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APPLICATII.N FOR CONSTRUCI,.��N PERMIT °�<«�' <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />i fM Everpreor� <br />i� irv or _ <br />, Nverett <br />� BUILDING DEPARTMENT I— <br />� 259-8810 <br />; �1 DEMOLITION � i COMDINATION <br />y�ryE�J��nr �� M�IL I1R[5� <br />�- <br />� <br />TEN�Ni M�IL�OORE55 <br />HEATING SYSTEM: ❑ GAS U ELECTRIC ❑ <br />�RCNITECT OR UES16NEP M�II AUDRE55 <br />.�I lNERI1lCONTR�C70 MMl �i[55 I <br />�/(� n�r c��.i . •�J . �().� ..{✓i%(/ <br />Mec�r��ca+rn�croR u�nnnonEss <br />PWMBIN�iGONiFACiOR IApILADORE55 <br />/ <br />BUILDING XMECHANICAL ,CPLUMBING <br />CILY 21P PNONF <br />f�,%, , � y���6 s.�y-s�,�� <br />LIIY ZIP PNONE <br />CIIY IIP PIIONE <br />cnr nr <br />��r. � <br />GIiY ZIP <br />I I SIGN <br />PHONE ICENSE � <br />/�S�id ������� -�o�/�� <br />mwr+e ��c se. <br />PNONE UCENSE• <br />� Cl SSOiWORK <br />, �NEW I I ADDITION '� P.LTERNION i HEPAIR '� �� DEMOLITION I' WOODSTOVE/FRPL INSERT ''� OUILOING RELOCATION <br />i ��� <br />' CONTqACT Fl110E OF WORN y <br />� OESC% IBE W011R �ND SOUARE f001�0/E INVOLVEO <br />A /O c ✓ �lerof !, �;c �/. : .i <br />f VROPOSED USE O: BUILOING <br />i <br />i S�„.1 -nr.:�J <br />I lE6AlDE5C IPTqNOFPROPERfVI5N0 PELON <br />� IOT�_ PIOCK O� <br />� <br />i <br />! rnaecrenoaess <br />; a�-�s`'H s> .s� <br />SINK 8 DISP <br />HER <br />TRAV <br />URINAL <br />DRINKING <br />FLWF DF <br />BACKFL01 <br />ROOF DRI <br />SINK (SER <br />. FOR OFFICE USE ONLY: <br />FNONTSEIB�CN �EARSEIAACR <br />2C1� 2 � <br />USEZONE iornne� <br />� ���� <br />IYPE pf CONIS �ILOWABIE IYPE Of LON51 �C <br />I U "N _� � <br />61ZE OF B100. NO OF STOi1lE6 <br />I I GO t�1+�0 Q, 1 <br />OCCUP�NCYIOAD (RiESP11NRLER! <br />N�r} r�U <br />RE�SON FOR SPRINXlFRS <br />UU <br />SUB TOTAL S <br />PERMIT $ <br />70TAL FEE 5 <br />er ruNs�rrno [onr <br />�� 1/y <br />NO <br />I HEHEBV CERTIFV THAT I HAVF READ AND E%AMINED THIS <br />�PPLICATION AND KNOW THE SAME i0 BE TRUL AND CORFECT. ALL <br />PROVISIONS OF l AWS AND OFDINANCES GOVEFNING THIS TYPE OF <br />WOi1K WILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN Ofi <br />NOT. THE GRANTING OF A PERMI' DJES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL iHE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. iHAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY i0 PERFORM THE WORK FOfi WNICH <br />APPLICATION IS MADE AND I COMPLY WI7H THE STATE <br />CONTRACTORS LAW iB27 RCW AND 296200 WAC. <br />fIGN�iUREOLCONiR�C10f10RAU1NOni2ED�GEN1 D�iE <br />X l'J -'"���` �� <br />_ � �s� ���,_ o��-s <br />�PnLIC� tSGi USMESSIICENSENO�NUBUSiNE55NAMF <br />MEGHANIGAL <br />NO. TYPE <br />UNIT <br />M <br />WATEP HEATER <br />WOOD STOVE Q_ �= <br />METAL FIREPLACE 6 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXfiAUST FAN <br />SIDESE111�C� PUNGHEC rvUMtlt�� <br />v�cnHrs(r�e R / FEES <br />�l OUILOING <br />trmrer�r. xonowriv;inns — <br />R1N1P / PLUMPINO <br />�� <br />B�SEUENi MECHANICRL <br />NEia���iOAuoN ADDI710N�lPUNCHECK <br />�Q/ <br />_ t� orr�en <br />STATE BUILDING SURCHARGE <br />CITY OF EVEREiT ruouc woaKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />M E.A. <br />SUBTOTAL $ �/Q <br />PERMIi S <br />70TAL F[E S <br />26 3 <br />fFE RECEIPiND <br />� UATION FEE <br />— � y�� <br />NS� <br />