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� <br />APPLIC�4T10�" FQ�R CONSTRUGTI�Rt PERMIT ���'«�« <br />me e�c��i<�on TO BE COMPLETED IN INK--PLEASE PRINT � <br />CITY pF <br />everett C <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />OYNER 61NLADORE55 <br />� � h�2 �y��� ��'='`�, <br />� a�+T /AI n MNLA�DRESS A <br />�./L_�f /Li_ \A/__ )I.Vif/ �2�//. <br />nHCHITGCTOR OESIGNEfl hINL ADDRESS <br />/�GENEP.ALCO�NT/q�qCiOF MAILFDDRESS <br />_��Lr/(�. <br />�dECH4NICAl CONiF�CTOR MAI� A��FESS <br />PIUMBINGCONTRqCTOR IAAILAOD(�E55 <br />CLASS OF WORK <br />NEW � � ADDITION <br />HEATING SYSTEtvt: ❑ GAS ❑ ELECTRIC J <br />BUILDING <br />CI1V <br />CITv <br />CITV <br />CITV <br />MECHANICAL <br />Z�N PHONE <br />��aiv ga <br />Z�P PHONE <br />��'S� / 2- <br />Z�P PHONE <br />Z�P PHONE <br />Z�P PHONE <br />Z�P PNONE <br />PLUt�1BING <br />LICENSE a <br />I.ICENSE> <br />LICENSE a <br />SIGN <br />ALTERATION �� REPAIR .. DEMOLITIUN WOODSTqVEiFFPL INSEFT -� BUILDING R[LOCATION <br />I CONiACT P[FSON AND PHONE NO. <br />ULSGRIDE WORK AND SOUFRE FOOTAGE �NVOLVED <br />�Nnf�v �e� r� ,�vc� � � <br />PROPOSED I15E OF BUIIDING <br />_D_F���e . <br />LEGAL �ESCRIPTION OF PROPEfiTV (SHOWN E3ELOW <br />f /�. i�p : /�i <br />L07 �, 2� BLOCK `/ OF <br />OR ITEM <br />LAV�TORY(WASH BA; <br />SHOWER <br />I(ITCHEN SINK 8 DISF <br />DISHWASHEF <br />LAUNDRY 7RAY <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKF�OW PREVENTERS <br />ROOF ORAINS—FAINLEA�7ER5 <br />Fo��� <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />IlIOHTSETBAGK REARSEIBACK <br />�liEZONE LOTAREA <br />IVP(OfLONiS.ALl71YA0LE iYPEOFLONSi,ALiUAL <br />' V `- �� <br />9I[ OF p�OG. NO. OF STORIES <br />�,�) $ .F�:O�c <br />OCCUTANCYLOA� FlRESPRNKLEPS R[O'D <br />14.ASON FOR SPR�NN�ERS <br />•.Ni��rc[F3V PLANS PPPOVEDBV <br />;'��1y� y�� <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />AP'LICATION AD;D KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIO�JS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK'NILL BE COMPLETED WI7H WHETHER SPECIrIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOL,aTE OR �ANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br />PERFORMP,NCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF TiiIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br />SIGNATUREOF�ONIHAGTORORAUTHOHRE�A3ENT D�TE <br />X � [^/ <br />• �PP .FN75CIiV BUSIN 5. LIpENSE NO. qNp BLISINESS IJAI.1�� <br />MGCHANICAL <br />NO. � TYPE OF EGUIPMEhT FFF <br />FORCED AIR SYS7EM5—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIOESETB�CK PLANI.HECHNU�dOER <br />�./,�Gvyf <br />VAG�NTSITE � FEES <br />BUILDING <br />occur;,xa uuorownu�,cixurs — _ <br />aouv / PLUMBIIJG <br />BASEMENi MECHANICAL <br />Hei�Hrunurnnon ADDI710NALPLANCHECK <br />OTHER <br />STA7E BUILDING SURCHAI7G'c <br />�ITY OF EVERETT pU�LIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUBiOTAL � <br />PERMIT $ <br />TOTAL FEE $ <br />i"EE J .� •/O REGjPj'G �� <br />c70 O <br />��an <br />�a <br />S�� ;S6 <br />