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APPLIC�+r10N FOR CONSTR►��TION <br /> PERMIT <br /> fhs Evarpreen <br /> CITY OF <br /> everett e°efC1 <br /> BUILOING DEPARTMENT � <br /> 259-88�o TO BE COMPLETEa IN INK— pLEASE PRINT <br /> avNEn Mea�ooness ��c�nr � zir PIIONE <br /> Cl����lC •��L� S E. 2���T7 �i�LL� <br /> TEN�Ni MAIIADDRE55 GIiY ZIP ��ONE <br /> � <br /> MCNITECTORDESIGNER —_ MAILROORE55 i�P P110NE <br /> ��..Z.r�G • ��,r <br /> OENER�LGONiR�GTOF MAIL�ODPE55 CRY ZIP PIIONE 4GENSE• <br /> MECM�NICALCONiR�CTOR M�IL�DORE55 CITY ZIP PNONE �ICENSE• <br /> VLUMBINOCONTR�CT011 MMIADOf1E55 CIiV ]iP PIIONE IiCENSE• <br /> l.�o.v.s��� /g�2?.l��,P.o�� �ii b�z-�/�a �.�-,�• <br /> �J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPLINSERT ❑ BUILDIN6HELOCATION <br /> 7ENINTIMPHOVEMENTORIM I_RPEMOOELONLY �� �pNTRCTPER50N�NDP110NEN0� � <br /> OONfMCi PRICE OF WnflK�^�Ov�/• �� �I'Ci_Y LL� � TZ ��/�_ <br /> OEBGRIlEWORK�N090U�REFOOfAOEINVOLVEO — F= <br /> Pip EOUSEOFBYILDINO <br /> X 1 HEREBV CERTIFY THAT I NAVE READ AND EXAMINED THIS APPLICATION AND <br /> KNOW T HE SAME TO BE TRUE AND CORR[CT.ALL PROVISIONS OF LAWS AND <br /> LE(ULDESCRIPiON FqOPEPTV�5110WN8ELOWOpATTRC11i0URGOPIE51 ORDINANCESGOVERNINGTHISNPEOFWORKWILLBECOMPLE7EDWITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> lOT___ BIOCN ov PAESUMETOGIVEAUTHOFINTOVIOLAlEORCANCEITHEPROVI510N50F <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PEF- <br /> FORMANCE OF CONSiRUCTI .THAT I AM AUTHORIZED BY THE OWNER OF <br /> TNISPROPERNTOpE M EWORKFORWHIC!{APPLICATIONIS iPDE <br /> ANO I COMPLY THE ONTRACTORS LAW 1827 RCW l,ND <br /> SION�TUnE �UiII�ENi 04E�'�I.�+ I <br /> YPROJECTAODRESS � %' <br /> �PPLIC�NTS IIYBU ESSUGENSENO,ANOBUSINESSN�ME <br /> PLUMBINO MECH L <br /> NO. 7YPEOFFIXTUpEORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILEn A/C—/VHNDLG UNITS—H.P. <br /> BATHTUB FORCEOAIRSYSTEAtS—BT.U. MEA <br /> LAVATORVryYASHBASIN) � UNITHEATERS—RT.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEiJ SINKB DISP. VENTILATION FAN <br /> OISHWA$HER RANGE HOOD <br /> LAU�IDRVTRAV � WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METALFIREPLACEB CHIMNEY <br /> DRINKINCa FOUNTAIN F�REPLACE INS€RT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTEFS GAS PIPING <br /> ROOF ORAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> c:s/ � <br /> i v�/ rt�. <br /> SUB TOTAL S f"' SUB TOTAL E " <br /> PEFMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE E <br /> FRONt5E1BGCN REAqSEiBAGK SID[SEIBRLK PUNCNECI{NUMBEq FEE RECEIPfNO. <br /> usEtoNE toteeen VAGINTSIiE pEES VALUATION FEE <br /> ❑YES ❑NO <br /> ttPEOfCON51. OCCUPANGYOBOUP NOAFDWEILINOUNIIS BUILDING <br /> ALLOWA9LE/ACTUAL <br /> PLUMBING � <br /> saeoro�oo. No.ovsrome� esuc occto�o -- <br /> � o N MECHANICAL _ --/�/1 /`V`1 <br /> (�/.l / (..�! <br /> HEICNTLIMIi�110N OTHER <br /> FIRESPRINNLERSFE0111(1ED OYE9 ❑NO <br /> STATE BUILDING SUfiCHARGE <br /> STATE ENEFGY SURCHARGE <br /> �PPUC4IIpNACGBY p��NSAPppBY - <br /> � PUBLIC WORKS <br /> TOTAL / <br />