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/lPPLI�.AT�OIv FOR CANSTRa9CT101�➢ � / � <br /> PERMIT <br /> fhe Evargrean <br /> H n � c�iv oF ew•rett <br /> everett �J'� � p_ � <br /> � � y BUILDING DEPARTISENT � I �l_�I/`..• <br /> A .bx <br /> a y y 259-88�0 TO BE COMPLETED IN INK- P'�EASE PRINT <br /> t� <br /> OWNER MFILNppflE55 CIIY ZIP PMONE � ' <br /> H � �-IPI�.� C':I��� - �5�� 1��m� -�1�_ �d-�- �� - 1g�l� <br /> � x Q TENANT MAllA00RE55 CRY ZIP oryONE <br /> �a H � ���/yLQi <br /> CA H <br /> � z � AOGHITECTOROESIGNER MAILAODRE55 CILY 21p PHONE <br /> � <br /> 1'3 rJ RILADDFES$ . bTT ZIP P NE LILENSE� <br /> GENEFRLCONTPACiOR <br /> H � �; ��}� I�I�T - D eaP �4� -Sy �.� V�NBl��.1 <br /> �y �. MELHANICALGONTRACTOR MAILAODFE55 CIL ZiP PHONE LICENSE�+ � � <br /> zH� �',—�3 /v <br /> � F3 z PWMBINGCONTRACTOR MAILAO�PE55 GITY ZIP PHONE LICENSEv <br /> Hy <br /> �y CLASSOFWOPK <br /> H <br /> C����---!!! C7 � ❑ NEW ❑ ADDITION �"ALTERATION ❑ REPAIR ❑ DE1.10LITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> �C �y T[NANiIMFFOVEMENTORINTERIORREMODE,LONLY GONTACTPERSONNN�PNONENO. <br /> z r3 iii � �� <br /> CONTRAGTPRIGEOFWORK {/ <br /> H O C/J OESGFI0EIVORKAN05 AREF iAGEINVOWEO / <br /> � 11 � (`{ �� <br /> l.l / �+-- (� <br /> vaoa05EouSEOFeU: o�+G � IHEREBVCERTIFVTHATIHAVEREADANDE%AMINEDTHISAPPLICATIONAND <br /> KNOWTHESAMETOBETRUEANDCOFRECT.ALLPROVISIONSOFLAWSAND <br /> �EGR�oEscaivrior+oFrAoaEarviSncwr+eeLowonnTrncMvouecoviEsi ORDINANCESGOVERNING7HISTVPEOFWORKWILLBECOMPLETEDWITH <br /> W HETH ER SPECI FIEO HEREIN OR NOT.THE GRANTING OF A PERMIT DOES NOT <br /> PRESUAIE TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> LOT__ BLOCK oF ANYOTHERSTATEOPIACALLAWREGULATINGCONSTRUCTIONOATHEPEF� <br /> FORMANCE OF WNSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH iHE STATE CONTRACTORS LFW 1827 RCW AND <br /> 296200 WAC. <br /> S�GNAiUPEOF�ONRVACtO1tOFAU➢�ORREOAGENL OAiE <br /> PROJECTAODRE55 � �� `�����' \�/� � � <br /> ��v�-^y/^� P CANTSCITYBUS E LICENS � .ANOBUSINESSNnME <br /> w� <br /> '�' PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE NO. TVPE OF EOl11PMENT FEE <br /> '_' WATERCLOSET�TOILE¶ _ A/C—A/HNDLGUNITS—H.P. <br /> BATNTUB FORCED AIR SVSTEMS—B.T.U: EA <br /> O�' LAVATORV(WASH BASIN) UNIT HEATEFS—B.T.U. M <br /> � ' SHOWER _ CLOTHESDRYERS = <br /> _ KITGHEM SINKB DISP. VENiILATION FAN <br /> DISHWASHER RANGE HJOD _ <br /> '�' LAUNDRVTFAV _ VlATERHEATER _ <br /> ' ' CLOTHES WASHER IVOOD STOVE _ <br /> � URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSEPT <br /> FLOOR DRAIN HEAT PUMP <br /> f�O _ BACKFLOW PFEVENTERS GAS PIPING — <br /> ROOF DRAINS—RAINLEACIERS E%HAUST FAN <br /> SINK�SERVICE—BAR,EiC.) — <br /> ' � <br /> ,_� --- -- <br /> �' - <br /> � SUBTOTAL 5 SUBTOTAL 5 (GU _ <br /> PERMIT 5 PERMIT 5 <br /> TOTA!FEE S TOTAL FEE 5 �IS <br /> FRONTSET9AGR REARSEi84CK SIOESETDAGN PLANCHECItNUMOEfl FEE AECEIP�NO. <br /> UcEZonE LOiAPH vAcnr�rsrte FEES `:ALUATION FEE <br /> ❑YES ❑NO <br /> BUILDING <br /> TYPEOFGONST OLWPANLYGRDUP NpOFDWELIINGUN1i5 — <br /> nuowna��actuni PLUMBIN� <br /> 92EOFBLOG. NO.OFSi0RIE5 BSML OCG.LOAO <br /> ❑y MECHANICAL _� — <br /> ❑N <br /> — HEIGHTLIMIIAtION OTHER <br /> fIRESPRWNLEPSPEOVIflE� ❑ves ❑ r+o STATEBUILDINGSURCHAflGE <br /> STATE ENERGV SURCHARGE <br /> ♦PPLICATION ACC BY I PLANS APPR.BY � . <br /> PUBLIC WORKS <br /> TOTAL I <br />