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,� .� ti���, <br />APPLICATIOr�I FOR CONSTRUCTI�N PERMIT <br />everett <br />IM� Evergreen e <br />CIN OF <br />everett <br />259L BI OG DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION I, COMBINATION � BUILDING j�; MECHANICAL i(�PLUMBING SIGN <br />OWNEP�y� . /%1'� AI�ADORE55 �$(JX..��+G' CITY ZIP PlIONE `_�r�—J3�� (.fr' <br />�dfi? f�/�%.c/rf' N%�/..H,dit' f%b�o /`id Svt�ir r� y�.�'03 3'�'-`� -�fj'�� <br />-- -'— MAIL ennacsc LITV 21P PNONE <br />ORDESI�+NEP MRIL <br />MECHANICAL <br />PLUMBING C( <br />AOORE55 <br />[d.10/n/ ! <br />Z�p PMONE <br />r 9��n � <br />ZiP PHONE <br />� ���3 � <br />21P PMONE <br />�ia PHONE <br />�c Hs� <br />8� <br />LILENSE � <br />LICENSE � <br />��j$$OF WOPK <br />r),INEW i i ADDITION -��. ALTERATION . I REPAIR �. �. DEMOLITION . WCODSTOVE�FRPL INSERT . 1 BUILDING RELOC <br />TENANiIMPROVEMENTORINTERIORREMODELONLY 1� � � CONTACTPERSONRNDPMONENO. <br />CONTRACT PRICE OF WORN �? Gyrr C' B</�N/� ��"���� <br />OESGRIBE WORK AN� SOW RE FOOTAGE INVd.VED <br />� <br />ior,�rloi�n eiocK .s � �r� _ oF � <br />Lvl�@ �itSf v�/� .Bu'G/� �3'/B <br />�J <br />-s <br />WATER <br />FRONTSETBR�K <br />-2 0 <br />US�E ZONE <br />�__s�-- <br />iVPE Of CONSi. PIIOWABIC <br />REASON FOR SPRINNLERS <br />pPPUC TION CG. BY <br />8 DISP <br />RE�RSETBACN <br />do� <br />LOTRREA <br />ttPf Of LON,STf. ACiUAI <br />�' N <br />NO.OF STORIES <br />FIR[ SPRNI LEPS REO'D <br />'�, 1 YES X NO <br />PLANS R�'P�ED BY <br />� // <br />7 <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPIETED WiTH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVIS�ONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRFD 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 fiCW AND 296.200 WAC. �/�.9/9� <br />SIGNA7UR CONTRRGTORORAUTHOfl2EDAGENT DATE <br />��,��.� <br />,o�i� �,�,�H �u�,�,�t��.��-%� <br />.�..�� wuciucssucEd5EN0.l�ND9USMESSNAME <br />NO. i �ve vr cw�rwcn <br />A/C—lUHNDLG UNITS—H.P. <br />_ FORCED AIR SYSTEMS—B.T.U. <br />._ UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />— VENTIUITION FAN <br />— RANGEHOOD <br />WATER HEATEF <br />— WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSEfiT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />ITAL $ J' ; � SUB <br />f S � PER <br />FEE 5 yS '� r TOT� <br />SIDESETBACN; PLANCHEC"NUMB R FEE1!� <br />S �� 07 <br />VRCANT SITE F S VA� <br />xYES � � N� BUILDING �S� <br />amv.xc+ codtmnuM1cuxns <br />�P�P PLUMBING <br />BRSEMENT MECHANICAL <br />YES �C NO /J <br />HEIGNT LIMITATION OTHER ���.( 4.� � . <br />1 <br />c� S STATE BUILDING SURCHARGE <br />STA7EENERGVSURCNPRGE <br />C;TY OF EVEREIT PUBLIC WOF7NS <br />I.00AL SALES <br />TAX CODEIS 31D5 TOTAL <br />$ <br />$ <br />T <br />1� <br />Nw�� <br />� <br />