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.�. ,��• <br />APPLICATIG.� FOR CONSTRUCT.JN PERMIT <br />everett <br />.heE,���� e <br />ciTv oF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLEIED IN INK—PLEASE PRINT <br />f DEMOLITION COMBINATION �BUILDING i_i MECHANICAL lJ PLUMBING I 1 SIGN <br />OWNER MFILADOfiESS CITV Z�p PMONE <br />`�«Zoti �1Auee�scw �3oSS MLDn � Gue er 9�sz o� ZS2 -$'19 1 <br />iENRNT MAILPItDRE55 CITV 21P PHONE <br />ARCHITECT OR DESIGNEF MnIL PUUness <br />�1,..Y. FvwaL'� ZO IO "7 S� <br />�NFRRLLONTRACTOA MAILADDRESS <br />MECHRNILAL <br />PLUAIBING <br />MNLADORESS <br />MRIL AD�RE55 <br />CIN ZIP <br />e �'��,r�-rt <br />dN ZIP <br />CITV 21P <br />CITV 21P <br />PMONE `� I � t I`Li M <br />.; 3�3-GGio <br />PHONE LIL[NSEI <br />PHO�E LiCENSE• <br />PNONE LIGENSE � <br />3�S'i 94z <br />G Z <br />c - <br />❑ ADDITION ❑ ALTERATION ❑ REPAIR �_ : DEMOLITION i.l WOODSTOVEIFRPL INSERT !_'� BUILOING RELOCATION <br />TENANT IMPNOVEMENT OR INl ERIOR PEMODEL ONLY <br />fONTFAf.TPRICEOFWORK: HSCiOO <br />OESGRIdE <br />rn��va���acvroo�.���.,, ' <br />� C �, i <br />LEGAL OESC IPTION OF PPOPERTV (SHOWN 0[LON � <br />LOT BLOCN OF <br />r— <br />ADORESS <br />WATER <br />FRONiSETBACN <br />�' <br />USE �QNE � <br />ic�� <br />1YPE OF GONSi. AILOWABIf <br />T- N <br />SIZE TFZB �` <br />SZ ^u <br />OJCUP�NCYLOPD <br />R[ASONF RSPRMNIERS <br />APPLICATION ACC. BY <br />REAfi5ET0A�N <br />� <br />LOT.A'RE� � <br />♦ <br />iVPC OF CONST. ACID>l <br />v - F( <br />NO.OFSTORIES <br />FIRE SPNNKLENS flE00 <br />�i YES �NO <br />CONTACi PERSON AND PHONE NO. <br />I HEREBV CERTIFY THAT I HAVE READ AND FXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE PiJD COfiRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEHIJING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPEClFIED ��1EREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOHITY TO V�OLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACiORS LAW 1827 RCW AND 296200 WAC. <br />SIGNATUFEOFCONTR�C70FOflAUTHORREDAGENT DATE <br />x 7/t-s-� � .r�,,,/� _- /1-l�1-�� <br />qPPLICANiS CITY OUSME55 LICENSE N0. AND BUSME55 NnME <br />N0. TYPE OF EOUIPMEN' <br />IVC-0.�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT HEA� ERS—B.T.U. M <br />Z CLOTHES ORYERS <br />9_ VENTILATION FAN <br />' I I WOODSTOVE <br />METAL FIFEPLACE <br />)TAL $ <br />i S <br />FEE $ <br />5 d/O�I <br />VACANT SITE <br />❑ VES !; NO <br />aauv�ncr �+awrnnumci <br />BRSEMENT <br />�l YES i� <br />HEIGMT LIMITATION <br />�_ I <br />PLRNSAPPROVE�DY CITYOFEVERETT <br />LOCAL SALES <br />,� C_.� TAX CODE IS 3105 <br />PUMP <br />PIPING <br />�UILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />1— <br />SUBTOTAL $ <br />PERMIT $ <br />TOTALFEE $ �— <br />RECEIPT NO. <br />� � <br />VALUATION FEE <br />�0041i. ( 1.�1� <br />I <br />��� <br />� <br />� <br />