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� � <br />� 1s' <br />..�« t ,�r-.'�.�., <br />c'� ov <br />everett <br />BUILDING DEPARTMEfJT <br />259-8810 <br />_� <br />,-y <br />APPLICI�+� ION FOR CONSTRl.6:TiON <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />�'. <br />-> --l.%C7 �- <br />MF:M�NI�/yCOMTRK.TON MI�ILIIUDFC63 C1fY ZW PMOME lKGMSE• <br />RUM&NOCOHTMLTOA M\III�D�RE59 CfiY 21V OMOME lIQN9E• <br />❑ NEW ❑ A�D�T10N ❑ �TERATION <br />TENANi1MPROVFMEMOPiMER1ORPLNO�EIONLY <br />C11HipqCi pRICE OF WOIiK <br />tOi <br />Bloclt OF <br />PLUMBING <br />yp, TYPE OF FIXTURE OR <br />I WATERCLOSET�iOILEn _ <br />� BATMTUB <br />LAVATOHY (W0.5H BASIN� <br />SHOWER _ <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDflV TFAV <br />CLOTHES VJASHER <br />UR�NAI <br />DRINKING FOUNTAM <br />FLOOR DRAIN <br />BACKFLOW PREVENTCRS <br />RnOF �RAINS — RAINLEAOERS <br />PERMIT <br />n rE8 ❑ <br />FEPAIR ❑ OEMOLITION ❑ WOODSTOYE/:RPL INSERT ❑ BUILDING 1iELOC�.TiON <br />I HE FF CY CERi1Fv?HAT I 1'AVE REAO AND E%AMINEO TMIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE dND COFRECT ALL PROVISIONS OF IAVJS AND <br />OROiNF1JCES GOVERNING TNIS'ryPE OF WOFY. WILL BE COMPLEIEG WI7H <br />WHETNERSP[CIFl[DHEQEINORNOLTNEGPANTIryGOFAPERMIT DOESNOT <br />PRESUME T O GIVE FUTNORiry Tp VIOLATE OA ChNCEL THE PROl'ISIONS OF <br />ANV OTHER STATE OR LOCAL LFW' REGULATING CG!:5 i RUCTION OR THE PER- <br />FORMAt�CE OF CONSTFUCTION TNhT I AM AUTHOFIZED BV THE OWNER OP <br />T1119 PROPERTY TO PES�ORM THE WORK FOR WHILN AGPLILATION IS MAOE <br />FND I COMPLV WITM THE STATE CONiRACTORS LAW 1827 RCW AND <br />296200 WAC. <br />516N4iUFE0f�ONiFAC*OfiflG.AIR�IpRIiLD�GC1d ��i <br />X / ' / . <br />' _,; �`�-' i <br />� r,�.�T �.� ' —�_� <br />��2p1v;�G y U C'SU! EHOI.NOB�51lCSS �!�E <br />MECHAN�CAL ��� <br />NO. TVPEOFEOUIPMENT _ FEE <br />NC— a'HNDLG UNITS— H P. <br />FORCED FIR SVSTEMS— BT.U. M EA <br />UNIT HEATERS— B.T.LL M <br />CLOTMESORYERS <br />VENTILATtON FAN <br />RANGENOOD <br />WATER NEATER <br />N'000 S70VE <br />METAI FIREPLACE 6 GHIMNEV <br />GAS PIPING <br />S <br />S <br />S <br />B <br />L` YCS ❑ NO <br />BUILDING <br />NO.OfDWFLL1110UNIB — — <br />PLUMBM� <br />ggut. occ�wo MECHANICAL <br />ur <br />❑N <br />HH6MiLIMIiAL10H OTHER <br />STATE BUIL�ING SURCHARGc <br />STATE ENERGY SURCHARGE <br />� PUBLIC WORKS <br />TOTAL <br />