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APPLICAT�Or�FOR CONSTRUCTI: �1 P��RMIT <br />rnee�a,�,ue� TO BE COMPLETED IN INK—PLEASE PRINT <br />CITV OF <br />everett � <br />BUILDING DEPARTMENT <br />259-8810 <br />I i DEMOLITION ' COMBINATION <br />RRCHITECT OP �ESIGNER <br />MAIL AOORESS <br />MAIL ApDRESS <br />HEATING SYSTEM: U GAS ❑ ELECTRIC U <br />BUILDING <br />cm <br />.� <br />LITV <br />PNONE <br />� <br />PHONE <br />PLUMBING <br />everett <br />e <br />SIGN <br />PLUMBINGC04TRACTOR M�ILADDRESS CITY 2�P PNJNE <br />LICENSE � <br />. ; NEW ' �� ADDITION <br />CONTMCTPRIGEOiWORK � <br />DESCflIBE WORK AND SOUnPE FO <br />LEGRL DESCRIPiION OF PROPI <br />LOT BLOCK <br />URINAL <br />ALTERATION <br />�'Ol/ <br />INVOIVED <br />� <br />YN BELOW OR Ai <br />__ OF <br />SUB <br />FOR OFFICE USE ONLY: <br />FRONTSEiBACN REARSETBACK <br />USEZONE LOTAREA <br />iIPEOFLONiS.RLlOWM19lE iYFCOiLONSt.AGi <br />SIZE OF OLDG NO.OF STORIES <br />7CCUPANLV�OAp FIRESPRNKlERS <br />ihASON FOR SPqrt1KlER5 <br />INiAHE BV <br />TPPROV[D�Y <br />REPAIR <br />DEMOLITION .� WOODSTOVFJFRPL INSERT `: BUILDING RELOCATION <br />WNiACT PERSON qND PMpNE NO <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />coaiEsi PROVISIONS OF LqWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WOfiK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A pERM1T DOES NOT PRESUMF TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERN TO PFRFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THc STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SIGN4TUREOFCONTPRCTOpOHRUTHOHIZED4GENT OATE <br />X` '0 �P /�% �' S Q2�.:�� <br />iAPPLIGFNiS CITY 9pSINESS LICENSE NO. RND BUSINE S N <br />rvn�.ouHina-.AI[MS—g.LU. M E.A <br />VNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT pUMP — <br />3A5 PIPING <br />=XHAUSTFAN <br />SIOESETBACN � PL4IJCMECNNUM/pER <br />� _.1 <br />VACI.NT SITE FEES <br />BUILDING <br />CCCIIMMCY NQ MOW[IlIHG11N115 <br />G9Wv <br />PLUMBING <br />OnSEM[NT MECHANICAL <br />NEiGNi uMrtqTloN ADDITIOryq� p�qN CHECK <br />_ OTHER <br />STATE BUILUING SURCHARGE <br />CITY OF EVF.RETT PUBLIC WORNS <br />LOCAL SALES <br />TAX CODEIS 3105 rora� <br />SUB TOTAL $ � — <br />PERMIT $ — <br />TOTAL FEE S -7�i � — <br />NO <br />fl <br />