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r. <br />APPLICATIOI� FOR CONSTRUCTIvN PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />!he Everpreen <br />an oF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC � <br />BUILDING DEPARTMENT <br />259•8810 <br />f] DEMOLITION i i COMBINATION _1 BUILDING !-! MECHANICAL ' PLUMBING i SIGN <br />OWNEP MAIL AODRESS CITY 21P PMONE <br />1�.� i tA �r-.� ��,r ��.� �nn� )�r-2 tx)�. t-� t� i P�ao.� <br />7ENI�N7 v Mu��ooNess i ���* �• •mm� <br />5��K � J^� µ� L' �J �'1 {k C_= � I� L44 a <br />�RCNITECTOROESIGNER MAIL�ODRE55 CITY ZIP PNONE <br />21P PHONE LICENSE� <br />y a 7a 6..s3 -a �ia �,ws �s <br />IIP PIIONE LICENSEII <br />PLUMBM6CONTRACTOR MAILADDRESS CITY 21P PlqNE LICENSEI <br />QASS OF M17AN <br />; 1 NEW S�ADDITION iJ ALTERATION <br />asn a� aa So c� / 9 <br />coarrucr rn� aF worm <br />pE$GqIgENVNNMlOSOU�RE T�GEMVOLVED <br />�p�r�iJ A�I?/o� o?O <br />D USE OF lDIN6 <br />�Qt� I tr.tiT/f1 L <br />LEOAL DE3CRIPTION OF PROPER7Y ISHOMM BELOW OH ATf�CH <br />LOT __ _ BLOCK OF <br />WATER CLOSET(TOIG <br />e�n+tus <br />LAVATORV(WASH BA; <br />SMOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDflY TRAY <br />CLOTHES WASHER <br />FOUNTAIN <br />PREVENTERS <br />FOR OFFlCE USE ONLY: <br />FRONTSETBACK RE�R: <br />1YM Oi rCONiS AIIOWABLI <br />1L'A� <br />SIZE OF BIDG. <br />S2/ Sf AoDe/ <br />OCCUPANGYlOAO <br />REASpNF RSPRINKLE <br />INTqKE BV <br />SUB TO' <br />PERMIT <br />Of STORIES <br />SPRNKLERS FEO'0 <br />� <br />7 � 9�fr <br />! i REPAIR <br />700 <br />i. - <br />i � DEMOLITION ��. J WOODSTOVE/FqPL INSERT G BUILDIN6 RELOCATION <br />GONTACT PERSON AND PNONE NO. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THiS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDtNANCES GOVERNINCi THIS TYPE OF <br />WOflK WILL BE CAMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL UW REGUUIING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TFIE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTHACTORS UW 1827 RCW AND 2%200 WAC. <br />SqNANiIE CUNTRACTOR OR AUTNqiIZED MiENT D�TE /G / <br />7 <br />X � � <br />PIICANTS CITY BUSME55 LICENSE NO. �lID BUSINE55 NAME <br />— NC—A/HNDLG UNITC�H.P. <br />- FORCED AIR SYSTEMS—B.LU. M E.A. <br />— UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEH000 <br />WATER HEATEH _ <br />WOOD STOVE <br />METAL FIREPUCE 8 CHIMNEV <br />FIREPUCE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />ANCMEGI(NUMBER FE� NECEIPTNO. <br />a �.s� � /s�=� �v .�3�v <br />V BUILDING <br />acuwr�cr xoaow[uiecui+rts <br />�qbJP I PLUMBING <br />BRSEMEN7 MECHANICAL <br />u <br />HEiGNTLIMiTATiON ADDIiIONALPLANCMECK <br />I <br />)7HER <br />STATE BUILOING SURCHARGE <br />CITY OF EVEHETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />PUBLIC WORNS <br />TOTAL <br />a <br />