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APPLICATI�.N FOR CONSTRUCi .ON IPERMIT <br />me e��� <br />ciTr oF <br />everett <br />BUILDING DEP::HfMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />DEMOLITION _ ; COMBINATION pBUILDINO MECHANICAL <br />everett <br />� <br />PLUM81N0 SIGN <br />OWNEP 4111L�DDRE35 CITY IIP PIqNE <br />/�iv�/(nl1 l's,,..�(. 2y2�r-i9A�°.( 1'�.. ��.�,,.,..��� 9�'e76 ��y�zJ� <br />�TEN�N1 MAIL �DURESS p�ry z�p p110NE <br />�RCHRECT OR DESqNER M�II MDqE86 CITV 21P p�pryp � �— <br />�or��N A��afiSr�. 73i-2�/JF,r..�J- r�iu�'�/h•- 9p��� �,-_ <br />OENERi1l Cd/iP�CTOP MI11L ��ORE38 CITv 21P VI LIGENSE I <br />S'�Q- �ec�eildv�— w.,c/%c-z�7-7J <br />MECNNIILAL Cd/TRACTOR Wll AODHE95 UTY ZIP P1qNE LICENSE I <br />PLUAABINOCONTN�CTqI MAIL�DDV�SS CIiY IIP <br />C 80FWpiM <br />�� EW ( 1 ADDITION f�f ALTEHATION .: REPAIR � I DEMOLiTION <br />' TEN�NTMVR'JVFYENTOqIYTERqR <br />CpRR�CT PRICE OF WOIM: <br />DEBCRIB'. NqRlt �ND 6dURE FOOTI <br />s FR, <br />raovos¢o use a euaon�o <br />r �2 � <br />LEMI. OERCRIPTqN OF FROPERTV �SMOWN BELOW OR ��T{7`�CN FW R CAPIE9� <br />l0T_� &Od( _L OF li✓ �I,C Li��� <br />PROJEC DRE95 <br />��°� �� ' -.� �� <br />nwrsu+a <br />NO. TYPE OF FD(TURE 011 REM � <br />UUNDRV TRAV <br />CLOTHES WASHER <br />UFlINAL <br />DRINKING FOUNTAIN <br />FLOUR ORAIN <br />BACKFLOW PREVENI <br />ROOF DRAINS-RAIN <br />SINN ISERVICE-BAR <br />FRON` 9E'T^B�C{( <br />�l/ / <br />U8E Zd,p1! <br />Y'�-� <br />IYPE Of GONSt �LLOWAlIf <br />V-,v <br />size oF e�oa rsee ss <br />t 4�/0 6qe� <br />M <br />OCCUPIINCY LO�O <br />RE�BON FO�BFR� INNLERS <br />�vr��c �cc ev <br />S�P. <br />SUBTOTAL S ° - <br />PERMIT s -�-- <br />TOTAL FEE S - <br />RE�RSET9�1�N BIOE9ETB�CR <br />�/ / <br />IOT�flE� WCNIiBITE <br />^� �p � v�'VES f 1 NO <br />NO OF BidilEb <br />FIRE BPRNI(LERS REf70 <br />' � VES tl�YNO <br />PLAN9 ��PPqOIVED BV <br />/ <br />'� ? 1 <br />B�8EMENT <br />I �� VES DKNO <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 9106 <br />P�MJNE LILlNBE� <br />(�-1 WWOSTOVE/FRPI.INSERT I I BUILDINORELOCATION <br />CMJi�tT PERBON. WD P1qNE 1q <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br />PROVISIC�Nc OF LAWS AND ORDINANCES OOVERNINO THIS TVPE OF <br />WORK WILL AE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ONANT'�•1(3 OF A PERMIT DOES NOT PRESUME TO OIVE <br />AU1HOfil7V TO VIOLATE OF CANCEL THE PROVISIONS OF ANV <br />OTHEF STATE OR LOCl1l UW RE�ULATINQ CONSTRUCTION OF THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BV THE <br />OWNER OF THIS PROPEATV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MAi1E AN� I COMPLY WITH THE STATE <br />CONTRACTORS UW 1827 RCW AND 296.200 WAC. <br />BqN1�URE OF CONTX/�CTOR OP �UtHONRED �OEhT D�7E <br />X-��.�� -- <br />�PPIIG� 79CITYB ESSLICE/� ENO�NDBUSINEBSN�ME <br />NO. <br />T <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INS�RT <br />HEAT PUMP <br />OAS PIPINO <br />EXHAUS? FAN <br />PERMIT <br />TOTAL FEE <br />iEE'-y-�� /�b <br />�/ � UJ <br />C/��{ <br />a���o�� �7�,.�'7C — <br />PLUMBIN(7 T <br />MECHANICAL <br />OTHER <br />STATE BUILDINO BURCHAROE _ <br />BTATEENEROY3URCHAROE <br />PUBLIC WOHKS <br />TOTAL <br />E.A. <br />� <br />e <br />