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�j��-�v� �� <br />APPLICATION FOR CO <br />PERMIT <br />everett <br />�E�.� �� � ��� e <br />CITV OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br />ER MRIL AODRE55 � � � _ ^ '� T� /� A IP' PHON n /� y �y � � <br />J A'^� ifY % <br />���� +-i"U v�..i 1 „C/ <br />� ILAUDRESS CITY ZIP PNONE <br />ANCN ECiORDESIGNER MA�LA�URESS CITV ZIP PHONE <br />� <br />GENEFALCONTR � S fp CITY ZIP .� ^ PNONE L�CENSE• ' <br />Y6i•6402 —�55�7730 — 7�2•9Y44 1� I � l_, <br />MEGHANICALCONTRACTO�SO I1�I1���55 CITV 21P PNONE UCENSE� <br />Lvtr�tt, Wuhln�ton Yl�01 <br />PLUMBINOGONTRACTOR M��LADUNE55 CITY ZIP PHONE LIf,ENSE/ <br />QASS OF WORIf <br />❑ NEW ❑ ADDITION . LTERATION I I REPAtR I 1 DEMOLITION I I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />7ENANiIMPPOVEMENTORINTER�pPREMODELON�y-� CONIACTPENSON�NOPNONENO. <br />ll�mi� r�/ 1 <br />LOT BLOCR OF <br />WASHER <br />FRONTSETBACK <br />USE ZONE <br />iVPE OF CONST. AILOW�BIE <br />SRE OF Bl0(7. <br />OGGUPANCYl0�0 <br />REASON FOR SPRINKLEflS <br />APPLICATIIXJ RCC. BY <br />, ���„�... ..� ..... . ...... . _..._ .._.__ ...._ _._. <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES G.VERNINO THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHE� � SPECIFIED HEREIN ��ii <br />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 TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGN�T IP[ Of CONTRRGIDA ON /�U7NORIZED AGENT O�TE <br />X <br />AP UCANTSCITVBUSiNE5SL1 NSENO.NlOBUSINESSNAME <br />VENTILATION FA`1 <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACI <br />FIREPLACE INSEF <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL $ 1 <br />PERMIT $ � <br />TOTALFEE $ ' <br />REAPSETB�GK SI�ESETBACK PUNCNECNNUMBER FEE <br />IOTAPEA VACRNBITE FEES <br />f.) YES ❑ NO BUiLDiNG <br />TVPEOFCONSi.RCN�L oc[urextr xo.aMttwxcuxns <br />4BWP PLUMBING <br />NO.OFSiORIES BASEMENT MECHANICAL <br />I 1 YES CI NO <br />FIAE6PRNNLEfI5RE0'U HEIGIITLIM17ATION OiHER <br />❑ YES CI NG STATE BUILDING SURCHARGE <br />STATEENERGVSURCHAFGE <br />PLANSAPPROVEDBY CITYOFEVEREiT PUBIICWORNS <br />LOCALSALES <br />TAX COUEIS 3105 TOTA� <br />� <br />)TAL $ <br />f $ <br />FEE $ <br />PECEIPT NO. <br />,,,.. <br />,, ,, .. , ,_ <br />,_.. , . ._ ,. . .. , ... _ . : <br />��LP"'tR'� . . . � . . . . . . <br />