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u' <br />�' APPLICATiOi., FOR CONSTRUCT�JN PERMIT everett <br />!ne Evergreen TO BE COMPLETED IN INK—PLEASE PRINT � <br />CI7V OF }* <br />� : eVerell HEATINGSYSTEM: OGAS ❑ELECTRIC ❑ <br />{' BUILDING DEPARTMENT <br />259•8810 <br />' I DEMOLITION I I COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OVlNFR MAILAD�FESS CITY 21P PHONE <br />�ilri�'.�iJr FCK/lt=/'L �5�� ;�,a^� sr F�,�.��" i�2ol �S3 ?.3�b <br />, ' TENPNT MRILRDDPESS CITV ZIP PMONE <br />� <br />RRCNITEGTOR�ESIGNER MRILr1�DflE55 CITV 21P PNONE <br />�p6,'. � <br />•}� GEYEflQCIYTRFCTOR MALADORE55 CITV ZIP PHONE LIGENSE• <br />}-' � (�AY !`0 1/1� FvF/1F� - nar7�L ���/ t UF�Zi`T� 98��Y 35G�3i3/ GJASN�Nrt-�2f�CC� <br />i MEGNRNICRLLONTRACTJR MAILRODRE55 �GfY ZIP PHONE LICENSEI <br />� <br />� i PIUMBINGCONTR�GTOR MAILRODRE55 CIiY ZIP PHONE LICENSEt <br />� GlAS50P WORK <br />�� � L�I NEW �ADDITION �. -�� ALTERATION .�. REPAIR � DEMOLITION �. WOODSTOVE/FRPL INSERT �� BUILDING RELOCATION <br />i <br />� CONTALT PERSON AND PMONE N0. <br />p.: �/ :... <br />� � CONTRALT PRICE OF WORN I!�� �.� , <br />I <br />� p DESCRIBE WORN AND SOUpPE FOOiAGE INVOLVED <br />�1i FVGL I.�NK 7�.� lo�'S I.:F��.�% <br />PROi'OSEDUSEOFBUIIDING I HEREBY CERTIFY THAT I HAVE FiEAD AND E%AMINED THIS <br />�� I S r F�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br />� �EG�L DESCRIPTIONOF PROPERTV �SNOWN BELOW OR RifRCN FOURCOPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR <br />_- � ior u�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />N <br />ADDRE55 <br />TYPE OF FlXTi <br />WATER CLOSET (TOIL <br />BATHTUB <br />IAVATORY(WASH BA; <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />UFINAL <br />DflINKING FOUNTAIN <br />FLOOR DRAIN <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />'� I'RONTSETBICN R[AFSETOAGK <br />USEZONE LOtAq[q <br />, IVPCOfCON75 ALLOWABIE TYP(OfCONSi ASTUAI <br />�. SIZEOPBLDG. NO.OfSiORIES <br />OCCUPANGYLOAO FIRESPRNKLERSREO <br />RERSON FOR SPRMKI[RS <br />INTANE BY PL.\NS APPROVEO BY <br />AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERPORMANCE OF CCNSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTO LA 1927 RCW AND 296200 WAC. �_�7, � L <br />51 TUREOF 0 NT �qTE <br />� AM�" Y I� !i /.JP] F> � O <br />� i�.s5 �:� r�, a <br />Z O I APPLICANTS GTV BUSMESS LICENSE NO. AND <br />riPE OF E <br />A/G -A/HNDLG UNIT; <br />FOR;ED A�R SYSTEA <br />UNIT HEATERS—B.T.I <br />CLOTHES DRYERS <br />VENTILATION FAN <br />fiANGE HOOD <br />WATER HEATEA <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDESETORCN PIANCHECNNUM�EH FEE <br />."Sf3?� <br />vncaNisrte FEES <br />BUILDING <br />OCCUPANCY NOMObIIIiNGONIiS <br />cnav pLUMBINd <br />onSEIAENT MECHANICAL <br />MEIGNT LIMITATION ADDITIONAI PI.AN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC \YORNS <br />LOCAL SALES <br />TAX CODEIS 3105 rorai. <br />M <br />SUB TOTAL 5 : ,i ; <br />PERMIT S /J ��_'-" <br />TOTAL FEE $ 3p � - <br />NEC[IPT NO. <br />VALUATION FEE <br />� <br />, c u <br />