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1.. ;;J';� <br /> APPLI�.�aT10N FOR CONSTF��JCTION �c �� <br /> PERMIT <br /> (he Everpreen everett <br /> CITV OF <br /> everett e � <br /> BUILDING DEPARTMENT <br /> 259•BBto TO BE COMPLETED IN INK-PLEASE PRINT <br /> �j�i(_� Lro�tt- �t I 1����L�1��u�iP ��� ����r�� �f�ol a5a-�¢i.o[d$' <br /> IEN�NT MRILADORE55 CIIY ZIP VNONE I <br /> ♦IICIIItEGTOROESIGNER MAIUODf1ES5 dfY ZIP PHONE I <br /> GfNER�LCONIR�CIOfI M�IL�ODI165 � GIIY lIP PIION@ UCENSE• <br /> I p���TMCTQR�. /� ��������� �'�G�' CIi� /'�� � ����� � LICENSE• <br /> � N r=a.JQ »- l�( ]��l <br /> ��- � OC(IL �`.Yl1 <br /> 1'LUMBINOCON AGiOR M�ILAOC�[SS CIIY ZIP PNOhE LIGENSE• <br /> CUSS OF WORN <br /> ❑ NEW ❑ ADDITION ALTERAT�ON ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FqPLINSEFT ❑ BUILDIN6RELOCAiION <br /> TENIINT IMPROVEMENf OR INTERI ODEL ONLY�� CONT�CT VERSON�N�PIIONE NO. <br /> CONTRACTPRICEOFWppIC �� � I <br /> pFSCR�WORk�S�EiGOT;0EINVOLVED �� � �i�� I <br /> 1 � II <br /> �-� � <br /> Pp0 OFBUILDING IHEREBYCER�IFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND ' <br /> ���� KNOW THE SAME TO BE TRUE AND CARRECT.ALL PROVISIONS OF LAWS AND <br /> LEOQ OESCHIPiIONOF PPOPEf1iY�5HOWNBELOW ORATUCH fOIIRCOPIES� ORDINANCES GOVERNING iH15 TYPE OF WORK WILL BE COMPLETED WITH , <br /> WHETHER SPECIFIED HEREIN OF NOT.THE 6RANTING OFAPERMIT DOEB NUT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR C/W CEl THE PROVISIONS OF <br /> ��t e�ocK oF ANVOTHERSTATEORLOCAILAWREGULATINOCONSTRUCTIONORTHEPER• <br /> FORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE OWNER OF <br /> THIS PROPEFTV 10 PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> — AND I COMPIY WITIi THE STATE CONTRACTOPS LAW 18.27 RCW AND <br /> 296200 WAC. <br /> SIONROREOFCONIA�CIO�OR�UTNORIZEDA6ENf U�LE <br /> X �c�LsHw �ut�cicJ /v/a�/fi9 <br /> ppp.��� DD��SS ���� /� _ _�_ �PPLIG� SCIfYPlI51NE55LICENSENO.AN�BU5�NE55N�ME <br /> /1 /�� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn A/C—A/HNOIG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS•-0.T. EA <br /> LAVATORY(WASH BASIM UNIT HEATERS—&T.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINK6 DISP. VENTILATION FAN <br /> DISHWPSHER RANGE HOOD <br /> I.AUNDRV TRAY WATER HEATER <br /> CLOTHES WASHER WOOU STOVE <br /> URINAL METAL FIREPLACE 6 CHIMNEY <br /> DRINKINQ FOUNTAIN FIREPLACE INSERT <br /> FLOOR ORAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADEPS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.� — <br /> SUBTOTAL S SUBTOTAL S I S <br /> PERAnIT S PERM�T S <br /> TOTAL FEE S TOTAL FEE E <br /> fItONBE1B�GN BE�NSETD�GN SIpES[10ACft P:JINCNECRNUM6EN FEE RECEIPTNO. <br /> u�ezorvE �Ot�nen vncamsn[ FEES VALUATION FEE <br /> U YES It NO <br /> BUILDING <br /> IYfEOFCONST. OGGUPANCYGROUP NO.OfOWCLLIN0UN05 - - <br /> nurnv�e���erue� PLUMBING <br /> sr.c or Btoci No.or siome9 osM�. ota�o�o ',7 JC'a <br /> ��r AIECHANICAI <br /> I/N <br /> uEimntiMnn�wr+ OTHER <br /> nnc srnwK�ensneouineo ❑YE9 o r+o STATE BUILDING SU(iGIIANGE <br /> STATE ENERGY SURGHAFiGE <br /> �PPIIC�iION�CCBY PL�NSMPf1.BY <br /> PUBLIC WORKS <br /> TOTAL ,7 � <br />