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_ 5 �' <br />L <br />the Ereigreon <br />CITY OF <br />ev�rett <br />BUILDING DEPARTMENT <br />259•8810 <br />APPLICAI �ON FOR CONSTRUV fION <br />PERIIAIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />� wu�+ s <br />z 7/�J �00%c�//4 .,4�r. <br />i�vrrelt <br />� <br />GENENRL CONTR4CiOR MAR AUOPE55 i� �IiY ZiP PnONE LiGENSE • <br />�ilv�i�rv .Sf�t .S�ri7� .%%� n� Ty// rit�trt �(/ «fLC/ 7SL ?/! fG�/,' SSi!/ <br />�.� �.,u.o,�.,.o .,.., .....� � _ _ i / -�>— /r7 <br />PLUM&NpGONTPACTOR MAILAODPE55 CIiY 21P PHONc �ICENSE• <br />❑ NEW ❑ ADDITION <br />CANTPNQ PRICE OF WOFK <br />LOT BLOCK Of <br />PLUMBING <br />NO. TVPE <br />WATER CLOSE' <br />ALTERATION ❑ REPA:F C oErnounou ❑ WOODSTOVE/FRPL WSERT ❑ BUILDING RELOCATION <br />IODEL ONLY �y� ep CONTP:T VERSON ANO PNONE NO <br />'Eb A _ J ',�.J S7%O <br />v. <br />KITCHEN SINKB DISP. <br />DISHWASHER <br />:_AUNDRY TRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />� <br />A <br />4LLOWNBLE/ACTWL <br />FIRESPRINNLEPSREOUINED ❑YES ❑NO <br />I HEREBY CERTIFV?HA71 FIAVE RF�� AND EXAMINED TH IS APPL!CATION AND <br />KNC W THE SFME TO BE TRUE AND COHREC7. ALL PROVISIONS OF LAWS ANO <br />ORDINANCES GOVERNING T�iIS TYPE OF WORK WILL BE COMPLETED VJITH <br />WHETHERSPECIFIEDHEREIPIORNOT.THEGRANTINGOFAPERMITDOES NOT <br />PRESUME TO GIVE AU7HORITV TO ViOLATE OR CAIJCEL THE PROVISIONS OF <br />ANYOI HER S7ATEOR LOCAL LAW FEGULA7ING CONSTRUCTION OR711E PER- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERN TO PERFORM THE WORK FOR W HICH APPLICNTIGN IS MAD'c <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296.200 WAC. <br />SIGNATUPEOF ONiR1CT0'�O6AUi110PRE0FGE4T DAT[ 6�)�l/Z <br />X ���%� � �.�- <br />� <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />A/C — A/HNDLG U NITS — H.P. <br />/ FURCED AIR SYSTEMS— BT.U.�,s, <br />UNITHEATERS—B.7.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WP.TER NEATER <br />WO00 STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />P <br />i;� _�G /`�a f <br />r�lXc���.Dl <br />� NOAFDWELUNGONIiS BUILOING <br />PLUMBING <br />esMr. xc �ono <br />❑ r MECHANICAL <br />❑ N <br />HEiGMTLIMILRTION OTMER <br />STATE BUIL�ING SURCHARGE <br />_, <br />S7ATE ENERGV SURGHARGE <br />PUBLIG �'�'ORKS <br />.�/L1 70TAL <br />SUB TOTAL <br />PERMIT <br />70TAL FEE <br />VALUA710N <br />5 U <br />5 /I� _ <br />S i <br />ELEIPT N0. <br />FEE <br />/ S �� <br />