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.. _ :���� <br />•.-� <br />APPLICAf10N FOR CONSTRl�CT10N <br />PIERMIT <br />1he Everpreen everett <br />CITY OF <br />everett e <br />BU�LDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK — PLEASE PRINT <br />OWNER M�ILADDRE55 CITY 21P PHONE <br />'���,, Fra►�1►i, ASIb A\vexx� S3l�Q. ��exc}� 942c1 252-b��F9 <br />'w S M�ILADDRE55 CITY ZIP PMONE <br />��r}�r►u.s�d.. Stb 141ue�so�'31vd. Euc.�ctt 9$2c1 252-b449 <br />�g� o IdNE�P� ,� �DDRESS � 532 Ccm�o�.� 9�.�P 98z 9Z b�9 - 3µ4 I <br />GENERAL��I.T R M�IL��OflE55 CITY ZIP PMONE LICENSE• <br />VAIJJG� <br />('��q,h.V�. .�$�Ipy��--Aoe �kf#d��;,: w�ed�—q��-- l� q-3196 -saaco BK <br />MECH�NICAL CONTP�CTOP Mn�L � ���ESS CITY 21P PNONE LICENSE • <br />(o9cv �// - �`u..vta.<-c� �. 5u �rj,Z <br />PLUMBINOCONTR�GTOR <br />BI NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />CONTRAGT <br />S� <br />,��„�,n.,,�.�� <br />,c3�,b�, AQP�. zqoo <br />� <br />LO' BLOGK OF <br />PLUMBING <br />TYPE OF FIXTUHE OR <br />IAVATORV (WASH BASI <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />YaIWL �i1dQ.� <br />DflINKINO FOUNTAIN _ <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />Zo' <br />USEZ _ <br />IVPE OF CAN!T. <br />�LLOW�BLE/ACTUIL <br />T-IJ <br />512E Of BLDl3. <br />2% S� <br />ieJ`� <br />FIPE9Pf11NNEfi5RE0UIRED O <br />�PPLICQION ALC.OV <br />1��„\ <br />SUBTOIAL _ <br />PERMIT <br />TUTAL FE� <br />R SETBACK <br />� ' -- <br />AflEA <br />UPA� R� � <br />2_3 <br />Z <br />Y <br />u <br />(:UNII�I:I YCMJVli nrvV Y1�VnC rvV <br />Zo nma ���a,►.klih Z52-b'W9 <br />Y�"y K/a_ua a�i/ee�_ loa9-3�9v _ <br />I HERE9Y CERTIFY THAT I HAVE PEAC' AND EXAMIN ED THIS APPLICATION AND <br />I:NOW THE SAME TO BE TPUE AND CORRECT. ALL PPOVISION9 OF UWS AND <br />CRDINANCES GOVERNINO TMiIS TfPE OF WORK WILL BE COMPLETED WITH <br />VlHETHER SPECIFIED MEREIN OR NOT. THE ORANTINOOFA PERMIT DOEB NOT <br />PRESUME TO GIVE AUTHORIiV TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHEF STATE OR LOCAL LAW F'EOULATINO CONSTRUCTION OH THE PER• <br />FORMANCE OF CONSTRUCTION. TriAT I AM AUTHORIZED BV THE OWNER OF <br />THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICAl10N 13 MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAG <br />SIGN�TUPEOFCONiRAGTORORAUiMORIZEOAGENT D�TE <br />X ��y,,v�,�,. � . �,a.A..JL, 7 - Il - 89 <br />APPLICANTS LITY BUSINE55 LICENSE NO AND B1151NE5S NAME <br />MECHANICAL <br />FEE NO. TYPEOFE�UIPI <br />A/C - A/HNDLG UNITS - Ii.F <br />� J_ FORCED AIR SYSTEMS- &7 <br />"" UNIT HEATERS- B.T.:1. M <br />= � CLOTHESORVERS <br />� VENTILATION FAN <br />� FANGEHOOD <br />_' WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 6 CHIMNI <br />FIREPLACEINSERT <br />HEAT PUMP <br />� <br />S <br />S <br />IOE SETBACK <br />C. � <br />�CANT SIiE <br />w415 ❑ NO <br />/ <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FEE S <br />H a � °— <br />FEES VALU <br />BUILDING � <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BU LOING SURCHARGE <br />STATE ENERGV SURCHARGE <br />PUDLIC WORKS <br />TOTAL <br />FEE <br />FEE <br />A <br />