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� � iAPPLICATION FOR CONSTRUCTION <br /> PERMIT . <br /> 1M Ewrprsen everett I <br /> cin oF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-BN10 TQ BE COM'LETED IN INK— PLEASE PRINT <br /> OWNEP MAIL�ODPE59 GIY Z�P PNONE �1 <br /> r��u..o�r— �v••s�, �'vc 24lto ,BRie�e. R�. i g.��,_,_ �'go3� 4A�-�sSS' <br /> i�El�NT MRitnvvneoa <br /> �ow �s - /�cAfr�.,.F �✓T• 75�2^S7LZ <br /> ARGMRECTOROESI�NER MML�DDRESS GiTY 21P PMONE <br /> r"i4i �tav� �d� 64 Tit�C �4/�a ��F..� RD l3RiFic ?s3o�o A87��'��7 <br /> GEIEIULCONTRACTON MAIL�DDiiE54 GTY Z�P P�` <br /> �A�rzfN[��31 N� <br /> MECN�NIGKGONTPI�GTOR MML�O�PESS QiY ZIP PNONE LtGENSE• <br /> PLUMNNOCOMTR/iL10R MARADOPESS GTY 21P PIIONE IIGiNSE• <br /> GABB OF WORN <br /> �.NEW ❑ AODITION ❑ ALTEPATION ❑ PEPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPLINSERT ❑ BUILDINGRELOCFiION <br /> T[NMIT IMVROVEMENT OR INiEHiOR REMOOEL ONIY CONT�GT VERSON AND PIIONE N0. <br /> ppNipACiPRICEOFWOnK t�� OUO <br /> pEBGPIBEM/ORN�NDSOUWEfOOTAO YVOLVEU <br /> �! CdNi('� �10 K 000 <br /> vnoroeeo use w eui�oiNa I HEREBV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND <br /> KNOW THE SAME 70 EE TAUE ANO CORRECT.AI.L PROVISIONS OF LAWS AND <br /> LEO�I.DESCNiVT�ONUFf'RO�EFTYISHpWNBELOWOR�TTACHFOUR OPIE51 ORDINANCESGOVERNINGTNISNPEOFWORKWILLBECOMPLETEDWI7H <br /> � W HETHER SPf.CIFIED HEREIN OR NOT.THEGRANTING Of A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �oT �2 B�oCK or 6 ~ � ANYOTHERSTATEORLOCNLLAWREOULA7INGCONSTRUCTIONORhIEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BI'THE OW NER OF <br /> THI$�ROPEFTY TO PERFORM THE WORK FOR W HICH APPLICATION IS MADE <br /> AN I OMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AN� <br /> 296 0 WAC. <br /> OFCONIRRCTORORROTIIORI2EO�GENi ��tE <br /> — \ <br /> PRJJF.CTAODRE89 G �5 �iY iINE54UCf.NSENO.ANDBU51NE5SN�AlE <br /> r � ` <br /> PLUMBINO MECHANICML <br /> NO. TY'E OF FIXNPE UR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLO.?Ef(TOILEi) A/C-AIHNDLG UNITS-H.P. <br /> BATHTUB FORCED AIF SYSiEMS-&T.U. M EA <br /> LAVATORY�WASHBASIN� UNITHEATERS-B.T.U. M <br /> HOWER CLOTHESDRYERS O <br /> KITCHEN 91NK6 DISP. VENtILATIOIJ rAN i <br /> D19HWA9MER RANGE HOOD <br /> UIUNDRYTRAY WATEF HEAT[R I <br /> CLOTHES WASHER WOOD SiOVE <br /> URINAL METAL FIREPLACE6 CHIMNEY i, <br /> ORINKINO FOUNTAIN FIREPLACE INSEfiT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING . <br /> ROOFDRAINS-RAINLEADERS EXHAUSTFAN <br /> SINK(SERVICE-BAR,ETC 1 <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT E PERMIT S _ <br /> TOTAL FEE S TO7AL FEE E <br /> FRO/Ni5)ET0�CK RE�RSET&1CK/ SIOESEi� PL/�N HEC IIIMBER FE�� fl pE������ <br /> V- I <br /> usezoNe �oinnen VpCANiBITE FEES VALUATION FEE <br /> I�YES ❑NO �/ <br /> �� Z�'�' BUILDING G '�37 3 7 O <br /> TYPEOFCGN9T. OGCUP�N YOROOP NO.OF�WElUNOUNlT9 <br /> AILOWABLE/��� Q- 3 , ... PLUMBING t� U . <br /> BIIEOF4LD[L NOAFSTORIES �yT. OCGLO�O �,``� <br /> MECHANICAL V <br /> l �2 � � on n�{ <br /> HEIOHTUMIIAfION OTHER 7 I 7V <br /> FIRESPRINNLEPSREOUIREO O YES D STATE BUILDINO SURCHARGE S <br /> STATEENERGVSURCHARGE <br /> APPLIG�TIOHACGBY PUN9�PP0.BY PUBLICWORKS <br /> � �Cw.� TOTAL �0�� <br /> -....._..-....��.,.......�...�.......r....._...........,..--....-....�.......--.-,..e.-..-:..,-......-.ti.....,+r-..�.���.e...�.......•«.-- <br /> 'M' "'_" ._ _.._.._....._._._�_--... l <br />