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APPLICATIOCi FOR CONSTRUCT�N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT 1 !! f � <br />rnaEwrgrenn �'9 �� <br />CITV OF �} I �/�R,S <br />eve�rett � '� <br />HEATING SYSTEM: ❑ GAS LECTRIC ❑ <br />BUILDING DEPARTMENT <br />259•8810 � <br />1 DEMOLITION ,�/COMBINATION BUILDING _ MECHANICAL _ PLUMBING : SIGN <br />L, i u�v � o a' a.�vv <br />TEN�NT MAILADDRE55 qTV 21P PHONE <br />ARGHITEGTORDESIGNER MAILADDRESS CITY 21P PHONE <br />GENERALCONTRACTOR MMLADDRESS dTY 21P oHJNE LICENSER <br />MEGN�NIGIILCONTR�GTOR MMLAODHE55 ' GITY ZIP PHONE IILENSE• <br />PLUMBIN:.CONTP�GTOR M�ILApDRE55 CITY 21P PNONE LILENSEI <br />NEW ❑ ADDITION �i� ALTERATION . . REPAIR <br />r/� l H. c <br />ITR�CTPRICFOFWORN i.I�l /�/ $�'� � � I.3 <br />LOT. ao BLOCN <br />PROJEGTAODRESS <br />X y� <br />DISP <br />o // s/� <br />� VJOODSTOVE/FRPL INSEnT L'� BJILDING RELOCATION <br />PERSON RND PNONE N0. <br />1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORHECT. ALL <br />LOW OR r1TfACH FOU�CR COPIES')1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />L 21 p 6 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY f0 PERFORM THE WORK FOR WHICH <br />— APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SIGNR FCONTRRCTORORIIUTHORIZEDRGENT TE <br />X <br />(�.nAI� A �PPL �NTSCITVBUSINE554CENSENO.�N�BUSIN SNAME <br />OR REM <br />SUB TOTAL $ <br />PERMIT 5 <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSEiBACK REARSETBACN <br />2�' Zo. <br />USE LON � LOj.AfiEa _ � <br />- I �� ,.'� <br />7YPEOftONiS.AIIOWABtE 7YP[OFCONSi.ACiUAt <br />SIZE OF BLDG NO.OF ST09IE5 <br />as�z sr r 2 <br />�Ifr S 'I <br />OCCUPRNGVlOAO FIRESPRNNLERSREO'D <br />A <br />REASON FOR SPRINKLERS <br />MTANEBV PLANSAPPROVEDBV <br />FEE I NO. <br />J'� <br />A/C—A/HNDLG UNITS—HP. <br />fORCED AIH SYSTEM�B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYEPS <br />VENTILATION FAN <br />RANGEHO00 <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDE SETBACK PLAN CHECN NUMBER <br />,5 9/ �7�%G <br />VRCANT SITE FEES <br />7� BUILDING C' �a� <br />acuPeucr xoawrtuweuxirs � <br />R"� l PLl1MBING <br />pRSEMENT MECHANICAL <br />0 <br />HEIGHT LIMITATION ADDITIONAL PLAN CNECK <br />� ' OTHER <br />STA7E BUILDING SURCHARGE <br />CITY UF EVEflETT rueuc woaKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTIIL <br />� y� �U <br />FEE <br />Yis�d � <br />� <br />0 <br />