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,.<<�� '� <br />APPLIC�ii�i ION FOR CONSTRl;.'�.TION! <br />F'ERMIT <br />fhs Erorpreen everetl <br />CITY OF <br />everett e <br />BUILDING DEPARTMENT <br />259•88t0 TO BE C061PLETED IN INK— PLEASE PRINT <br />APCIIITECTONOESIONER MAIL�OORE59 CILY ZIP PMONE <br />OENER�LCONTPI�GIOR M�R�DDnESS GITY 2�P VHONE LIGENSE• <br />5�c.ve.eua� Cr�usr�. �u�. �o•ao,c si�s �ve��{-+ y8zo6 as-a-�13( sscv�si�iti <br />� MECH�NIGQCONTR�GTOR � M�IL�UDRE55 CIfY 21P PNONE LICENSE• <br />0.UMBINOCONTMCTOR MML�ODRE55 CITY IIP PNONE LICENSE• <br />NEW ❑ AD�ITION ❑ RITERATION ❑ REPAIR ❑ �EMOLITION ❑ WOODSTOVE/FPPLINSERT ❑ BUILDINGRELOCATION <br />. CONTMCTPPICEOFWORK �EA.�J <br />p[pGpllE WOPR �ND SOUME FOOTAGE I! <br />� Ne ul G�+�Ge � <br />� rrqy�eouseoreuamNo <br />7'R�rc C�+i� <br />LEOK D[HGIIPTION UF flipl'ERtt ISNOW <br />�otSQ�le�ocK tl0.'1"D'Do'� <br />• �A F fDM 3 W Co/L i <br />i, a� e ios Fr ,� rva <br />'' ��y. of Gr- rN ,vor � <br />.. PROJECTAODRE99 <br />�: 71q DeXr�,e <br />vwrsiNo /.lo[,,� <br />e <br />— WATEP CI <br />BATHTUB <br />P7697 <br />URINAL <br />FIOOP DRAIN <br />BACKFLOW PAEVENTERS <br />ROOF DHAINS — RAINLG <br />SINK ISER�ICE — BAR, ETI <br />SI2E OF BLDQ <br />LIRE 9PRINKLERS REOUIRFO <br />'xia' — �b8 �F <br />!LOW ON �R�CN FOUN COPIES� <br />�AIKVIEcc� NEIG�{t3 <br />� y�ro rN 58fJ * �3 <br />todr ��a a7e <br />ReF*.�rv �«r NBR <br />G o 3 E Fo� e,00co u-��t nEs <br />OR ITEM FEE <br />i�JB TOTAL b <br />�ERMIT S <br />'OTAL FEE S <br />SETB�CR SIDESEIBr�CN <br />5 � ,�5� <br />qEA VAC�NT511� <br />O YE3 ��NO <br />PANCY=POUP NO.OFpWELI�NOp <br />_} 1_ <br />GTORIES esMr. xci fo <br />I ❑Y <br />ON <br />I HEFEBY CEtiTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION ANU <br />KNOW THE SAME TO BE TriUE AND CORRECT. AlL PROVISIONS OF �AWS AND <br />ORDINANGES GOVEFNINO THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHEfi SPECIFIED HEREIN OR NOT.THE GRANTINGOF APERMIT DOE9 NOT <br />PRESUME TO GIVE AUTHOR�N TO VIOLATE OF CANCEL THE PROVISIONS OF <br />ANY OTHER STAtE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE PER� <br />FORMANCE OF CONSTRUCTION. THA1 I AM AUTHORRED BV THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE <br />AND I COMPLY WIiH THE STATE CONTRACTORS LAW 18.27 RCW 11ND <br />296200 WAG <br />SIGN�TU ONIP�GTORONFUTNOIi2E��GENi �A1E <br />X �%'(tif � . t,..,.�...... Z�ZI ��5' <br />�PP IG�NI CITYBUSINESSUCENSENO.FNDBUSINESSN�ME ��%— <br />MECHMNICAL /JO/JF� <br />NO. TYPE OF EOUIPMENT <br />A/C — A/HNDLO UNITS — H.P. <br />FORCED AIH SVSTEMS — 6T.U. M[A <br />UNITHEATERS—BT.U. M <br />CLOTHES DR1'ERS <br />VENTIIATION FAN <br />i7ANGE HOOD <br />WATER MEATER <br />WOOD STOVE <br />METAL FIREPLACEB CFI:MNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING __ <br />E%H.4USTFAN <br />SUB TOTAI <br />PERMIT <br />TOTALFEE <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />OTHER <br />STATE BUILDING SURCHARGE <br />STAiE ENERIiV SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />