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APPLICATIO.� FOR CONSTRUCTIJN PERMIT <br />everett <br />ure E�a,A,�,� e <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />I I DEMOLITION I COMBINATION BUILDING _�QiIECHANICAL ,� PLUMBING I i SIGN <br />ONTlER M�II. �D�NE55 QTv ZiP P�ION[ <br />�c�� ��2.�n .��9 ���ra�:��� �-z-�- �v�-,�_ as� -��,�s`_ <br />TENRNT MRILADDPG55 CItY ZiP PIIDNE <br />GGNERIIL <br />MMI. AODR[SS <br />MML ADDRC55 <br />Zlf' <br />diV 21P <br />P110NE <br />PIIONE 1 iCGNS[ � <br />MEGNRNiGMCONTRACTON M�ILADDR[55 f.ITY ]II' P�IOH[ IICF.NSL� <br />ti,/ � � ..aa F� i4�r�c.� suv i1�� p�i. _�� ` - �� � _ ,�;` _�J tik'� �fh_cs;J3}�_ <br />YWMBINGCONiR�CTOR MAIIADORE55 CI1Y IIV PHON[ IICENSER <br />�C�Lry SOFWORN <br />hl NEW I I ADDITION I i ALTERATION ! I REPAIR I I DEMOLITION :� WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />iENANT IMPROVEMEM ON INIERIOR PEMOOEL ONI Y <br />CONTR�CTPPICEOFWONN: ��` '�— <br />DESCPIBE WORK RNO SOU�IIE FOOIRG[ INVOIVC� <br />—[��u�.� Q �.. �i ...�J(j� <br />PROPOSEDUS BUII.DI(I <br />LEGAL DESCRIPTION OF PROPERTY (SIIOWN OEIOW OR �TTACII FOIIR f.OPI[51 <br />lOT BLOGN OF _ <br />3a P`�? w e �-rrc,R�e <br />PPOJECTA06iE55 <br />TYPE OF FIXTURE OH <br />CLOSET ITOILET) <br />LAVATOfiV (WASIi �A; <br />SHOWER <br />KITCF'EN SINK 8 DISP <br />DISHV/ASHER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFI.OVJPREVENTERS <br />ROOF LRAINS—RAINLEADERS <br />SINK (SGRVICE—BAR, ETC.) <br />fPONTSETBRCK <br />USE 20NE <br />iYl'E OF CONST Al10WABlE <br />SIZE OF Bl DG <br />OGGUPANCYLOPO <br />REASON FOR SPFIHNlERS <br />RPPIIGATION FCC. BY <br />FEE <br />__—_ _I__—_—___!_—. <br />- T' <br />CONiRGi P[I150N ANO PIION[ NO <br />I HE�lEIiY CERTIFV THAT I fiAVE READ AND EXAMINED THIS <br />APPLIGATION AND KNOW THE SAME TO BE TRUE AND CORRiCL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORH WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PREuUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATINCa CUNSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TfiIS PROPERTY i0 PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORSLAW1827RCW AND,^.96200WAC. <br />S�G��AiUREOfC01liRACTORONM1I110fl12E0RG[NT DRTE <br />X„ <br />�)_�r/L AU <br />4PPIIL�tl1Ff:11V11115MlSS111' S[NORNOOIISMC551lAMC <br />NO. TYPE OF EOUIPMENT <br />AiC - A91NDI.G UNITS--H.P. <br />_ FORCED AIR SYSTEMS—B.T U. M <br />UMIT HEATERS—�,T.U. M <br />� CLGTHES DRVERS <br />VENTII ATION FAN <br />RANGEHOOD <br />_ � WATEP I IFAT[!i <br />WOODSTOVE <br />METAL FIREPI.ACE 8 CNIMNEY <br />FIREPLACE INSERT <br />IiEAT PUMP <br />GAS PiPING <br />—1-- -- <br />EXNAUSTFAN <br />_.___i_.._ _._ .- --_. <br />___�_—.. .. _ ____ .-- <br />SUB TOTAI. $ <br />_--*— _ .-- _ <br />PERMIT $ <br />TOTAL FEE $ <br />PERRSEiOPCN 9PG5[IDAGK P1ANC11[LNNIIIApER <br />ioinnu vacnNtsrte FEES <br />� YES i I NO OUnOitdG <br />1VPEOiCON57ALi11AL a�a��F��t�r npfNpv¢inncuun5 --- <br />tnour p�U1dBING <br />NO OF STORIES <br />HRE SPRHNI ERS REOD <br />I I YES I I NO <br />iy►ua���aci.mm�n� <br />BASEIA[Ni <br />i�YES '�INO <br />IILIGIII UM114tIOH <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CO�E IS 3105 <br />IdL=CHANICAL <br />UIIILH <br />S1AlE BUIIDING SUfiGHAHGE <br />STATEENERGVSURCHARGE <br />t�uai.ic woaHs <br />TOTAL <br />SUB TOTAL 5 /� <br />PERMIT $ // i <br />TOTAL FEE $ 3 0 � '— <br />FEE RECEIPT N0. <br />VALUATION FEE ` I <br />� I <br />i <br />i <br />�C� <br />_ __ ___ i <br />__ ; <br />— _ —_—�' <br />� <br />� <br />� <br />