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APPLICATIO�. FOR CONSTRUCTI..iN PERMIT <br />rne E�e�pree� TO BE COMPLETED IN INK—PLEASE PRINT �/��G <br />/� <br />CITV OF <br />everett � <br />BUILDINci DEPARTMENT <br />259•8810 <br />DEMOLITION COMBINATION <br />HEATING SYSTEM: O GAS J$ELECTRIC U <br />MECNANICAL <br />everett <br />e <br />SIGN <br />py�ryFq MI11L ADD'1E55 LITY ziv rrnmc 9�/� p <br />WfSTw�oO 1�cr� zN� -6ai-N��i1WhY-9•C'�4'l.i,' SI�EUf�uS � 33`I�3Sfr� <br />iEN�Ni MAIL�ODRE55 QTY IIP PNONE <br />�PCHREGT OR DESIGNER M�II �OONE55 CIiY IIP FMONE <br />GENEMLCONTR�CiOR MAILADDRE55 CITY ZIP PHONE UCENSE• <br />S�►`^£ (�5 (i'$o�f �W�'� we:i�N� a991�CJ <br />MECNANICALCONTRALTOR MAIL�DDRE55 CITY IIP PHONE UCENSEI <br />PLUMBINO CONTMCTOfI MNL �ODFE55 CITY 21P oMONE IICENSE � <br />J'qr-L P�uw-�,r� �- �,sro�.- ��3a° su sve -�Joii c�L PLU – II OL Z <br />C1A580F WORN <br />pj,►�p(i ! 1 ADDITION :' ALTERATION � REPAIR <br />..1�^�.:13 <br />PROPOSEO USE OF BUILOINt3 <br />LEOAL DESCRIPTION OF PROPf <br />IOT� BLOCK <br />DEMOLITION <br />WOODSTOVE/FRPL INSERT .. � BUILDIN6 RELOCATION <br />Ay�.Br1011E NO _ <br />I HEREBY CERTIFV THAT I HAVE FlEAD AND EXAMINED THIS <br />APPLICATION AND HNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�SNOWN BELOW OR �TT�CHFWR COPIES� PROVIS�ONS OF LAWS AND ORDINANCES GOVERNINO THI� TYPE OF <br />WORK WILL BE COMPLETED WITH WMIETHER SPECIFIED HEREIN OR <br />oF NOT. THE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV 70 VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW FlEGULA7ING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PPOPERTV TO PERFORM ?HE WOPK FOR WHICH <br />APPLICATION IS MADE ANO I COMPLV WITH TH[ STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />� F�• SKIN�TUREOFCONTR�CTORORAUT1101i1IE0AGENT DATE <br />PROJECT MOPE55 <br />•L - 9S71a 5T. S In/ <br />WATER CLOSET (TOII <br />BATHTUB S il0a <br />LAVATORV�WASH BA <br />SHOWER <br />KITCHEN SINK 8 DISF <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVEN' <br />ROOf- DRAINS-RAIN <br />SINK (SERVICE-BAP <br />FOR OFFICE USE ONLY: <br />FPONi6EiB��N AE�H! <br />l/1 / Z(�' <br />LOT �REA <br />Zo0 q4 <br />IVVF Of CON51 �LtWI <br />� �� <br />NO OF 6TORIES <br />•Z <br />SRE OF BLDG. <br />SUB TO' <br />PERMIT <br />TOTAIF <br />� i p, <br />SPRINNLERS <br />PUNS �PPROVEO F <br />Q�d <br />O <br />� <br />� <br />� <br />N0. TYPE OF <br />NC-A/HNDIG UNI' <br />_ FORCEDAIRSYSTI <br />UNIT HEATERS-B: <br />CLOTHES DRYERS <br />4 VENTII.ATION FAN <br />WOODSTOVE <br />� METAL FIREPLACE 6 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDESETBAgN Y.INCMECI UMBEn <br />s� � ' % O <br />VACAN' SRE FEES <br />BUILDING <br />at�o�xcr xoapWflIINGI1X�16 <br />GRbJO / pLUMBINO <br />BISEMENT MECHRNIC�L <br />HE�o�7wN ADDITIONALPUNCHECK <br />2�' OTHER <br />STA1E BUIL�ING SURCMAFOE <br />CITY OF EVERETT Pl1BLIC WORKS <br />LOCAL SALES <br />g�i2 TAX COUE IS 3105 TOTRL <br />M E.A. <br />SUB TOTAL <br />PERMIT <br />TOTAI FEE <br />'/G2+- <br />�� .� <br />7 <br />-:�n � � <br />