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APQLICATf�N FOR �ONST�i�uc:T10N <br /> PERMIT <br /> fha Evelgreen trv��rcli <br /> CITV OF <br /> everett � <br /> bJILDING DEPkRTMENT i <br /> 259-88�0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> A OWNER MAILADDPE55 GIIY 11P FIION[ <br /> `.�_`t_1ZM �� S"���.(�'L �-I lrC-9 t-L 1�� t l�t I�i 7T4 u`r 1 - I <br /> iENPNT AUILADDREBS GItY ZIP PIIONE <br /> ANCNIICGTOROESiGNEA RUI��O�RE55 GIiY ZIP PMONE <br /> OENER�LGONiP�fTOR �h ; iti�oon „� .� 1 �. QIY ZIP PIIONE LIGENS[• <br /> ��� 152 i. Marine V�� Dr. ��Itfl U��Ck- )��1-- <br /> ��� MELMANIGALGONIRAGIOR E��� ayy��-pflq,�wbn 9R201 I:ITY 21P PMO'IE LILENSE• <br /> 2:!!J'ZYYl I�/7�J <br /> syy PWM8INGCONIRAGiOR ti'�>�LAOOPE55 CiiY ZIP PHONE UGE115L� <br /> F3 �H GL�SSOF WORK <br /> � F3"�C ❑ NEW ❑ ADDITIOY ❑ ALTEFATION ❑ REPAIR ❑ DEMOl1Tl0?I ❑ WOODSTOVE/FRPL INSEPT ❑ BUILDING RELOCATION <br /> � N� 1EN4NIIAIPROVEMENTORINiEN10NHEMO�ELONLV GONiACiVENSONPNDP',�MONENO � <br /> y� GONTRfGTPR'CEOFWORK ���•C� ���I} ��L\ �II1 � <br /> yz DESGRiOEWORKPNO50UPFEF00AGEINVOLVE� I <br /> � y d (��Ct__������' _�-- �r�`�.lh�l\ l:�i �ri� ���k-�����_� __ <br /> ve0wsenuseov i�oi c IHEREBVCERTIFV?HATIHAVEREADAND[%AMINEDTHISAPPLICATIONAND <br /> "'.GH �C7 I���� �Q,��('Q . KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVIS'ONSOFLAWSAND <br /> 0 ORDINANCES GOVERNING TH:S T'PE OF WORK WILL BE COMPLETED Y�ITH <br /> �� � LEG0.0ESGR�P1iOMOFF�EPttISNOWNBELOWONATiPGMFOIIRCOP1E51 WNETNERSPFCIFIEOHEREINORNOT.THEGRFNTINGOFAPERIdITDOESNOi <br /> zy� FRESUh7ETOGIVEAUTtIORITVTOVIOLATEORCANCELTHEPROVISIONSOF <br /> � �pT BtoCK OF ANYOTHEFiSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> z FOR�dANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNEF OF <br /> f.{H] THIS PROAERN TO PERFOR�d THE WORH FOR W HICH APPUCATION IS MADE <br /> �y y AND I COMPLY WITH TML STATE CONTRACTORS LAW 1827 RCW AND <br /> � N 296LOOWAC. <br /> O C� SIGNFLOPEOFCONiRPCiORORAI�➢�ORIZEDAGE.'R D�LE <br /> � �r � � � ���_�� <br /> y o v��, X �-',-��t��— "d�9-���_ <br /> PROJEGT�DDPE55 ppp�i�ANiSCIiYBCS�NE55 .ICP�SCNOAN00VS4E`S�U E <br /> ��G(�`� k�-- i�� � ��1�C� <br /> PLUMBING MECHANICAL <br /> NO. TYPEOFFIXTUiiEORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> �� WATERCLOSET�TOILET) — A/C—A/HNDLGUNITS—H.P. --- <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U:IrJM EA <br /> I!�� LAVATORV�WASHBHSIN) UNITHEATERS—B.T.U. M <br /> ! SHOWER CIOTHESDRYEPS <br /> ' KITCHEN SINKB OISP. VENTILATION FAN _ _ <br /> �IE.,� � DISMWASHER RANGE HOOD = <br /> ti � I LAUNDRYTRAY I WATEpHEATER <br /> ' CLOTHES WASHER WOOD STOVE _ <br /> URINAL METAL FIFEPLACE 6 CMIMNEV _ <br /> I � "'� DRINKING FOUNTAIN FIREPLACE INSERT <br /> I !! FLOOR DRAIN HEAT PUMP _ <br /> �. BACKFLOW PREVENiERS � GAS PIPING <br /> � � � ROOFDRAINS—RAINLEADERS E%HAUSTFAN _ <br /> �_�� SINKISERVICE—BAR,ETC.) <br /> �� � -- <br /> �, SUBTOTAL 5 SUB70TAL 5 _ <br /> s <br /> I ' PERMIT 4 PERA7IT S __ <br /> ^'�s <br /> TOTALFEE 5 TO?ALFEE 5 <br /> �RONi5Et0A�N PUPSLIBAGN SIpESEiBAGK PUNCNECNNURIBEN( //^ FEE PECEIP�HO. <br /> �� ���� �.'. '1C/ <br /> usezon[ LOiAREA VAQNi51iE FEES VALUPTION FEE <br /> ❑YES !:NO <br /> BUILDING <br /> ttVEOFCANST OCGVPANGVGROUP NOAFDWELLINGUNrtS — ""—� <br /> QLOW�BIE/ACipAL PLUMBING <br /> SaEOFe�oG rvooruToaies &SML OLCLOAD MECHANICAL <br /> ❑v _ <br /> ❑ N <br /> NEiGNTLIMIUiION OTHER <br /> vw�svmHn�easneouiaeo ❑res ❑No STATE BUILDING SURCMARGE <br /> STATE ENERGV SURCHAFGE _ __ _____ <br /> APPLIL�➢ONACCOY PLANSAPPRBY PUBLICWORNS <br /> roia� <br />