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�� . <br />APPLICATIO►.. FOR CONSTRUCTI�..N PERMIT °�""'�` <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />Ilin N�cr9reen , <br />ciTv or _ f��c C� <br />everett HEATINGSYSTEM: ]GhS ,�ELECTRIC J_---� <br />BUILDING DEPARTMENT <br />259-f3810 <br />DEMOLITION COMBINATION <br />O\YNE(i !a�'�L �DDRESS <br />� ��+,:r_ L �i 5yt" 5�, <br />.cveur 11.AlLR�DRE55 <br />BUILDING <br />ME�"HANICAL <br />� p r'HORE <br />9,f z� 1 3 <br />Z�p PHONE <br />PLUMBING SIGN <br />� ��Z� <br />ARCHiiELTOR�l51GRER IANLADOFE55 <br />GrtY LP PHONE I <br />GtlNERALCONTi1RCTOP IAAILADOPESS CIiV ZIP) PN01lE UCENSEa II <br />I r � / S�, lA'A.%YZ7U �'lVIQ7 .PPNAi�lOd�/ll <br />�ivA�sSAn/Cc� �u����Prs /�1715 ,a crl<ir,�r!�(. S,�o•o•,� <br />GRv Zi PHONE �iGRlSEv ( <br />MECN�NICnLGONiRACTOR IdNLADORE55 I <br />PLIIMBINGCONTPACTOF n M�RAODRE55 GiLY Lfr' �NGNE LICENSEa I <br />l�� e �Asf" YLu�-rbi ' <br />cinss eF v�or+K <br />NEW � ADDITION �CALTEFATION REPAIR DEFAOLITION WOODSTOV6FRPL INSERT BUILDING RELOCATION <br />C/O'f�RA/�CT PERSOt! AND PNONE NO /y 1 <br />CONTRRCTPFICEOf1V0��N �/J�/0 a� 1.,/Uc� 'PP='���SSA~c� V�/ f� Ll�' <br />DESGP.'9EtY9RK�ND50UAqEF00'AGERIVOLVBO .7 �// <br />Z,�S��T. .�3s—/ s7 <br />A2�44� Co,vuer.yie..i � <br />PROPOSE�USEOFBWLDING I HEREBY CER7IPV THAT I HAVE READ AND EXAMINED THIS <br />Z• yy�� n�� w APPLIGATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />__LQ— '� � PROVISIONS OF lA'NS AND ORDINANCES GOVERNING THIS'fYPE OF <br />iccn�oescaianor�oFv Er+rvivwwr+oeiowoanrraa�/FcuncoPiesi y,�ORK WILL 6E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�or�_ Biock oF _SPJJ-/LV� N� 4� NOT. THE GRANTING OF A PERAIIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF ANY <br />'y/ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />— �U' Z I/� l �/ �y " PERPORMANCE OF CC'NSTRUCTION. THAT I HM AUTHORIZED BY THE <br />OWNEFi OF THIS PROPERTY TO PERFORM THE WURK FOR WHICH <br />APPLICATION IS MADE AND I COPdPLV WITH THE STATE <br />COIJTRACTORS LAVJ 1827 RCW AND 296200 WAC. <br />�'�„'iaiJnEGIr I�iRAC G'10 rutMOAR�p nG[Ni pni[ <br />_ � X /�,(/� p,,v�,l' y_ z -'rJ/ <br />7�f r' .�� <br />��� �11.--=-�-ji—✓P�C Lv _ WA __ — Qj/N/�l/ISANLC� Y� �F/f ' <br />FPGEGT PDOPESS � <br />AVPL�CA�I*5 Clrv flIISiNf S3 �'�=[f1S'[ NO A��O BUSR:[55 NAtdE <br />BATHTUB <br />LAVATORY (WASH BASIN <br />SHCWFR <br />KITCHEN SINK 8 UISP <br />DISITYlASHER <br />IAUNDRYTRAV <br />URINAL <br />DRINKING <br />FLOOR DF <br />OR <br />FEE <br />�� '� <br />i <br />SUBTOTAL S �Sr__ <br />PERMIT 5 <br />TOTAL FEE 5 J_�� � — <br />Np, TYPE OF EDUIPN <br />A:C—AHNDLG UNITS—H.P <br />fORCED AIN SYSTEIdS—B. <br />UNIT HEATERS—B.T.U. 1d <br />� _ CLOTHESDRVEFS <br />�;_ VENTIL�TION FAN <br />RANGFHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIM <br />FIREPLACE INSERi <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />FOR OFFICE USE ONLY: __ _ <br />FP011i5GT0ACK i�1�AR5�L0ACK � �.J_ SID[�IMCt � Pl�tlCHf.f,KNlll��Efl <br />i �._ �Tt � I� /•2 G� %.1 .3 <br />O �' <br />u;rror�e �orna[n vncnursae FEES <br />�' � S y � . ! � . '� ° kiUIL�ING <br />` �- <br />n��eorcor�isnu.ov�no�[ rrvEorcorisr.�eruni ��:a«i,c� •:+��;r.,�.���.��..,�+ — <br />r,�,nu� / p�UM�ING <br />� // -ni -- <br />SItE Of BLUG NO.OF STORiES �1ASE�dENi �,�[CHANICAI <br />ZI6 5! ccr�ve<to-w ' ��p � <br />OCCUPAtJCVLO�D FNESPRNNL[RSPEQO HEiGHiLIf.11iNI0N <br />ADDIiIONAL PLAN CHECK <br />='Y=- nl° �' _ _ oriiEi� <br />RE�SOH FOR SPRINKLFflS <br />STATE BUIL�ING SURCHARGF <br />unnKE m rinr�snaaeoven!�r CITY OF EVERETT PUBLIC WORNS <br />� ��, / � LOCAL SALES <br />p v/_, 1'AX CODE IS 3105 TOTAL <br />M <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE 5 <br />nr.c[irr r�o <br />fEE <br />S:�G� v7Sr <br />O <br />A <br />