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", t�i ,,,r:;�� <br /> i „ APPLIC���'IpN FOR CONSTRI�ii,.T10N <br /> j PERMIT � <br />:I fhe Everproen <br /> CITY OF <br /> � everett eVPfC. <br /> , � " <br /> � BUILDING DEPARTMENT <br /> 259•8810 � / Tq BE COMPLETED IN INK- PLEASE PRIN <br /> � �d7L.�/vN /S /Vo�1j/< AIL�DfEG�? GG�-�vwoo�nY I�U� Zp �trr�,r,-ra�a 98�0� 339 /2/B <br /> , <br /> � N�Ni M�IIADDRE55 CIiY ZIP PHONE , <br /> � ARGHITECTONOESIONER MAILRDORE55 CITY ZIP PMONE <br /> I <br /> 1 <br /> OENEN�LCONTRAGTOR M�IL�ODRE59 <br /> � CIIY ZIP PHONE LILENSE• <br /> 4 � <br /> I'f MECN�NIC�LCONIRAGTOR MAIL�DORESS CITY ZIP PMONE LIGENSE• <br /> i �Il,_?Ylc� , . <br />�� v�VlnemuwNl �CTOF M�ILAODRE54 QTY ZIP PHUNE �IGENSE• <br />.l ' <br /> I, \CU990FNORI( <br />�j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION ' <br /> 1� tENMIT IMPNOVEMENT Ofl INiER10t1 NEMO�EI ONLY CONi�CT PERSON RNO PIIONE NO <br />��� CONTRAGiPPICEOFWORK <br /> DEBCRIBE WORN AND SOU�RE FOpUGE INVOLVEO <br /> j x�Nrr.s« GAs P��d�G'�vr�on .��'nc�h�-Ar�or <br /> RqP09E0U9EOFBUIlDINO ,�'NJ L S � /�IC' TLz'R <br /> � I H EREBY CERTIFV TNAT 1 NAVE READ AND EXAMINED THIS APPLICATION AND <br />�j �- -SJN�LGs x�MIG /E��,f/p2?'NCLs NNOWTHESAMETOBETRUEANDCOR(7ECT.ALIPROVIS10N50FUWSAND <br /> LEMLDE9CRIPTIONOFPqOP[FfY�SHOWNBEI OF�TT�CHfOUPCOPIESI ORDINANCESGOVERNINGTNISiYPEOFWORKWILLBECOMPLETEDWITH <br /> W HETHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOFS NOT <br /> j l0T BlocK pF PRESUME TO GIVE AUTHORITV TO VIOLt1TE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br /> � FORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE OWNEH OF <br />� THIS PROPERN TO PERFORM THE WORK FOR WHIGH APPLICATION IS MADE <br /> AND I COMPLY WITH 7HE STATE CONTRACTORS LAW 1827 RCW AND <br /> 298200 WAG T� <br />� SION.ITUREO 0 IMCIOqONR iNORI 0 . N//iG' W ' ��� <br /> X '-'' <br /> rpWECTAODIlE93 V�JC.�"JJ- �pp��CANTSCITYe 5�NF6LSIGENSENO.�N�SIIIESSN�ME <br /> r �3 GG� �voo /�U�o �Wn �. <br /> . PLUMBIN6 MECHANICAL <br /> '�'NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br />'� � WATERCLOSET�TOILEq A/C—A/HNDLGUNITS—H.P. <br />� BATHTUB FORCED AIR SYSTEMS—9T.U. M EA <br />� LAVATOFY(WASH BASIN) UNIT HEATERS—&T.U. M <br />,� <br />� ' 3HOWER CLOTHESDRVEt75 <br />� <br /> i� ,� ' KITCHEN SINKB DISP. VENTILATION FAN <br /> !" DISHWASHER <br /> RANGEHOOD <br /> LAUNDRYTRAY WqTERHEATER <br /> I� CLOTHESWASHER � � WppDSTOVE _ <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br />�h DRINKINO FOUNTAIN FIREPLACEINS�RT <br /> FLOORORAIN ' HEATPUMP <br /> BACKFLOW PREVENTERS OAS PIPINQ <br /> �� ROOFDRAINS—RAINLEADERS� EXHAUSTFAN <br />�� � SINK�SERVICE—BAR,ETQ) <br />�� <br /> ISUBTOTAL 5 SUBTOTAL '• <br /> 1 PERMIT E PERMIT S <br /> TOTAL FEE E TOTAL FEE S <br />� FRONTSET6�CK REAfl5ET8�GN SIOESETBI�LK PUNCNEGKNUMBER FEE PECEIPTNO. <br /> I USE20NE �otnnu VRL�NTSITE FEES VALUATION FEE <br />� �', O YES O NO — <br /> TYPEOFLONST. OCGUPANCYpROUP NO.OFOWEIIINUUNIT9 BUILDING <br /> QLOW�BLE/ACTUAL <br /> PLUMBINO <br />, BIZEOFBLOQ NO.OF9IORIE9 BSMi. OGGLOAD ^� � <br />� . �Y MECHANICAL d/ <br /> pN <br />' NE16NTlIMI1�710N OTNER <br /> J FIRE9PRINNLEfISPEOUIREO o res o r+o STATE BU�LDING SURCHARGE <br /> 1 <br />! STATEENERGYSURCHARGE <br />( MPLICATION�GGBY PLANBAPPROY — <br /> PUBLIC WORKS <br />� <br />� TOTAL �� 5� I <br /> I <br />