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APPLIC�.�ION FOR CONSTR4.:TION <br />PERMIT <br />rne e�erorea� <br />CITY OF <br />; everett <br />BUILDING DEPARTMENT <br />259•8810 <br />owNea <br />2_A�Ni�� �-i� <br />TO BE COMP�ETED IN INK— PLEASE PRINT <br />�ooiaess cnv zia <br />��i��- �4Y" �7. s� �c�;>>a � . <br />�ooness ���r Z1P <br />�.T, � l%�� �U�2etl ����+'� e��; y s�t� <br />mnnccc GIIY 21P <br />everett <br />e <br />OENEN�LCOJNTfl^�CTOP / C ^� /�^J���"� ""' �j <br />S 1-/L��L 1�U� J l L�iV l�G'�� �r��F� ��• �C E�F � C/� � � f�i0k�l ���� <br />MECMANiC�LGONTR�CIOR M�IL�ODlIE55 GIiY ��P� r`�, P�ION�E.�3� LIGENSE• <br />5 <br />PLUMBINOCONLR�CLOR MMIAD�fVE05 CIIY ZI� PIIONE LICENS[• <br />NEW ❑ ADDIiION ❑ ALTERAT�ON ❑ RE�AIR ❑ DEMOLIfION ❑ IVOODSTOVE/FRPLINSEt1i ❑ BUILDINGREIOCATION <br />MTIMpROVEMENiORINTER/lO1%� REM/O A�)E/L�ONLY LONiRGtPER50NRNOP110NEN0. <br />IUCTPRIGEOFVfOflK �-("���(� (�' <br />e <br />� 71 /YI'+LC' <br />LOT BLOCN O� <br />����; ��� n� <br />PLUMBINO <br />V�WATER <br />I:ITCHEN <br />CLOTHES WA: <br />URINAL <br />DRINKINO FOI <br />FLOOR DRAIN <br />CI I <br />nre or wnsr. <br />�LLOWABLFFCiU�L <br />FIRE <br />� �/ <br />I HEREBY CERTIFY TNAi : HAVE READ AND E%AMINED THIS APPLICATION AND <br />KNOW TI1E SAME TO BE TF UE AND CORRECT. ALL PFOVISION3 OF LAWS AND <br />OHDINANCES GOVERNIN.i THIS TVPE OF WORK WILL BE COMPlEfEO WIiH <br />W HETHE95PECIFIED H(.REIN OR NOT. THE GRANTINQ OFA PFRMIT DOES NOT <br />PRESUME TO GNE AVT'� :^p�rv TO VIOLATE OR CANCEL THE PROVISIONB OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATIN� CONSTRUCTION OR 7HE PER• <br />FOAMANCE OF CONSiRUCTION. THAT I AM AUTHOR12ED BY THE OWNER OF <br />THIS PROPERTV 70 PERFORM THE WORI( FOR WHICH APPLICATION IS M�DE <br />AND I COMPLY WITH THE SiATE CONTRACTORS LRN 1827 RCW /AND <br />Z96.��� WA�. �/• 9 / '9 <br />CiiGNSNREOF ONfNAC10B011AU�N0 EOAGEN� AORTE -%- <br />Xi' 'f,/ '//( //_ ll�� <br />. /�li �Y �C� � .Ll� '�[ `" <br />•pPUC�NISGItY6U51NES5lIGE EN .�NDBUSINESSN�ME <br />MECHANICAL <br />ITEM FEE NO. <br />I wc—. <br />SUBIOTAL 5 <br />PERMiT 3 <br />TOIAIFEE S <br />❑Y <br />❑ N <br />❑ YES n No <br />fJ YE9 ❑ NO <br />GAS <br />TYPE OF E�UIPMENT <br />NDLG UNIT9—H.P. <br />Jq SYSTEMS— O.T,U. <br />'ERS—&T.U. M <br />DRYEHS <br />ON FAN <br />8 CHIMNEY <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STA7E BUILDING SURCHARGE <br />STATE ENERGV SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />VAlUAT10N <br />