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.-� <br /> �:;:t; :,'�i <br /> `•'i-' E't:� � <br /> APPLICATION FOR CONSTRUCTION � <br /> PERMIT �. <br /> fAs Ewrpreen f <br /> CI7Y OF everett <br /> everett e ' <br /> , <br /> BUILDING DEPARTMENT <br /> 259-eB10 TO BE COMPLETED IN INK— PLEASE PRINT <br /> . <br /> OWNER hUI��DDIiE55 GITY ZIP PNONE I ' <br /> .� ii r��,fe �J 8'`f/�' E'Mf�vo�J �G. E�F��tir�— � r <br /> �N�NT MFIL��DNE55 CITY ZIP PMONE � <br /> ' �/� M� i . I ' � <br /> RICMITECTORDESIGNEq NAILADDPESS GITY 21P PryONE � , . <br /> 6ENEMlGONTBACfON M�ILAODHESS CITY 21P (n PqONE UCENSE• <br /> /�-�erTS J'a..�+h �<d �<{�f 0<f Jniokacy Pr:rT P�✓i nnanyJdi�c£ ott/�— �)bn� i?!A-iy i <br /> MECHANIGILCANTRAGTOR MAILADOflE 5 CITV ZIP PIIONE IICENSE• ` <br /> PLUMBINOCONTIUCTOR MAIL��OFE95 CITY 21P PHONE , � �ICEN9E{� ;, <br /> ! <br /> � cussorwon�. <br /> ❑ NEW ❑ A�OITION ❑ ALTEMTION ❑ REPf.IR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGHELOCATION •� I � � {L <br /> TENNITIMPpOVEMENTORINTERIOpREMODELONLY ��j ,l �N CI,�_ /C CONTpCTPEHSpN�N�PMONENO. �, I� <br /> �" �'IOJI 1 <br /> CONTMCT Mi10E Of WORK 4 <br /> DEBCRIlE WORK ND SOUAl1E FOOTAOE INVOLVED � S -I' �� <br /> I' <br /> PIqPOSEO BUILDIN � �� <br /> GGt • IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND �' <br /> ry(�`A G�£ KNOW THE SAME TO BE TRUE ANO CORRECT.ALL PqOVISION$OF UW3 AND <br /> LEOALDE9CpIPfIONOFPRIX+Efltt�SMOWNBELOWOR�TIACHFOURGOVIES) ORDINANCESGOVERNINGTHISNPEOFWORKWILLDECOMPLETEDWITH <br /> WHETMERSPECIFIEDHEREINORNOT.THEGRANTIN60FAPERMITDOESNOT ; <br /> �oi.�� e�ocK Or PRESUME TO GIVE AUTHORIiY TO VIOLATE OR CANCEL THE PROVISIONS OF : <br /> ANYOTFIERSTATEORLOCALLAWREGULATINOCONSTRUCTIONORTHEPER� � <br /> (��'� — FORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BY THE OWNER OF i <br /> �j�(a(S2�r �, TNISPROPERiYTOPEFFORMTHEWORKFORWMICHAPPLICATIONISMADE ' � <br /> AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 7g,27 RCW ANDI <br /> 296200 WAC. <br /> 516NATUNEOFCONTMCTOflOR�UTHORIZED�OENT D�TE I� <br /> PROJECT�DOPESS � / " C /5�+�-�-� OC.•T �/� I ! I� � <br /> APMIC�NTSCITVBIISINE53LICENSENO.ANDBU51NE59N�ME � <br /> F1q15 � <br /> PLUMBINO MECNANICAL . I' t <br /> NO. TYPEOFFII(TUREORITEM FEE NO. TYPEOFE�UIPMENT FEE i� � <br /> WATER CLOSET(TOILEn A/C--NMNDLG UNITS—H.P. b <br /> } <br /> BATHTUB FORCEDAIRSYS7EM5—B.T.U. MEA i <br /> LAVATORY�N/ASH BASIM UNIT HEATERS—B.T.U. M � <br /> BHOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWA3NER RANGE HOOD <br /> LAUNDRY TRAY WATEq HEATER � <br /> CLOTNES WASHER WOOD STOVE ' <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PI�ING <br /> ROOF�RAINS—FAINLEADERS E%HAUST FAN <br /> 91NK(SERVICE—BAR,ETG) <br /> r <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT 5 PERMIT E <br /> TOTAL FEE S TOTAL FEE 5 <br /> FIiONTSETB�GK flEAfl5ET9�L1t 910ESETBRCK PUNCNE NUMBER fEE pECE1PTNO. � <br /> ' ' c ' a3�8'3 �c'a 6S a fo S� ; <br /> usex E IOT�qEA V�GNTSITE FEES VALUATION FEE <br /> ��, O YES �NO <br /> TYPEOiGONS}," OCCUP�NCYGBOUP NO-0fOWELLINpl1NIT5 BUILDING . � <br /> �LLOW�BLEUCTUY� <br /> .l'N � "/ I PLUMBING <br /> SI2EOFBLIXi. NO.OFSTORIES 0.5MT. OCGIO�U - <br /> �OO S'F � �Y �� MECHANICAL <br /> HEIGNTLIMITATION OTHER <br /> ZB � <br /> FIRE SPRINKLERS REOUINED O YES NO STATE BU�LDING SURCHARGE � <br /> STATE ENERGY SURCHARGE <br /> •PPLICATIONACGOY PLANSAPPR9Y <br /> � � /J PUBLIC WORKS . � <br /> � ��� TOTAL <br /> � <br />