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,p►PPLICalION FOR CONSTR4.:TION <br />PERMIT <br />Ihe Evorpronn <br />CITY OF <br />everett <br />EUILDING DEP,4RTMENT <br />259 G810 TO BE COMPLETED IN INK - PLEASE PRINT <br />pWNER \IPILApUfIl55 Q�Y 211' PIIONE <br />G�E�ii�o��TJ�'��•v:��;_(�vt_27:lI-IIG���-`'[`_ L-_Vt([c.TT_.%az�'K_._ 337-7��-� <br />IEN�IR IANIAPIIf1F55 LI�Y )iP PIIONf- -�- <br />�pCN11EGTORDESiGNER `���L��DRC55 Cliv Zm <br />OENEMLCONfR�C108 MAl1�001tE55 CiIY 2iP PIIONE IICENSE• <br />SA•n� - <br />MELIUNIC�LGON10ACi011 M�il�00nESS CIIY IiP PRONE 116EN5E• <br />PLUMpINaG@IIMLIOO MML�Of1fIf55 - ---�-��-- ���Y IIP�� _ -- �-��1'l1011f --------llf.fN9f • <br />� _.__-.__ __._... _. .._. _. _.__ . _ . ._ _-__.._._._.--__"__--__-_ <br />G/�USSOf W011N <br />laJ NEW ❑ PODITION ❑ ALTERATION ❑ REPAIR ❑ Df.MOLlIIOt! ❑ WOOOSIOVE/FfIPLIN3Gf1I ❑ f1UIL01NOtlflOCNION <br />___ —___' _ '... _ _ .__ ' .. ._____'_"""...._.__..__--__-'_ <br />IEN�NI IMPPOVEMEN� O� IN�Ef1101111E�M1CVEI CNQLY C. CONIGC� f'LIi50N ANU PII@IC NO <br />GONIIIACIPNL[OFWOOK �(����J ``J _ _ ___I____ _____ _________ — <br />�L <br />�o. e�ocK ov LoT I CARotC�DA <br />fZpv��-L I�I PJF f <br />SN�'H�JM� � CUU��_T <br />IJEGT�UOpESS <br />�I I� �rll <br />PLUMBINti '- <br />10. TYPE OF FIXTURE OR <br />rL WATERCLOSET�TOILEI) <br />�L BATHiUB <br />'2 LAVATORYIWASHBASIN) <br />SHOWER <br />KITCHEN SINKB DISP. <br />/ DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />F�OOR DFAIN <br />T �4CKFLOW PREVENTERS <br />(o ROOF �RAINS— RAINLEADERS <br />SI�'K ISERVICE � - BAR, E1C.) <br />L YS <br />� SUBTOTAL__S — � <br />PERMIT 5 <br />TOTALFEE S <br />fRONT5EI9�CN �E�BSEIBACN S�OESFIO�LK <br />2o zn � � <br />USE20N L01.1PEA VAGyJfSrtE <br />�—� $ �� O O w•FES t� NO <br />rvreoFcor+s�. occurnHcranaur Nooruw[u.0 <br />�IIOW�OLEI�GIpet <br />�- _�_ 2 -3. i <br />srze or a�oa �o or sronies ASMI — OCG LO�U <br />❑Y <br />33S � � <br />REIG111 UMIIAf <br />nnESrnrt+K�EnSncoumEo nres 1vl�o <br />I HEREBY CERTIFY THAT I HqVE READ AND EXAMIN ED THiS APPUCATION AND <br />NNOW THE SAME TO BE TiUE AND COf7RECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING iNIS TYPE OF SYORF WILL BE COMPLETED WITH <br />WHETHEqSPECIFIEDHEf7CINOR NOT. THEGRAN7INGOFAPERMITDOESNOT <br />Pt7ESUME TO GIVE hUTHORITY TO VIOLAf E OR CANCEL THE PROVISIONS OF <br />ANVOTHERSTATEORIOCA! LAWREGUTAiINOCONSiRUCTIONOFTHEPER� <br />FORMANCE OF CONSTPUCTION. 1HAT I AM AUTHORIZEO BV TNE OWNEF OF <br />THIS PROPFRTY TO FGRFORM THE WOf7K FOR WHICH APPUCATION IS MADE <br />AND I COMPLY WITII iHE STATE CONTPACTORS LAW 1827 RCW AND <br />286200 WAC. <br />swueroneoreaN���cionnnnumonirroeeer�i oere <br />x�.�.-�'���v a,P. 3=z�-�� <br />�PPLICANISGIilL.51NE$Sll NS[NO�NOIIUSINEGSN�ME <br />C� 2 n 0 2 /'a,>FAT.u',✓t7Uu �sT PAi.vTi�tir <br />MECHANICAI <br />�� <br />TYPE OF EOUIPMENT <br />A/C- A/HNDLG UNITS- H.P. <br />FORCEDAIRSYSTEMS-B.T.U. M <br />UNITHEA7ERS--O.T.U. M <br />CLOTH[SDFlYERS <br />VENTILATION FAN <br />RANGFHO00 <br />WATER HEATER <br />GAS PIPING _ __ <br />E%HAl1ST FAN <br />SUl3IOtAL S <br />___ __._.___.__-_--__ <br />PEf7A11T S <br />TOTAL FEE 5 <br />BUILDING � 4 a 8 � <br />PLUMBING <br />MECHANICAI <br />OTHER J�1G1.�i� _C� ' F�__ <br />r. L <br />STA1E BUILDING SUF�CI1AfiGE <br />STATE ENEf7GV SURCHnt7GE <br />PUBLIC WOPKS <br />TOTAL <br />