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APPLICNTION FOR CONSTRt.CT10N <br /> PERMIT <br /> the Everpreen <br /> CITY OF <br /> everett `°efe" <br /> BUILDING DEPARTMENT � <br /> 259-8810 TO BE COMPLETED tN INK— PLEASE PRINT <br /> OWNER , MAILAD�RE55 LITY :IP PHONE <br /> � f�•r ��/1��'�,�. .&����� ,C�:k�'e��Fi�E.�� `�h•��8 �,��-<���,'G'f <br /> TENANT MRILADDPE55 GIIY ZIP PHONE <br /> I��i�.�E�J�r��/b���.� /�/C'% /�C'�f C'f/� �i��lr/�i� �4�i f <br /> �RCNITEGTOROESIGNEP MAI�ADOflE55 CITY J / Zip PMONE <br /> GENERR�WNTRAGTOR MpILADORESS CRY ZIP PHONE �ICENSE� <br /> ��r,��Ar r-- ���f-C��'"4� <br /> MEGNRNICRLCONTRFCTOR MqIIADOPESS GTY ZIP PMONE UCENSE� <br /> PLUMBINGCONTRAGTOB MAILpODRESS CITY 21P PYONE LICENSE• <br /> C�U(SS OF YpRN — <br /> yY NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TEN�NTIMPRpVEMENTORINTERIOPREMO�ELONLV � CONTAGTPERSONr1NDPHONENO <br /> �NTR�GTPRICEOFWORK ' '� J�_ <br /> DESCFIBE WOR"K�ANO SOUARE FOpTpGE INJOLVE <br /> �F'lc� /-/!'I7,'C <br /> PROPOSED USE OF BUILDIN� <br /> I H EREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> �• /'-• �fS/�F�7G�' KNOW?HES�METOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> LEGAL OESCqIPT10N OFPROPERiY�SHOWN BEIOW OR RTfACH FOURCOPIES) ORDINANCES GOV'cFNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br /> L /' WHETHEP.SPECIFIEDHEREIN OR NOT.THEGRANTING OFA PERMITDOESNOT <br /> �or�m��'V BioCK oF��/C���.�- ,Ct t�t� E. PRESUMETOGIVEAUTHORITYTOVIOLATEORCl+NCELTHEPROVISIONSOF <br /> C ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br /> ��` ' �'� ��1� 7 / �If I(Ii O/ ��X THISPRO EP.N O ERFORMTHErWORKFORWH�ICHAPP ICATIONISMADE <br /> AND I COMPLY WITH THE STATE CONTRACTOFS LAW 1827 pCW AND <br /> / /I�� 9 �o f!x �'/,!f t�/1f.�o/' zsc.zoownc <br /> �/_%(,f�/j� �J�(O/ !A SIGNATUHEOFCONTRRCTOROiAUT110RIZE0AGENT DFTE <br /> � '� <br /> �k'�tr�.t��:.���/. �r���QfS 7�;1�V /f�• .�C'd. X� C l�'li' ll�r,�'I�� /F J�� <br /> PROJEGT�DpRE55 <br /> APPUCANTSpiYB SINESSLICENSENOINDBUSINESSNAME <br /> 7C�'�'.D.v/�;�•%O .L/!. GC'f/�� <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> �' WATERCLOSET(TOILEf) A/C—A/HNDLGUNTS—H.P. <br /> '' 8.4THTU8 ? FORCED AIR SVSTEMS—B.T.U. M EA <br /> " LAVATOFY(WASH BASIN) � � ✓ UNIT HEATERS—B.T.U. M <br /> SHOWER - — / CLOTHES DRYERS <br /> -/ KITCHEN SINK 8 DISP. VENTILATION FAN <br /> / DISHWASHER FANGE HOOD <br /> / LAUNDRVTRAY �^ / WATER HEATER <br /> / CLOTHES WASHER ` / WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CFi�MNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS �� CaAS PIPING <br /> S ROOFORAINS—RAINLEADERS EXHAUSTFAN <br /> SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL g 1 '—' SUBTOTAL 5 <br /> PERMIT $ PERMIT 5 <br /> TOTALFEE g i TOI�LFEE 5 �— <br /> FqONTSEtBACK � REpR5E1BAG�./ SIDE�:BnCK PIAN�EC.�OE��� FEE�/��`p IIECEtPTNp�����` <br /> `8� S � 7 S � � j <br /> usezor+e LOT�Rd VACRNTSITE FEES VAIUATION FEE <br /> � � / �') � ES ❑ NO <br /> �� 6UILDING 46 <br /> ttPEOFCANST. OGCUPRNGYGHOUP NO.OFOWELLINGUNITS Q�_ <br /> AILOWABLE/ C UaL `� � <br /> � PLUMBING J /;��) <br /> 512EOFBLDG��.� NOAFSTORIES &SMi OCGLORD L��� <br /> �SSf � j�� MECHANICAL 1 �� -_ <br /> N <br /> NEIGHTLMITBiION OTHER � /i l, � <br /> / //i <br /> FIRE SPRINNLEPSREOUIFED ❑YES NO � STATE B ILDING SUHCHARGE � �\ <br /> STATEENERGYSURCHARGE <br /> APPIIGATION ACG BY PUNS FPPq.BY <br /> 9� PUBLIC WORKS <br /> TOTAL �/ C / <br />