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I l�I APPLICATI�N FOR CONSTRUCIYON PERMIT <br />; � <br />I <br />IfM Everpresn <br />CITV OF <br />! everett <br />I BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN <br />' ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING <br />� <br />O ER /� MAILAO �flESS� /� dTY � <br />LJ ��C 1�/� 1 <br />' 7E T MA DDFESS C1TY <br />i <br />I ARCNIIECTOP�ESIGNEfl MAILADDRESS CITY <br />� NEPQ P�GTOvA���, ��URAL SGAS� INC. C1TV <br />1 <br />. ECHANIGLLGONTRACTON A S' C'i•Q� �/�� FITY� <br />; �605 MeDougall <br />1 \l 1 <br />, EWnl1, •.. r11rV <br />' PLUMBINCGONTRACTOR �I CITV <br />GUSSOF WORK <br />I_l NEW I I ADDITION <br />7ENAht IMPROVEMENT OP INTE <br />CONTMCT PRILE OF WORK: <br />� PROPOSEOUSEOFBUILDIN� <br />� LEOALUESCRIPTIONOFPROPI <br />LOT BIOCK <br />UUNDRV TRAV <br />CLOTHES WASHER <br />FRONTSETBACN <br />USE20NE <br />ttPE �F CON57. ALLOWABIE <br />SQEOFBLDO. <br />OCGUP�NCYLO�D <br />REASON FOR SPPINKlEflS <br />APPLIC�TION �CC. BY <br />� ,.... . <br />ZIP <br />ZiP <br />nr <br />PRINT <br />ANICAL <br />�PNONE <br />� <br />PHONE <br />PHONE <br />❑ PLUMBING <br />�� � <br />YXVRt UCtNSE• <br />PH NE UCENSE� <br />L. � (�^ <br />PNGNE LIGENSE� <br />everett <br />e <br />❑ SIGN <br />I I FEPAIR I I DEMOUTION I I WOUDSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />�SHOWN BELOW OR ATT�CN FOUN COPIES� <br />OF _ <br />CONf�CT VERSON �NO PIIONE N0. <br />I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS j <br />APPLICATION AN� KNOW THE StiME TO BE TRUE AND CORRECL ALL I <br />PROVISIONS OF LAWS AND ORDINANCES GOVEP�JING THIS TYPE OF I <br />WORK WILL BE COMPLETED WITH WNETHER ��PECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THA'�' I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFOfIM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I�:;;4PLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 29620C WAC. <br />SIGNRTU OFCONiR�CTOROR11UT110FIIEDApENT J�TE <br />X ����.�T �� � <br />�V LICANTS Cltt BUSI SS Lt�EN' SE NO. NIO BUSINESS NAME <br />IpNIGFL <br />TYPE OF t��:�MENT <br />NC—A/HNDLG UNI7S—H.P. <br />FORCE[? AIR SYSTEMS—B.T.I;. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTIIES DRYERS <br />VENTILATION FAN <br />HEAT PUMP <br />GAS PIPING <br />E7(HAUST FAN <br />SUB TOTAL $ ' <br />PERMIT $ � <br />TOTAL FEE $ <br />REARSETBACN SIOESETBICK PIANCNECKNUMBER <br />LO7AHE� VACANTSITE FEES <br />❑ ves n No BUILDING <br />iYPEOFtONSi.�L1UAL atur�xtr xo.aowFluxcuNrts <br />GNWv <br />PLUMBING <br />NO.OFSTORIES URSEMENT MECHFNICAL <br />I_l YES 1 I NO <br />FIRESPRNKLERSIiEOD MEIGHiLIMIT�TION OTHER <br />❑ YES ❑ NO STAtE BUILDING SURCHARGE <br />SiAiEENERGYSURCHARGE <br />PIANSAPPROVEDBV CITY OF EVEflETT PUBLIC WORNS <br />LOCAL SALES <br />TAX COOEIS 3105 TOTAL <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />FEE <br />u <br />� <br />� <br />i <br />-T <br />NECEIPT NO. <br />� <br />s <br />