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.. - <br />APPLIL.�TION FOR CONSTRJGTION <br />PERMIT <br />fhe Cverpreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />�� � SAME AS <br />AlIG111CG1 Ofl UCSIGNER <br />C08RA Cc�N <br />pENER0. CON1R�GiOR <br />cos2A eoNsr. <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />inuuuvnccs urr nr <br />:S �J11 l� � SNo 1�0 . �i$r1_�i <br />MRIL�DDRC55 ���Y l�P <br />A BoVe <br />Mniiaotiniss ------ciiv-------iin <br />ST� <br />IARILROORE$$ CIIY 21� <br />Po 6on 1295 ���rr a�2c <br />��.55��WO�K - <br />�NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOV[ <br />TEN�NI IMPROVEMENT OR �NTERI�OjA c�EMUDEI ONIY �U�� AN A„1 <br />cor+rn�ttrnir,torwonK O'�7Q���t� � T <br />r� Hvo�.vEo <br />rv�rcll <br />e <br />' 552Z <br />- <br />.JSERT ❑ OUILUING RELOCATION <br />4��IJ�� .2/Fs-3G� <br />OESCRIBE WOf1N FND 50{IANE <br />8t�5: " r'rx�so-�4 ;�fi �I ���s ; %„ � � --- - - <br />Miui-sro�� <br />LEO�L D[°G���°110N Uf i'nOPERtt 18H( <br />lpT�^--� OLOCK 4� <br />/ A -r'�rn i el �r � <br />�' ir� r�. � ��o ���,�„�.., <br />PLUMBIN6 <br />NO. TYPE <br />� WATERCLOSE� <br />KITCHEN SINKd DI <br />DISHWASHER <br />LAUNDflVTRAY <br />CLOTHES WASHER <br />I HEREBY C[RTIFY THAT I I1AVE REAO ANO EXAMINED THIS FPPLICP.710N AND <br />KNOW THE SAME TO BE 7AUE AND CORRECT ALL PROVIS�ONS OF LAWS AND <br />OADINANCES GOVERNING 7HI5 TVPE OF WORK \NILL BE COMPLETEG WITH <br />WHE7 HER SPEGFl[O H ER[IN Oii NOL THE GRAN7ING OF A PERfdli OOES NOi <br />PIiESUME 10 GNE AUTNOR�iV TO VIOLATE OR CANCEL TME PROVIS�ONS OF <br />ANv O71iGR S7N E Of7lOCAL LAW REGULATING CONSTRUCTIOh OR THE PER� <br />FORMANCE OF CON51 RUC710N. TI1AT I AM AUTHORIZED BV THE OWNER OF <br />THIS PROP[RTV TO PEHFORM THE WORH FOR WHICH APPLICATION IS MAOE <br />ANO I COMPLY R'IT4 THE S7ATE CONTRACTORS LAW 7827 RCW AND <br />296.200 WAC. <br />S�cNATunEo� '+TA���on�zEonccNt oPtE <br />X Z.-15 -50 <br />MECHANICAL � <br />OH ITEM FEE NO. TYPE OF <br />A/C—A/tiNDLG UNII <br />FORCED AIR SVS1Eb <br />UNIT H£AlERS— DT. <br />CLOiIiES DR'/[RS <br />_� VENTILATION.'-AN <br />RANGEHOOD <br />WATER HHATEF <br />WOOD SiOVE <br />METhL NFEPIACE 8 <br />FlPEPLACEINSERT <br />PREVEN7ER� <br />JS — RAINLEADERS <br />rc _ wew crr� <br />SUOIOTAL S <br />PEHMIT E <br />TOIALFEE E <br />'RONi5E1BPCR RERRSETBACN SIOESEIBRGR <br />USE20NE LOIPPER VACANT IT <br />❑ YE9 NO <br />� fGONSi. �{'I OCCUPpNGYGR00P NO.OFOWELLIN( <br />RLLOW�BLE/�CtUAL �/. � t ¢ ^ � �. <br />Ji' ^r �/ <br />sizEoro�oo. No.orstomfls esrni oc¢loao <br />� I uY � <br />n <br />NE�0111 LIMIi�TI( <br />FRESPPINNLERSREOUIREO ❑VE9xND � <br />�:N��di 1�1�1 ........./�� <br />fAN <br />— B.T.U. M EA <br />M <br />SUB TOTAL <br />PERMIT <br />TOTAL FE[ <br />iEE 2 <br />J <br />�1C/ _/ <br />' FEES � <br />DUILQING a� <br />PLUMOING <br />MECHANICAL <br />OTIiER <br />STATE BU!LDIN6 SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS _ <br />T07AL <br />��" <br />FEE <br />� 5 .F J <br />. �, . . . . _ .. . _ <br />SI <br />