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� <br /> �, ,� <br /> ����• APPLIC.+flON FOR CONSTR�.CTION 1 � <br /> � PERMIT <br /> fha EverOreen evrrett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-88�0 TO @E COMPLETED IN INK— PLEASE �RINT <br /> �i� �,��Ep MAILPOOFE55 LItY Z�P �'�uN� <br /> � �(�:-uiJ�q���L�'1iE.-��1� ��i.L An n�.� ° ` ��rr 7� `��o� 3.53- �`f12 G= <br /> iEN�Ni I.IAIIADORE55 GiY ZIP PHOl.E <br /> ARGNREG' 1R�ESIGNER MAILAODRE55 CItY ZIP PHONE <br /> I <br /> GENERALGONLRACfOR A'FILA��RE55 CIiY 21P VNOtIE LICEHSE� <br /> ��� M[GMAi�ILALCONiFAGIOR MAILADDRESS GIiY ZIP PHONE LILENSE� I � <br /> a�y - [�iy 21P GIIONE LIGENSE• <br /> PUeMBINGGONiRACTOP MNILADDP[55 <br /> ~ ^� I <br /> H H h GU550 'WOPK <br /> K n �y <br /> F3�.E ❑ NF1Y ❑ ADDITION ❑ ALTERATION ipi REPAIR ❑ DEMOLITION ❑ WOOOSiOVFJFqPL.INSERT BUILOING RELOCATION <br /> � N� �[v�NfIMPPQ.EbENiORINTEPIORREMODELONLY CONiPLTPE9SONPNOPMONENO ' <br /> �H GONTRdGT PRICEf F WORk <br /> � x OESGRIBERJMK�NUSOUAREFOOTAGEINVOWED <br /> H / <br /> �d �N .� A rr ��; .�.� - o - iq� . <br /> ON� caoco5eou5Eorewiowc IHEFEBI'CERTIFYTHATIHAVEHEADANDEXAMINEDTHISAPPUCATIONANU <br /> CU O \/ • '� KNOW'HESAMETOBETfiUEANDCORRECT.ALLPROVISION50FLAW3AND <br /> N C+9 r �1N,.li on / �!°S i �NC-v OROINANCES GOVERNING THIS TYPE OF YIORK WILL BE COMPLETED WITH <br /> �� � �EGAl0E5G IPiIONOFPqOPEA1YI5HOWNbELOWORPTTACHGOURCOPIE51 y./HETHERSPFGPIEDHEREINORNOT.THEGRANTINGOFAPERMITDOESNOT <br /> ' /� PRESl1ME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> yy �o�� e�ocK�_ o� O v �Z ANYOTHERSTATEOHLOCAILAWREGULATINGCONSTRUCTIONORTHEPER� � <br /> �.w � FOflMANCEOFCONSTRUCTION.THATIAMAUTHORIZEDBYTHEOWNEFOF <br /> yJ ,�� ,zQ � ������� THISPROPERTYTOPERFORMTHEWORKFOFWHICMAPPUCATIONISMADE <br /> •�^^. l' " TnG � - ��—�—�- AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 1-I L 296.200 WAC. � <br /> OON <br /> � SIGNALUPEOFGONiRAC10AOFRUiHOAIZEDPGENi OAiE � <br /> ,��, �� ;l,�P, K �!.A' ��, . ,r�.����.�v -��.1aie �_�_�.. <br /> � � � % W__,�,;r,J �. �����ri,� . �� /5�- �Yl <br /> y py �PROJECTADDRE55, ,1 APPLICA TSGiTBO51NE55LICE SEN ANOBUS�NESRNAME <br /> / . � C, > <br /> PLUMBING MECHANI�:AL <br /> Np. TYPE OF FI%TURE ON ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> G WATER CLOSET(TOILET) A/C-A/HNDLf UNITS-M.P. <br /> {, BATHTUB PiIRCEDAIRSVSTEMS-BTL. MEA <br /> I '�� UNi?HEATERS-BT.U. M <br /> _ ' LAVATORV�WASH BASIN) GLOTHES�RYERS _ <br /> SHOWER <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> ��.. � DISHWASHER RANGE HOOD <br /> � I LAUNDRYTRAY WATEiiMEFTER <br /> CLOTHES WASHER W�OD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> '� � DRINKING FOUNTAIN FIREPLACE INSERT <br /> � <br /> �i FLOOR DRAIN <br /> FIEAT^J�'P <br /> BACKFLOW PREVENTERS GAS PIPWG � <br /> � <br /> ROOF�RAINS-RAINLEADERS E%HAUST FAN <br /> `'� SINK(SERVICE-BAR,ETG) � <br /> '��r <br /> i! - <br /> SUBTOTAL S SUBTOTAL 5 <br /> I_'�' PERMIT 4 PERMIT 5 <br /> TOTAL FEE S TOTAL FEE 5 <br /> FPONTSETBAGH dE/•NSELBAGN St�ESEfBACN PUNCHECI(HUMBEN FEE PECE�PfHO. <br /> � � <br /> uSEzoNE LOTA]EN vecnr�rsrt[ FEES VALUPTION FEE <br /> ❑YES ❑NO <br /> BUILDING <br /> ttPEOFCANST OGLIIPANCYGFOUP NOOFOWELLINGUNIiS <br /> p��pWABLE/ACTUAL pLUMBING <br /> SIZEOFBLDG NC.OFSiORIES OSMT. OCClOnO MECHANICAL <br /> ❑Y <br /> ❑N <br /> dE1GMiUMiiATiON OTHER <br /> rieEsrai�uaePSeEowaEo ❑YE+ ❑xo STATE BUILDING SURCHARGE <br /> ST,1TE ENEPGY SUHCHARGE <br /> APPLIGATIONFGC.OT PlANSFPPP 9Y PUBLIC WORKS <br /> TOTAL <br />