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� C� <br />��1,,,�i <br />I � e <br />APPLItr.�TION FOR CONSTR.JCTlON <br />PERMIT <br />bs r L vergree�, rvvu t I <br />;"TY OF <br />ev�rett <br />B_:ILDING DEPARTMENT <br />25s-Pe�O TO BE COMPLETED IN INK— PLEASE PRIIVT <br />......_....�. r.irv zm vuo�.c <br />G[NCR�IGONiRnLTOB MNilP00FC55 CItV ZiP PIION[ IIGENSC� <br />„ _ ., _ _..,,� _ ,. ., ..,. . ._ �,� __. .: �D 7.�,L, <br />�TUMBiNGGOHTf>GiOR MAqqDDRE55 GILY Ziv � �� <br />S� = A.� �33 <br />�ClI/55 OF WORN <br />,U?IEW ❑ AODITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOIJTION ❑ WOODSTOVE/FR7LIh5ERT ❑ OUILGINGfiELOCAiION __ <br />LOT BLOGN OF <br />PLUMBING <br />yp, TYPE OF FI%TUiiE OR IT[M <br />WATER CLOSET(TOILET) <br />6ATHTUB <br />IAVATORV IWASM BASINI <br />SHUWER <br />KGCNEN SINKB DISP. <br />ROOF DRAINS- RAINLEADERS <br />PERMIT S _ <br />TOTAL FEE $ <br />LRONTSELBRCK AEARSEiBAGN SIDESEi9AGN <br />US�jQNE� LOTRREA WC�NTSIIE <br />�� r ❑ YE9 O N( <br />TYPEOFCANSi. OLCUPANCYGPOUP 'YOAFDWELL <br />AILOWABLE/ALTUAL <br />S12EOFBLIX3. NOOFSTORtES BSMT. OLGLO�D <br />❑Y <br />❑N <br />MEIGNi LIMItI <br />FlHESPqINrcIENSHEOVIPED ❑YES ❑!:O <br />PPP4CATIOHAGG6V PlAH5�PF0.8Y <br />� V <br />�2lL�J �_��� � <br />SrEr�� Jq��snr� - .��G��� ,G�JI, <br />I HEREBV CERTIFV 1HAT I HAVE REAC AND EXAtdIN[D THIS APPLICATION AtID <br />KNOW'. HE SAIAE TO BE TRUE AN� O�HFECT ALL PROVISIONS OF LHWS AN D <br />pRDINANCES GOVGRNING THIS TVPE OF N/ORK WILL BE COMPLETED WITM <br />WMETN[RSPEGFIEDHEREIM1 OF NOT.THEGRANTINGOFAPERMIiDOES NCT <br />PRESUME TO GIVE AUTHOR�IY TO VIOLATE OR CANCEI TH[ PROVISIONS OF <br />ANY OTH ER STATE OA LO�' SL LFJ: i7EGULATING CONSTf'.UCTION OR TME PEf i� <br />FORIdANCE OF CONS7RUC710N. TNAT I AM AUTMORIZEO U� THE OWNER OF <br />THIS PROPERTV TO PERFOFM THE 1NORK FOR W HICH APPUGATION IS MADE <br />AND I COMPLV WIT4 THE TAiE CONTRACTORS LAW 1827 RCW ANU <br />296200 WAC. <br />9GNI.ipaEOF ONTriACtO i�i4V IOPiZCD�4Urt 04iL <br />X � /�'��` �� <br />i ` "/% �9,'Ii.i�ii% . <br />MECHANICAL <br />FEE ND. TYPEOFEOUIPMEni <br />A/C - A/HNDLG C�WTS - H.P. <br />FOHCED AIR SVSTEMS- B.T.U. '.� <br />UVITNEATER3- 3°i' M <br />VENTILATION FAN <br />RANGEHOUD <br />WATER NEATER <br />METAL FIREPLACE 8 <br />FIPEPLACEI4SERT <br />GAS PIPING <br />EXMAUSTF/ <br />SUB <br />FEE <br />3 <br />FEES VALunTlon rcc <br />BUILDING_ _ ��,ry%� ��� <br />- r—/—ib <br />� <br />PLUMBINC <br />MECHANICAL <br />OTMER <br />S7ATE BUILDING SURCHARGE � <br />STATE ENERGY SURGHARGE <br />PCBLIC WORKS <br />TO7AL ' c�'l��C_.! <br />\ <br />t <br />