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APPLIC.=:�'ION F�OR CANS'PR1���TI�N <br /> PERMIT <br /> the Everproon evcrell <br /> CITY OF <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•BBto TO BE COMPLETED IN INK— PLEASE PRINT <br /> OVNER MML�DORESS CIIY 21P Nr10NE <br /> — PIeT2v5 CokP �62D (96''NSu� �y,��we�� �'�a36 7�5'-�67� <br /> TEN�NI MAllAD011E94 CIIY 21P PNONE <br /> OWNe1r <br /> AfiGhItECTONUE5IGNER MIJL�DDflE59 CIIY ZIP PIIONE <br /> (�wN �Y� <br /> GhNERALCONTP�CTOR MAIL�ODRE59 GTY 21P PMONE LICENSE• <br /> MECN�NIGLCONiNaG10B MMLI100FESS CII" 2�P FMONE UCENSE• <br /> Kn����r i 2�s,� <br /> VLUMBiNOCONIP6C10R MML6DOItESS GfY 21P PIIONE UCEHSE• <br /> — �(�.D �l.u��bitist z73� S� JP�/�'`` E'vum c.c.�..v� w� pdoaa b'�s-3�/o <br /> C VSS OF WOIIK <br /> ❑ NEW � ADDITWr! ❑ ALlERAT10N ❑ REPAIR ❑ DF�MOLIiION ❑ 1VOODSTOVE/FRPLINSEi1T ❑ DUILDINGRELOGATION <br /> TENANi IUVR09EMENT OR IME1ii08 HCMOOEI ONp fANUGT PEOSON/W 0 PNONE NO <br /> fANtlUCT PPICE OF WOHIC <br /> DESGRi9E WCflN AND SOU�RE f00TAGE INVOLVEO <br /> � ADO oNe FG2 Sialc �}- GAS p�Pin� <br /> vnor�oseo use or ouuoiNa I H EREBY CERTIFY THAT I HME READ AND E%AMINED THIS APPL ICATION AND <br /> � ��7iZA KNOWTHESAMETOBETAUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> LEO�LUESGRivIqNUFPROVEN1Y�51�pMX0ElOWOPATf�tNfOL':IGUPIES� ORDINANCESGOVERNINGTHIS7VPEOFV/ORKWILLBECOMPLETE�WITH <br /> W hIETliER SPECIFIED HEREIN OR NO7.iHE GRANTING OFA PERMI7 DOeS NOT <br /> PfiESU ME TO GIVE AUTHORITV TO VIOLnTE OR CFNCEL THE PROVISIONS Of <br /> Lp7 e�otK or ANYOTHERSTATEOF7LOCALLAWREGULATOlGCONSTRUCTIONORTHEPEfl• <br /> FORMANGE OF CONSTRUCTION.THAT I AM AUTHOFI2ED BV THE OWNEfi OF <br /> THIS PROPERTY TO PERFORM iHE WORK FOR WHICH APPLICATION IS MAOE <br /> AND I COMPLY WI7H THE STATE CONTFAC70RS LAW iB27 RCW ANO <br /> 296200 WAG <br /> S�GNAiUP[OFCONi{1AGIOOORAU1110NZEOAGFNI DAIE ' <br /> FPOJEQAO�fiES: �Pp��,VfSGIY 51 - ENS O.NIOBUSINES �[ ' /�' '� O ' <br /> — �i(O09 E�e� �eP� w <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OH ITEN fEE NO. TYPE OF EDUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/NNDLG UNITS—H.P. <br /> BATHTUB FORCEDAIRSYSTEMS—F7.T.U. MEA <br /> LAVATORY(WASHBASIN) UNITIIEATERS—B.T.U. M <br /> SHOWER CLOTHE•SDRVEFS <br /> KITCHEY S�NK801SP. VENTIlA710N FAN <br /> DISHWAShER RANGE HOC�J <br /> LAUNDRYTRAY WATER HEATER _ <br /> CLOTHES WASHER VJOOD STOVE � <br /> URINA� METAL FIREPLACE 8 CHIMNEY <br /> DNINKING FOUNTAIN FIFEPLACE INSERT _ <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING __�Q�_ <br /> ROOF DRAINS—RAIN!EADERS E%HAUST FAN __ <br /> SI NK ISERVICE—BAR.ETC.) <br /> LLN�+aL �J !' SA(A.( DA!! <br /> SUBTOTAL S SUf1TOTAL 5 (y� <br /> PERMIT S PEf'.MIT S �� <br /> TOTAL FEE S TO �LFEE 5 /;(/ <br /> fNOHT56i9�CK Ri�fI5E18ACR SiUESET&�CK FUNCNECKNUMBEN ;[E AECEIefNO. , _ . <br /> u5ezoe�E �oTu�u vM.wrsite FF.ES VALUATION FEE <br /> u res ❑no <br /> BUIIDING <br /> TYPEOFCpNST. OCWPAIIGY6NOUP NQOFpWELLINOUNITY — -� — <br /> i4LOWABLE/�LLU/�l <br /> PLUMBING S (yO <br /> 9ZEOFOLOQ MQOFSTORIE9 &SMC OGGLO�W <br /> u r MECHANICAL � <br /> uN - - <br /> NEIONTLIMI1AilON OTHER <br /> liHE 9PRiNNLEF9 PEWIREO O YES O NG STATE�UILDING SURCHAtiGE <br /> STATEENERGYSURCHARGE <br /> APR:CATION/�CGBY PLAiISAVPRBY � <br /> PUBLIC WORKS <br /> v11�� � Tora� _ r�,3 <br /> .-. - - - <br />