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,-� ^ <br />APPLICATII.N FOR CONSTRIiCiION PERMIT <br />the Ereqrean <br />C17V OF <br />everett <br />BUILDING DEPARTMENT <br />2ss-ee�o <br />! DEMOLITION D�' <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />COMB�NATION ! BUILDING ❑ MECHANICAL <br />nr rraNe <br />.i. _ �.-. � .... <br />dTY 21P <br />ARCNITEC�qiDES10NER M�RADDNE55 CITY 21P PIIONE <br />everett <br />� <br />1 PLUMBING SIGN <br />PLUMBMOCOMTRACTOR M�ILAODRE65 CITY 21P PHONr LICENSE• <br />�� NEW '' ADDITI�M I 1 ALTERATION IJ REPAIR f 1 DEMOIITION LJ WOODSTOVE/FRPL INBERT ❑ BUILDINCi RELOCATION <br />W.NTIMPAOVEMENTOHINTERIORREIIWELONIY � CONTACiPERSON�N PHONENO <br />__-.----_--...___. i��r^,. rr-v� .G., o� � i i�o r, � n �"r�.li_�'z� <br />LEML OESCRIPTION OF PROPEPTV �SIqV/H BEIOW OR �TT�CN FOUR COPIEfi� <br />wr e�ocK a <br />5 <br />. i I�`�N <br />TYPE OF <br />IAUNDRVTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOR �RAIN <br />size a eioo <br />S�W <br />OCCUP/JICY IO�D <br />NGI130N R SPPINNlER9 <br />B� <br />RE�R SEIH�CN � <br />/ � <br />LOUHE� 1 <br />f� <br />Oi CON57 ACIIIAI <br />�.•—� <br />NO Of 6�U111E8 <br />FIRE fiPflNl(LERS REO'D <br />f 7 VES `��JO <br />1 <br />VlANSIPpqOVEU BY <br />,_ <br />61DE 6ETH��K � <br />VAC� bITE <br />VES f] NO <br />accuvr.xcr xo a owtwwc uwnc <br />BASEMENT <br />I i YES <br />CITY OF EVERETT <br />LOCIIL 8ALES <br />TAl( COUE IS 9105 <br />I HEREBV CERTIFY 7HAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND I,NOW THE SAME TO 9E TRUE AND COHRECT. ALL <br />PRO\'ISIONS OF LAWS AND ORDINANCES 60VERNINO THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OiHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTHUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF TIiIS PflOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPIY WI7H THE STATE <br />CONTRACTORS LAW 1827 RCW AND 298200 WAC <br />6�ONAlUREOF TMCTOROP�UT/qRII�TE <br />x /�--�%$9 <br />APPLIC TSCITYBU ESSLICEN9EN0/�NDBUSINE63N�AIE <br />YCRY�YIC�1 <br />CLOTHES DRYERF <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />W000 STOVE <br />METAI FIREPLACE d <br />FIREPLACE INSERT <br />HEAT PU'AP <br />G�< <br />BUILOINO <br />PLUMBINO <br />MECHANICAL <br />OTHER ���u C� a � <br />STATE PUILDING SURLHARGE <br />STATE ENEROV SURCHAROE <br />PUBLIC WORKS <br />TOTAL <br />�i <br />� <br />_�Y�' '. <br />—i—' <br />