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� <br />APPLICATIO�� FOR CONSTRUCTI�/N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />fM Everpreen / <br />CITV OF � <br />everett � <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />/ l�i�k- (1 ��A9N.00R��� <br />TEIPANT �� M�II.ADDRE 5 <br />� LhM -ri <br />HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />BUILDING <br />CITY__ ZIP <br />� <br />GTY Z�P <br />PHONE <br />PLUMBING <br />11NCHITECTORUESIGNER M�IL�DORE55 QTY ZIP rrxmc <br />�ENENAL CONTRAGTOR MA�L �UURE59 CITY IIP P/Id1E UCENSE / <br />I SIGN <br />CV1550F WOAN <br />I 1 NEW � i ADDITION � <br />CONTRACT PRICE OF WORK <br />DESCII�BE VIO�I( �ND�! ��A� �T� <br />�i'ir,Ta6A5 K+�7C� <br />PROPOSED USE OF BUILDIN � <br />S <br />LEOALDESGRIPTIJNOFPPOPER (SI <br />LOT BLOCN _ <br />� / 1 <br />OF <br />SHOWER <br />KITCHEN SINK d <br />DISHWASHER <br />IAUNDRV 1'RAV <br />ROOF <br />+TLTERATION i l REPAIR �� DEMOLITION �. -. WOC�DSTOVFJFRPL INSERT f i BUILDINO RELOCATION <br />/�,..L1 CONTACTPERSONANOP./ONENO <br />C7C! <br />�� <br />�EINVOIVED <br />—� I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. ALL <br />BEIOW OR �iT�CH FWR COPIE6� PROVISIONS OF LAWS AND ORDINANCES GOVERNIN3 THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />or NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br />� AIITHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />— PERFORMANCE OF CONSTHUCTION. THAT I AM AUTHORIZEO BV THE <br />OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. /�`�^ �/ <br />6i6HATUREOFCON RAGTORONAUTNOAIIE �OENT UATE <br />X � . � <br />) �PPLICANTSpttB INESSLICENSENO �NOBUSINESSNAME <br />FOR OFFICE USE ONLY: <br />FRONT 6ETB�Lk AE�R 6ETBACN <br />U9E 10NF. LOT �RE� <br />TYVf q CON15 ALLOWABIF 1YM 01 CONST. �Cl <br />C�fC K NI M 1i� Of $T�li$ <br />REI150N Fi <br />INT/�NF. BY <br />BY <br />N0. TYPE OF EOUIPMtn <br />N�A/HNDL� UNITS—H.R � <br />� FORCED AIR SYSTEM <br />UNIT HEATERS—B.T.U. <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />W000 STOVE <br />METAL FIREPLACE 8 CHIMNEI <br />FIREPLACE INSERT <br />TPUMP <br />GAS PIPING • <br />EXHAUS?FAN <br />S <br />SIDESETB�CN PI�NCHEC1cNUMBEN <br />VAC�NTSIIE FEES � <br />BUILDINO <br />acuwncr rx� aovrtui�Gu+�it <br />a�ouo pLUMBINO <br />BASEMENT MECHANICAL <br />HEIGNT I�MIT�TION ADOITIONAL PUN CNECK <br />OTHER <br />ST�TE BUILDIN� SURCHAR6E <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SIILES <br />TAX COpE IS 3105 �TAL <br />S �fo � � <br />S / �' <br />:t C S� : ' <br />� <br />i — <br />