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� <br />r�*. <br />' APPLICi�. �'ION FOR CONSTRUCTIO�1 <br />PERMIT <br />;��� <br />r0 <br />>Ht�� <br />H7G� <br />fC C9 <br />� <br />O� '� <br />yVi N <br />t�7 O � <br />OH <br />��g <br />�Y (] <br />t"y� <br />gyy <br />��� <br />�o� <br />fhe Every�een «'�'�e« <br />CITY OF � <br />everett <br />BUILDING DEPARTMENT <br />259-88t0 TO BE COMPLETED IN �NK — PLEASE PRINT <br />FIAILA�DRE55 /J CILV^ �/ ZIP PMON�+E <br />/IA/��,._�.�.. ��..nn //1-�-�:i /J/F //ninLt Y.C! �/.Cf �O'S� .O� �%� <br />M <br />GENERRLCONiRNGTOfl MA�LAOORE55 CITY ZIP PHONE LICENSE• <br />MECMPNICALGUNTMCTOR MNILAO�RE55 GTY ZIP PIIDNE LICENSE� <br />i, . �% . _ .__.vJ ,.i.-_ �dno,/r,.,.,_- /'nn St�9-�.1 `I���.Pio/?.rn <br />NEW ❑ AODITION ❑�1�TEHATION ❑ REPAIR ❑ DEMOLITIGN ❑ H'DODSTOVElFPPL INSERT ❑ BUILOING RELOCATION <br />LOT BLOCN Oi <br />'s �� .iF ev@.or 'r1�,,/l 1�. <br />PLUMBING <br />NO. TVPE OF FI%TURE OR ITEM <br />WATERCLOSETITOILEn _ <br />BATHTUB <br />LAVATORY (WASH BPSIN) <br />SHOWER <br />KITCHEN SINKB DISP. _ <br />DISHWASMEFi <br />LAUNDRY7RAY <br />CLOTHES WASHER <br />URINAL <br />. DRINKING FOUN7AIN <br />^ FLOOR DRAIN <br />�� BACKFLOW PFEVENiERS <br />� ROOFDRAINS—FAINLEADERS <br />SINK (SERVICE — BAR, EiQI <br />SUBTOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />AILOWABLE/AGTUAL <br />FIRESPRINK.ERSREOUipE� ❑YES <br />I H EREBV CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION AND <br />KNOW THE SA1AE TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AW S AND <br />ORDIYANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETED WITH <br />WHETHERSPHCIFIEDHEREINOR NJT.THEGRANTINGOFAPERMITDC�ESNOT <br />PRESUME TO GIVE AUTHORIN TO VIOLA7E OR CANCEL?HE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH E PER- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE OWNER OF <br />TI115 PROPERN TO PERFORM THE WORK FOR W HICH APPLICATION IS MADE <br />AND I COMPLY YiITH TNE STATE CONTRACTORS LAW 1827 RCW AND <br />29620G'NAC. <br />S:GNATUREOFCONiNACtO ORA�THORRE�AGENi OAtE <br />�l/�/ ! O�� U V - <br />qPP .IT iNE SLIGENLENO.AN06USMESSNAME <br />MECHANICAL <br />Np, TYPE OFEQUIPMENT FEE <br />NC—A/HNDLGUNITS—H.R ��___ <br />FORCED AIR SYSTEM1IS — 9T.U. M EA <br />UNITNEATERS—&i.U. M ___ <br />CLOTHESDRYERS <br />VENTILATION FAN _ <br />RANGEHOOD _ <br />� WATER HEATER _� <br />WOODSTOVE _ <br />METAL FIREPLACE 8 CHIMNEY _ <br />FIFEPLACE I(JSERT _ <br />HEAT PUMP _ <br />GAS PIPING <br />EXHAUST FA�J <br />SUBTOTAL S <br />❑ YES ❑ NO <br />BUILDING <br />NO.OF DWELLING UNIiS <br />PLUMBING <br />BSMi. OCGLOAD �,�ECHANICAI <br />❑Y <br />❑N <br />HEIGHTLIMITATION OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />� PUBLIC WORKS <br />TOTAL <br />FEE <br />