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APPLICAT101� FOR CONSTRUCTI�.N PERMIT e�«P'� <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />Ihe Evergreen <br />CITY OF <br />everett - - -- -- -- -- - <br />--- -- ---- ---- <br />H[ATING SYSTEM: J GAS IJ ELECTRIC IJ ___.___ __ —� <br />BUILDING DEPARTMENT � � -------- - - - — <br />259-8810 <br />I i DEMOLITION � COMBINATION <br />BUILDING MECHANICAL PLUMBING <br />__ - - - - -- - __ _ .. ---- <br />_.._ _ __- -a�,,:.,, <br />i SIGN <br />IAAII AUDRE55 <br />CIIY <br />RALLONTjjAGTGR ld0.� /�DRES$ CIiY 21P ,fPHOt �IIC.EIHS p <br />-� yp�ALLEY NAiUBAL CAS INC___v�-�-�_�����_���'-L _ -��I- L_ <br />AIECHANILRL COIITPACTOR 1.fA1L9.i�dA�r 355J730 - 742•2944 CIiY � 21P PIIO E I SE M <br />q��� 2605 McDougail __ _____ _ ____— <br />PLUMBINGCOIlTRALTOR HAlI.A176N@SR: Washington 38201 �irv 1ir wiaie iictus[. <br />CLASS OF WORN <br />I i NEW I i ADDITION ��Al,T6RATION . REPAIR �� D[MOLRION ��, , WOODSTOV6FFPL INSERT �� � BUILDING RELGCATION <br />---------------� cou�ar.i rensou arm rno'rie rio <br />CONIflRG7PNICLUI'WUIIN l.�L� I�1��`-'� __ -�/.�_�____.. . _'_-'_'_.... <br />qe5`c.-�V �C'�C.,-�-n�lp��� �'Y�.�S.-��.1-�"����--- <br />PROPOSGU USE OF BI III DING�� �• <br />'`���-="---------- <br />iecn� oescmrnor+or r�mrtnrv icuown oei ow nn mtacu roun cnries� <br />LOT �IOCK Of _ _._""_" __"__--_-- <br />PFOJELT ADDRE55 / 1�' l �_ I _ ;�/ ! � <br />f.,�x l ��-� �7�� �- �) <br />TYPE OF <br />CLOSET <br />LAVATORY (WA511 BA_ <br />SIIOWER <br />KITCIIEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />FOUNTAIN <br />UR ITEM � FEE <br />-- ---- --i-- <br />-------.._. _ ____----'-- <br />------ ------- �-- <br />I IIEREBY CERTIFY THAT I fIAVE REAU AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PHOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WUHK WILL BE GOMPLETED WITH WHETHER SPECIFIED HEREIN OR I <br />IJOT. TfIE GRANTING OF A PERMIT DOES NOT PRESl1ME TO GIVE <br />AUTHOFIiY TO VIOLATE OH CANCEL THE PROVISIONS OF ANY � <br />OTIIER STATE ON LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEHFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE I <br />OWNER OF TVIIS PAOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE i <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. ', <br />SIGtlAlI1REOFG(illlfiNC70qORFUT110BI1LDAGENT DATE � '� <br />� �(1 /' �,y�1 ' <br />`�1L "=���L f�r��-��� ! / � t� II <br />AI'PIIC�1175GIYU1151 SSLICEHS ARD�USIIJESSNnM11E <br />MECHANICAL _. __ <br />TYPE OF E�UIPMEN7 <br />A'C--AIIINDLG UNITS--H.P. / <br />FORCED AIR SYSTEh15-B.T.U�M E.A. <br />UNIT IiEATERS-BS.U_ M __ <br />CLOTHES[7RYERS <br />VENTILATION FAN <br />RANGE FIOOD <br />WATER FIEATER <br />WOOD STOVE <br />METAL FIRC-PLAGE 8 CHIMNEV <br />FIREPLACE INSERT <br />__— <br />I IICAI PUMP <br />FLOOR DflAM ._� _ . _ � .___ . ------ <br />�ACKFLOW PREVENTERS ; _ CiAS I'IPING _ _ <br />ROOF DRAINS RAINLEA�ERS __ �� CXIIAIIST fAN __ ________ <br />. _.._ __ ..�_ . ___. ..._ <br />SINN (Sf_RVICE �BAR_LTC.� _ . _ _ , _ i <br />FOR OFFICE USE ONLY: <br />FROI�i5ET0ACK f1EAfi5f.TPACK <br />usr tor+� �� rn nnrn <br />IVP[ 01 CI1NI5 AI <br />SIZL OF OLIH'. <br />SU� TOTAL $ � <br />—T' <br />PERMIT $ _ __ _ <br />TOIALFEE S <br />Ismeseroncn ----- rinn <br />VAf.AHI::IiI: -- --� <br />PERMIT <br />TOTAL�EE <br />aii m nwc; <br />--- -- - — - <br />- - - - — <br />lYPf111CI111IFIIIIN ui�rv:� qn�il�nunidin'. '-"'- <br />' '� I I Uh1f31NG <br />_ __—_ "_ <br />__ ___'_" .. '_ ..... —_ <br />�looF5Taf7iL5 uA�tr.1[ui ldhCHANICAI. <br />-' --'�----- �UDIIIONALPLANCIILCK <br />OCf,UPANCYIOA� fII1C5PNNN1EIiSRf(]'0�.._..IIIJGII711RIIINI01! _.__'__"_'____'__"___"_ <br />onitr� <br />REASON FOR SPR:IlHI.ERS <br />SIA1 E OUII.DING SURCI IAHGF. <br />.. .' _-_-'___—'_'—_'_ -.— <br />__'_' _'_ '_ ' ' __.. <br />INIANE�Y FIANS�PI'ROVCOl1Y CITYOFEVERETi ruoi.icwoians <br />LOCAL SALES <br />I TAX CUDE IS 3105 TOTAL <br />$ h )' _ <br />2 /,�� _' <br />$ -�� <br />�ecemt rio <br />F—E�— <br />� <br />-- ---`-- <br />- � <br />� <br />__�— <br />� <br />_ _ � 'i" "- <br />--i <br />_—___� <br />i <br />---� <br />�� <br />�O �7 ' <br />