ ADDITION <br />h� <br />LOT �aK <br />ADDRESS <br />KITCHEN SINK <br />JG FOUNTAIN <br />DRAIN <br />fION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING REIOCATION <br />BELOW OR �TfAGH <br />OF <br />SUBTOTAL $ <br />PERMIT 5 <br />TOTALPEE S <br />FPONT SETB�CK REAR SETBACI( I SIDE SETBACK <br />USE20NE I LOTAFEA <br />TYPEOfCON57.�llOWFBIE- I TYPEOfCONSi 1C7UAL <br />SIZE OF B106. <br />OCGUPANLYLO�D <br />RE�SON FOR SPRINNlERS <br />AVPLICATION �GC. BY <br />ND. OF STORIES <br />FIRE SPRNKLEPS fiE09 <br />U YES ❑ NO <br />V�CANT SITE <br />❑ YES u r,o <br />occunra xoaow�wxci <br />LRWP <br />B�SEMENT <br />❑ YES ❑ NO <br />HEIGHT LIMITATIDN <br />FUNSAPPROVEDBY I CITY OF EVEflETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />CONT�CT PE SON AND PHONF NO. <br />C' � /1 L L � <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIO�S OF UWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE CiRANTING OF A PERMIT DOES NOT PRESUME TO CaIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br />PERFORMANCE 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 RCW AND 296200 WAC. <br />SI6N�TUREOFCONTRIGTONORIIUTHORIZED�GENT D�TE � <br />APPLIL4ITSGITVBUSMc55 �CEHSENO.ANDBUSME��"'� �Y' % <br />METAL FIREPLACE 8 <br />HEAT <br />GASF <br />PL�INCHECKNUMBER I FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHEF <br />STATE BUILDING SURCHAPGE <br />SThTEENERGV SURCHARGE <br />PUBIIC WORKS <br />TOTAL <br />� <br />E <br />E <br />RECEIPT NO. <br />M <br />dS � Cv <br />