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APPLICATIQ"`, FOR CONSTRUCT'lN PERMIT ����� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />HEATING SYSTEM: �}GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION f_l COMBINATION L] BUILDING �IAECHANICAL ❑ PLUMBING ❑ SIGN <br />�ppNt55 <br />��n� <br />TEN�NT <br />ARLMRECT OR DESIGNER <br />GENERALCANTRACTOR <br />MEGH�NIGALGONTRACTOP <br />CONiRALTPRICEOFV/ORK ��,�, \ <br />lJ <br />DESGRIBE NVRN 11NU $OI��aF. FOOTAGE INVOLVEO <br />PROPOSEDUSEOFBUILDING �� <br />LEGAL OESCHIPTION OF PROPERTY (SHONM BEL01 <br />LOT BIOGN -- OF <br />PARGELTA%I.D.NUMBER <br />DISP <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />cm <br />GITV <br />cm <br />GTv <br />� <br />cin <br />ZIP <br />� ..nn <br />fANTALT PERSON ANfI PHONE NO. <br />�r� - 3�io3 <br />STATE LIGENSE I <br />STRE IICENSE � <br />=731j ,���nr <br />STqTE IIGENSE � <br />:<< / /�'��� <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 1YPE OF <br />rocoriesl WORK WILL DE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOl". THE GRANTING OF A PERMIT DOES NOT PRESUME t0 GIVE <br />AUTHORITY TO VIO�ATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTiON OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROUERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />_ D��- CONTRACTORS LAW 18.2� RCW AND 296200 WAC. <br />I \ �/,(�� lN/ �( �(`7`� <br />1r SIGN�iU �'J '� OA1f <br />1 . , <br />LITY BUSrt1E55 LICENSE 1q <br />TOTAL $ <br />MIT $ <br />�L FEE $ <br />fOR OFFICE USE ONLY: <br />FPONTSETB,ICN REARSETBACK <br />USE 20NE LOT AFEA <br />TYGE Of CON57. NO. OF SiOR1E5 <br />SRE OF BLDG. FIRE SPRINKLERS NEO'0 <br />OCCUPANCV LOAO FIRE AURM PEO'D <br />REASON <br />BV <br />DATE <br />RANGEHOOD <br />WATER HEATER <br />W000 STOVE <br />METALFIREPLACE� <br />FIREPLACE INSERT <br />❑ YES CI h0 BUILDING <br />OLCUFANtv HO Oi0'MLIiNGUH�15 " - <br />�9p"P PLUMBING <br />BASEMENT MECNANICAL <br />❑ YES ❑ NO — <br />HEIGMT uMiTATION ADDIT.�NAL PLAN CHECK _ <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCIIL SALES <br />TAX CODE IS 3105 �TAL <br />-B.T.Li. M <br />M <br />FF.E <br />FEE � NECEIPT <br />i <br />i <br />� <br />