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APPLICATIQ"' FOR CONSTRUCT'-1N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />3UILDING DEPARTMENT HEATING SYSTEM: U GAS G ELECTRIC O <br />259•8810 <br />DEMOLITION I i COMBINATION I i BUILDING � i MECHANICAL I�LUMBING I 1 SIGN <br />�WNER MAILADORESS CITY ZIP PMONE <br />Ex� �D�vc,. 323 i�M1.EGQAP� QP � BGU,1ut�N4N qb12c. �3�0) co��-'tz'1'� <br />ENANT MAILAODRE55 CITY ZIP PMONE < <br />�RCHITEGTORDESIGNER M�RADDRE55 CITY ZIP PMONE <br />L'�1nw��S �'1c¢qq,� 1301 �S�ve¢�..i LwE- Ev�¢e-�< `18203 (26a) 353-z9r�y, <br />:ENER�LCONTR�CNR MMIADORE55 CITY ZIP PHONE STATELICENSE� <br />(C�cK �H . SAIAE h5 A13oJE <br />�ECNRNICALGONTR�CTOq MAILADDRE55 CITV Z�P PNONE ST�TEUOENSE� � <br />'WMBINGCONTR�CTOR M/�ILADDRESS CITV qP PHONG STATELICENSEI <br />('jU 6 ) <br />4ovwN��,v F�c�¢u.6c�wa -Bc.� ISQ3 WOpd.aJna..� �a�L�l2 aY>35�5'f ADdqwtFPj�iqF� <br />:USS OF WORK <br />xNBW I I ADDITION I I pLTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL �NSERT I I BUILDINQ qELOCATION <br />.ONTP�GT PRIGE OF WOflK � <br />�ESCRIBE WORK AND SOW pE FOO <br />F�Vx 'PZc<ta.S�ua <br />or e�ocK <br />A-�'-tn.c►_+ <br />���� �-. <br />� � - � <br />i 'R0.IECTAD R� � <br />y <br />' PLUMBING <br />' �10. TVPE C <br />1-L•CN3tlS�P.7 <br />EiNVowEo�Ny�p�y,pF�y�� p <br />IST��M— 4 9au.o�.,yS <br />)WNBELOWOP TTACHFWRCOPIES) <br />_ OF <br />� 0, / <br />" b` � / <br />�i ,�a�o °` � <br />�. '�Szsi�4o�_,�./ �OJ <br />� _ ,/� � CtY"(O Ri <br />=0R OFFICE USE ONLY: <br />NOkTSETBACN REARSETB�CK <br />i5E ZONE <br />/YE OF LONfi. AIIOWABIE <br />.IIE OF BLDG. <br />�CW PANGY LOAD <br />�E�SON FOR SPRINNlERS <br />VT�KE BY <br />SUBTOTAL S <br />PERMIT $ <br />LUTApEp <br />IYPE Oi LONSi. �L1UAl <br />NO.OF STORIES <br />FIRE SPRNKlERS RE00 <br />PLANSAPPROVEDOY <br />��M �l �19� <br />VACANTSRE <br />OCGIMNLV I MJMOW[ILiNG11Mi15 <br />4�W� <br />HEIGHT LIMITATION <br />CITY OF EVERETT <br />LOCALSALES <br />TAX COUE IS 3105 <br />CONTAGTPERSONANDPHONENO. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SA�.IE TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS "YPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED 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. THAT, I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />GAS <br />PUMP <br />fy_1:1 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPFiINNLER <br />STATE BUILDING SIJRCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />r s <br />FEE E <br />