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APPLICATIOW FOR CONSTRUCT�c�N PERMIT <br />tne Ererpreen <br />CIN OF <br />everett <br />BUILDING DEPARTMENI' TO BE COMPLETED IN INK—PLEASE PRINT <br />10 <br />everett <br />e <br />259-86 <br />• ❑ DEMOLITION ["��COMBINATION ❑ BUILDING ❑ MECHANICAL 1 1 PLUMBING ❑ SIGN t <br />I��- OWNFA NAILADDR SS CITY ZIP PHONE eu,poRt- C�CI` <br />° F�tER.�-�Ae,�� �ARtn��, Nn.S e , � , <br />ATENANT M ILADORE55 CITY 21P PI/ONE <br />fi (�1 A U i�W � '.t, <br />� ARCHITECT OR D SICaNER MRIL AODNESS CITY ZIP PNONE <br />� � � UE� � 1q _ c <br />�� GENEfl�L RACTOR MAIL ADDRE^u5 r�,� QTY ZIP PHONE LILENSE e ''� <br />Q i � -� i� -' t c-• R'' - , 1 - I 33 <br />MECHNiICAL CONTR�CT P. MAII �DDRESS UTY 21P PMONE LICENSE • <br />_ i:�As!�;,,; ��n Nr�tu -� ��AS - <<l� I �f-ra �k��o� n � '� <br />�� PLUMBINOCONTRA R M�ILAD�RE55 CITV ZIP PHONE LICENSEI <br />'�' �N�nl�,_��iN��; /3�rLiC �iF[ D _ . -- <br />� cussoFwoRK <br />� CI NEW ❑ ADDITION I I ALTERATION I I REPAIR I I DEMOUTION I I WOODSTOVE/FRPLINSERT I.! BWLDINGRELOCATION <br />¢ <br />'� ^� TENANi IMPROVEMENT OH INTEFIOA R�MOOEI O4LV CONTRCT PERSON AND PHONE ND. <br />• I�i pONTRACT PRICE OF WORN• » S nnac°. <br />1� UESCRIBE WORN AND SOUARE FOOTAGE INVOIVED ���� ,/� <br />. TT .__..n_.,n....,,nJG Ti• .0���'IL.L`�.� — <br />IEGAL DESCRIPTION OF PROPERTY ISHOY/N BELOW <br />�or e�xK oF <br />N0. I TYPE OF <br />LAVATORY�WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DR�NKING FOl <br />FLOOR DRA�N <br />SINK <br />FOUR COPIE51 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXtiMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A�ERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LUCAL LAW RECULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE ANI' I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW h�.J 296200 WAC. <br />SIGNATURE OF CONiRACTOR OR AIITHORREO AGENT DATE <br />' �X('��,,;�'a�� 'un�nA2d�5 �inecif� iC_S <br />���fl n qPPLICANTS G1iY B SINESS LILL�NSE NO. AND BUSINESS N� <br />�Jr <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FHONTSEiBACK REARSET30.CN SIDE SEIBRCK <br />USE ZONE <br />�IYPE Of 01 <br />SIZE Of BLD(3. <br />Lf4S T�1. <br />OCCUPANCYLOAD <br />G�� <br />PEASON FOP SPFINNLERS <br />RPP�ICATION <br />L0T AREA <br />iYPE Of CONSC ACiUAL <br />� _,� <br />NO. OF STGRIES <br />� <br />FIRE SPRNKLERS REO'0 <br />LJ YFS Ij3�N0 <br />PLANSAPPROVEDBV <br />�� <br />FEE <br />V�CANTSITE <br />I I YES f 1 NO <br />acu-ercr xaaowm-xa� <br />GPWC <br />a3 <br />13ASEMENT <br />1=1 YES l�KNO <br />NEIGHT LIMITATION <br />CITY OF EVERETT <br />LOCAL SALES <br />TA% COUE IS 3705 <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATEiiS—B.T.U. M <br />CLOTHES DFiYERS <br />VENTILATION FAN <br />RANGEHOOD _ <br />WATER HEATER <br />WOOD STOVE <br />MeTAL FIREPLACE & CHIMNEY <br />FIREPIACE INSERT <br />NGAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILOING <br />PLUMOING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENE(iGY SURCHAHGE <br />f JBLIC WORKS <br />TOTAL <br />TOTAL $ <br />NIT $ <br />�,L'� <br />e <br />N <br />