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, y.: .._. <br />e <br />C�J �i � <br />m�t% <br />,�sy[~i� <br />H �� <br />� H� <br />'��1. H'i1 <br />y y L'H" <br />i� o � <br />HC <br />O �+ <br />��g <br />(�] Y n <br />9H� <br />t'� z <br />HH <br />g�' <br />H <br />C] C N <br />� � C=1 <br />HOfyi� <br />QPPLICATit�.d FOR CONSTRIDCT.JN PERMIT <br />!na Evergreen <br />CITY Of <br />everett <br />IiUILDING DEPAPTMENT <br />259-8810 i O BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION COMBINATION .: BUILDING �ECHANICA <br />OYINEB MRILADDRESS CiiV ZiC <br />��1 n.�Prl ��Y1�S�� — � � I —,51��t ��--�'y � -=��;`�t <br />ureur 1.IAIL D�{iES.S. �—� GRY 21P <br />DESIGNER MAIL <br />ZIP <br />PHONE <br />PNONE <br />PLUMBING <br />>�—G,� <br />everett ' ' <br />e <br />SIGN <br />�- I <br />; <br />I <br />I <br />.. �. NEW �-_. ADDITION �AL-TERATION . . REPAIR <br />TENANT IMPPOVE1AENi OR INtERiOR RIE,MODIEI GNtY <br />CONTRACT PFIC[ OF WORH: L+�C�J � l�� _ <br />OESCRIBE WORKq� D OUP�OOTAGE IYVOLVED <br />-t-/nC d'� U� L�ti 4 1, v�!A ( � =�- � P�� � <br />LEGAI �ESGRIPTION OF PRDPI <br />LOT __ B�CCK <br />NO. <br />KITCHEN SINK <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PReVENI <br />FFlONi5ET0�CK <br />US[ZONE <br />iV�E Oi CON4. ALLOWAdLE <br />SIZE OF OLDG. <br />OCGIIPANCY IOAD <br />REASON FOR SPRINKlEPS <br />APPLICATI0114CC EiY <br />ATTACM <br />OF <br />OR <br />SUBTOIAL <br />DEMOLITION WOODSTOVE/FRPL INSERT _�� BUILDING RELOCATION <br />I CONTACiPER50NANDPHOtlENO <br />I HEREBV CEFTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLI;ATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS FND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANI"ING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOflITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEF STai E OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OVJNEP OF THIS PROPERTY TO PERFOFiM THE WORK FOR WHICH <br />APPLIC�TION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 78.27 RCW AM1D 246.200 WAC. <br />. SiGt�AtUR GPC@1TRACiORCPAl1iHOAiZEOAGE��t DATE <br />�_7Y�J lli i� i"'��i ., �1I� //�( 1' �� ��• �j��{!� G U i <br />� <br />AI+PI.}CPN'SCIivpUSirv 95. ENSLNOANpOUSiHECSflAIdE f <br />i <br />MEC.HANICAL t <br />NO. TYPE OF E�UIPMENT FEE <br />A�C--A�HNDLG UNITS—H.P. i <br />FORCED AIR SYSTEMS—B.T.U'� E.A. ! <br />UNIT HEATERS—B T.U. M _� ` <br />CLOTHES DRYERS N <br />VENTIIATION FAN ; <br />_ RANGEHOOD 4 <br />WATER HEATER ' <br />WOOD STOVE � i <br />METAL FIREPLACE & CHIMNEY <br />FIREPL�CEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />TOTA� FEE 5 � <br />REAii5Ei0ACH SIOESETpFCN �'LRNIriCCNNORIEER <br />lOT AFEA VACANT SITE FEES <br />� ' YES NO BURD�NG <br />iYPEO(WNSihC10Al acureuGv nvoivwu�.s;i,ias <br />r,anw pLU6101NG <br />IIO.OFSIv`al[S �/S[IdENT �A[CHANICAL <br />VES NO - <br />FlBBSPRkRlEP5RE0'0 �iEIGNiIIfAITATION �THER <br />. YES �. NO STATE BUILOING SURCHARGE <br />STATEENERGVSUHCHARGE <br />PL�NS�PPItOV[0 BY CITY OF EVERETT PU�LIC K'ORKS <br />LOCAL SALES <br />TAX COOE IS 3105 TOTAL <br />SUBTOTAL 5 � <br />PcRA9T 5 � <br />TOTA�. FEE $ �j' <br />F[E �EC[IPTNO. <br />T VALl1ATION FEE <br />