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�r� <br />A .�i `X. <br />'�" H <br />aycn <br />H aa <br />y xH <br />� H� <br />o so <br />'i1 H'i1 <br />VJ H <br />� H C7 <br />��g <br />�r n <br />zH�y H <br />rHy <br />g �' <br />C� C C/� <br />��M <br />H O ty/� <br />a I <br />APPLICATION FOR CONSTRUCTION PEE�f1A1T <br />everett <br />Inr Cvo�amen � <br />GITY OP <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE i'RINT <br />259�8810 <br />DEMOLITION COMBINATION " BUILDING MECHANICAL . PLUMBING SIGN <br />o\VrvER IAAIL nDOPE55 C�tt ➢� �'������ <br />:;-_�_1 �Scn /n90�G/a5ncl,-/7irnrcr •,:1 S±�{� 'c�. <br />f�� �o sC sr- 75as <br />1ENANL <br />M�ILADDRE55 f.ITV 2iP PNONE <br />�1� GTY ZIP PHONE <br />AFCIII1ELiOiiCC51GNER I.IPILAO�RE55 <br />pE�J[RALCONiRALiOR MRILAD�8E55 Cltt ZIP PNON[ LICENSE/ <br />—�—� � CITY 21P PMON[ UGENSE/ <br />MECIIANIGILOMRACiOR MAILAppRE55 <br />hOn� PNONE LICENSE� <br />PlNA01NGCONiPnCiOR MAiIAD�RE55 ��TM Z�P <br />,�o rR- <br />„NEW �. ADDITION ALTERATION J� FlEPAIR <br />i[rvANTIMPFOVEMCNtORIIIIFP�ORR[MO�EIONLY <br />DESGRIf1[ WORK ANp SOIIARE FOOiAGE INVOW [J <br />T�i ro .-�,i,� re nc <br />PROPOSED 115E. OP OUR�iNG�— <br />_�-' o v� 1 0. I � �1 K� <br />LEGAL�ESCRIPiIOtlOfPROPERTVISNOWNO � <br />�pT OLOLK OF <br />TVPE OF FIXTURE OF i7EM <br />NATER CLOSET (TOILET) <br />3ATHTUb <br />.AVATORVIWASHOASM) <br />iHOWER <br /><ITCHEN SINK 8 DISP <br />�ISHWASHER <br />_AUNDRY TRAY <br />�LOTHES'�'ASHER <br />URINAL _ <br />DRINKING FOUNTAIN <br />FLOOP DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK �SERVICE—BAR, ETC.) <br />SUBTOTAL $ <br />PERMIT S <br />�RONLSETBPCK <br />USf ZOtll <br />RI:AR SEIDACK <br />lOif.RfA <br />ivP[OfGON51.0.10WABLE � tYPEOitON51.4LIWl <br />9Zf OF BLIX'i. <br />pf,CU�ANCVLOAD <br />PEASONFOl1SPRiNKLERS <br />Pt'PUGATIpN RLL. B I <br />NO.OF STORiES <br />FIRE SPRNnLERS RE00 <br />I '. YES �. � NO <br />PLNNSAPPRDVIDBY <br />SiDE 5[ LBACK <br />DEMOLITION WOODSTOVEFRPL INSERT � BUILDING RELOCATION <br />COAiRCivERSGNANOPHON[HO. � � _ ^ <br />\'ACANT SIiG <br />YES NO <br />n-n;nh[r xo urp�{uLhci <br />BRS[MENi <br />' �. YES �. . NO <br />H[IGML LIIdITALION <br />CITY OF EVERETT <br />LOCALSALES <br />iAX CODE IS 3105 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLE7ED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />FUTHOHITY TO VIOLATE OR CANCEL THE PHOVISIONS OF ANY <br />OTHCR STATE OR LOCAL LAW REGUI.ATING CONSTRUCTION OR THE <br />PERFOfiMANGE OF CONSTRUCTION. iHAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR 1NHICH <br />APPLICATION IS MAD[ AND I COMPLY WITH THE STATE <br />CONTRACiORS LAW 10.^7 RCW AND 296200 WAC. <br />SIGNF111�EOF;,OYtRM10RORh1liHORi1[�AGENi DATE <br />X _�,�-.�,� %%7 /.�l.�C��. l - l9 - 9n <br />APPIiC SGITY�USINESSLIC[NSENDANO�USINESSNAh'�E <br />FORCED AIR SVS7EM5—B.T U. <br />11NlT HEA7ERS—B.T.U. M <br />CIOTHES DRYERS <br />VENTILATION FAN <br />RANGENOOD <br />WFTER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />� euerorn� s _ <br />PERMIT 5 _ <br />TOTALFEE 5 <br />PIAHCMWNNOMBEP fF[ RECEIPTIO_ <br />f3111LDING <br />r�ur,+�+iNc <br />MECHANICAL <br />OTHER <br />S1ATC BWLOING SURGHARGE <br />STATEENERGVSURCHARGE <br />PUAUC WORKS <br />TOTAL <br />� <br />• <br />