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G�� � 19���k- � <br />��' APPLICATIO� FOR CONSTRUCT�ON PERMIT <br />!M EreNme^ �, , <br />I C�n' OF <br />everett � <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-8810 <br />❑ DEMOLITION I l COMBINATION I] BUILDING -y..LMECHANICAL I_1 PIUMBING <br />MAR�DDRE55 C� V ZIP PNONE, � <br />�E ��l-. T�t � r�(Y.lm. .�'r�;�l -tz?t'rt�Q1 �l�01 -�25�= 3� � <br />��r� nr r�wne <br />APGNITECTOROES�bNER M�IL�ODRESS CIiY Zm rnonc <br />OENERKCON7R�CTOR M�IL�ODRE55 GRV 21P PMONE LIGENSE� <br />i <br />� NNIICAICdifReGTO <br />, ►LWBMO-:ONTR N <br />�� �� <br />, ❑ NEW ❑ ADDITION <br />TEINNT MPROVEMENi OP INtE� <br />CONT1`�CT PNKE OF NV11N: <br />pEBGRBE�A�50U � <br />. voseo us� oF euno <br />�or <br />�DOf1E65 <br />everett <br />e <br />rJ SI(iN <br />' �.Vr - / - • r v C.�w • � � .r - � w - . � - _ <br />��DRE55 CIIY ZIP PIIONE IICENSE�� _��_ � <br />v��N�-153 �. <br />ALIERATION I 1 REPA�R I 1 DEMOLITION I I WOODSTOVE/FRPL INSERT CI BUILDING RELOCATION <br />g�p�j� OF <br />SINK <br />FRONTSETB�CK <br />U6E ZONE <br />TYPEDFCONSf ALLOWABIE <br />6QEOFBL00. <br />OCCUPANCYlOAO <br />REASON FOR SPRINKLERS <br />AFPLICATION �GC. BY <br />REARSETBAGN <br />LOTARE� <br />1YPE 0� CONSC �CN�L <br />NO.OF STORIES <br />�IRE SPRHNLENS RE00 <br />u vcs ❑ No <br />PUNS �PPROVED BV <br />COPIES� <br />SIDE SE7BRCN <br />V�CANT SITF. <br />LONI�CT PEf150N ANO P11pNE NO. <br />I HERLBY :ERTIFY THAT I HAVE RERU AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO 6'� TRUE AND COPRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS TYPE OF <br />WURK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 41VE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />QTIicR STATE OR LOCAL UW REGUUTINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TFIE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH <br />.4?PLICATION IS MADE AND I COMPIY WITH THE STATE <br />CJNTRACTORS LAW 7827 RCW AND 296200 WAC. � <br />510 �TUREOFCONTRACTORORAUTNORRED�OENT DATE ` �I <br />�� 9 <br />(J g <br />APPLICANTSCITYBUS SSIICENSENO.ANOBU51NE9SNAME <br />FORCED AIR SYS' <br />� <br />CLOTHES DRYER; <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACI <br />FIREPLACE INSEF <br />HEAT PUMP <br />GAS PIPING <br />PUNCH"�KNUMBER I FEE I RELEIPTNO. <br />I 1 YES ❑ NO BUIWING <br />p�M.K� MOdDWIIIiMGYNi15 <br />0R°pP PLUAIBING <br />B/uEMENT M[CHANICAL <br />I I YES O NO <br />HEIGHTLIMIT�IION �THER <br />S7ATE BUILDING SURCHAriGE <br />STATE ENERGV SUfiCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LQCALSALES <br />TAX CODE IS 3105 TOTAL <br />