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� APPLICA�ION FOR CONSTRV�TION <br />` PERMQT <br />,:���p <br />H���d <br />"���"� <br />�p H <br />LyO� <br />ON <br />��g <br />QY (] <br />t"y� <br />�y <br />gd� <br />��� <br />�-3 O CA <br />Ihe Ever9rebn <br />CITY OF <br />ever�tt <br />BUILDING DEPARTMENT <br />259-8810 <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />ABGNITECTOR�ESIGNER MA�LAU�RESS CIIY ZIP PMONE <br />GENEFNLCONiRALTOP �AILADDFESS GIiY ZIP PNONE LICENSE� <br />M[LHANIGPLGONTRRCTOA MAILA�ORESS CILY ZIP PIIONE LILENSE• <br />�NEW ❑ ADDITIUN ❑ ALTERATION ❑ REPAIP ❑ DEMOLI710N ^LJ WOOOSTOVFJ'RPLuRSERT LJ BUILUIM1UHtLVcniiurv <br />LOT BLOCN OF <br />� <br />PLUMBING <br />NO. TYPE O� <br />WAi ER CLOSET IT( <br />' SHOWER <br />KITCHEN SINKB C <br />L1ISHWASHER <br />LAUNORVTRAY <br />CLOTHES WASHE <br />UFINAL <br />� DRINKING FOUN7 <br />� FLOOR DRAIN <br />' BACKFLOW PPEV <br />ROOF DRAINS -- <br />cuiv ievo�nre _ <br />FIRESPPINKLERSPEOOIHED ❑ <br />ITEM I FEE <br />TOTALFEE g <br />vserancn smeseloncrc <br />AflEA VAGANiSI1E <br />❑ YES ❑ NO <br />UPnNLYGRO- �1P I NOAFOWELLR <br />DFSTOFIES 95MT. OCGLOAO <br />❑Y <br />❑N <br />MEiGHT LIIAILPT <br />3 o NO <br />I HEREBY CERTIFY 7HAT I HAVE READ AND EXAMIN ED THIS �PPLICATION AND <br />KNOW THE SAME TO 8E TriUE AND CORRECT. NLL PROVISIONS OF LAWS AND <br />OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETcD K'ITH <br />WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUGTION OR l HE PER� <br />FORMANCE Of CONSTRUCTION. THAT I AM AUTHORIZED BV THE OWNER OF <br />THIS PROPERN TO PERFORM THE WORK fOi W HICH APPLiCATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRFCTORS LAW 1827 RCW AND <br />296.200 WAC. <br />SIGNAiUPEOFCONiRACtO�OiV.0iH011iZE0PCENT DATE <br />XSf,l BU�S/UCENSENO�ANOBUSINESSNAME <br />MECHANICAL <br />— AJHNDLG UNITS — H.P. <br />ICED AIR SYSTEMS — &T. <br />iHEATEPS—B.T:J. M1� <br />RANGEHOOD <br />WATER HEATEF <br />WOOD STOVE <br />MET�1L FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />SUB TOTAL <br />PERMIT <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STA7E BUILDING SURCHARGE <br />STATE ENERGY SURCHAfiGE <br />PUBLIG WORKS <br />70TAL <br />5 <br />FEE <br />fEE <br />nu:a • <br />C <br />� <br />� <br />