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� <br /> APPLIC..TION FOR CONSTRI. TION <br /> PERMIT <br /> the Everpreen <br /> CITY OF �'°�'���� <br /> everett e <br /> BUII.DING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> OWNER AIAIL.DDRE55 GiIV ZI�(��.��.�i PHONE <br /> MoN - �'hc�„� L�N �a� � �9 th s Z CU�Rc�1 %c� �' ���.,.7- o �'- <br /> TENANI MAILAp�RE55 GITY 21P PMOIIE � <br /> �RCHRECTBBAEB�IBR MARRDDRE55 LITY Z�o PMONE <br /> Epw,A, McHufrFl �lt $¢5 108 Nr �2 {3�.�y�vu� 980� q-S�'^06qa 22�2 <br /> GENER�LGONTf+.RCTOR AINILAOORESS�� �Y� 2��� , P��ONE �� I�C[NSE• <br /> + Tc� F3G SEL�G fTi' i <br /> i�� t <br /> ECHANIC�LCONTR�CTOR MAILAOORE55 GITY ZIP PHON�E � %�p /7IICENSE� <br /> PWMBINOGONTReCT]H M41LA�DRE55 �T�J���NE u���� <br /> C�L,�/55 OF WVRN <br /> L7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ' EMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ Bl11LDING RELOCATION <br /> TEN�NTIMPNOVEMENTORINTERIORREMDOELONLY � CONGGTPERSONNNDPHONENO <br /> � W. �NUGFI �F54-o6 0 <br /> CqNTRAGT PRiCE 0F WOPK ��� � M S <br /> � DESCRIBEWORN�NOSOU�REFOOT�GEINV iVED <br /> � IG, �oas9 -ct� <br /> � a+orose u5eorsui wc IHEREBYCERTIFVTHATIHAVEREA�ANDE%AMINEDTHISAPPLICATIONAND <br /> . MOTEI� KNOWTHESAMETOBETr�UE�NDCORRECT.ALLPROV1510NSOFLAWSAND <br /> LEG�L DESCRIPTION OF PROPERTY ISMOWN BELOW OR ATTACN FOUP COPI[51 ORDI NANCES GOVERN ING THIS 7VPE OF WORK W ILL BE COMPLETED W ITH <br /> W METHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES N07 <br /> PRESUME TO GIVE AU7HORIlY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �ot B�oCrc oF qNYOTHEHSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> fORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> , A•RMGNLs� THIS PHOPERNTO PERfORM THE WORK FOR WHICH APPLICA710N IS MADE <br /> AND I COMPLY WITH THE STATc' CONTRACTORS LAW 1827 RCb`/ ANO <br /> 276200 WAC. <br /> SiGNAiUPEOFC NiPACiORO1:AUT110Ri2E0AGENi ORTE <br /> X / ' <br /> ' �'- � S- -d' <br /> - PROJEITA�OHE55 j�� APPLIGA SCITYBUSW[SSL EM1SE O.ANOBUSINESSNAME <br /> �� �/(/� <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPEOFFI%TUREORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSETITOILET) A/C—A/HNDLG UNITS—HP. <br /> BATHTUB FORCEO AIR SVSTEM1IS—B.T.U. M EA <br /> LAVATQRYIWASHBhSIN1 UNITHE4TER5-6T.U. M _ <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAM <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY �'/ATER HEATER <br /> CLOTHES WASHER �YOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIIJ FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOrV PREVE�TERS GAS PIPING <br /> ROOF DFAINS—RA'.NLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETQ) <br /> SUBTOTAL S SUBTOTAL S <br /> PEFiMIT S PERMIT 5 <br /> TOTAL FEE 5 TOTAL FEE S <br /> FRONTSETBAGK pL�F5EQT8AGN SIOEaS[TOACK PIAN`MECI(N MBEN FEE O� ^ ZO PELEIITNO.�� <br /> � � _� 7 <br /> usczay� �o-��r+� V�GANTS17E FEES VALUATION FEE <br /> , J� ❑YES ❑ NO --� ^ <br /> V -� <br /> nae OF consr BUILDING <br /> � OCJUPANGYGPOUP NO.OFDWEIIINGUNITS <br /> ALLOWABLE/F�L� I ��./ �� PLUMBING <br /> �� r - <br /> SREOFBLDG. NOOFSTORIES OSMT. OCGlOAD <br /> � Q �5�. n - ❑r L�}. MECHANICAL _ <br /> [.� t� 'T Q <br /> HuwrtuMrtnnorv O7HER � �j,�g 1 (, <br /> +qf � <br /> FIRESPRINNIERSFEOUIRED ❑YES O ✓' STATEBUILDINGSURCHARGE <br /> STATE ENERGY SURCHARGE <br /> RPPIICATIONPCCBY PU�NSAPPR.O� � <br /> PUBLIC WORKS <br /> ��� �� / TOTAL <br /> �(o`j �� <br /> , � <br />