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� <br />the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTNENT <br />259-8810 <br />,:. . � �� `�. <br />APP�.ICI�►�r ION FOR CONSTRti�.:T10N <br />PEFiMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />p�RE55 _ CIiT ZIP <br />; <br />evcre❑ <br />� <br />K���.. <br />GENENALCONTRACiOp MAILP�OFE55 CIIY ZIP PMONE LICENSE• <br />MF.CHA:IIC�LLONTq�CTOR MAI�D�R[55 CIIY ZIP PIIONE LICENSE• <br />MUMBiN6GONTR�CTOH Mul�00P[IIS GITY ZiP PMONE LiGENuE• <br />< <br />_ `i <br />CLASSOF WOpN <br />�NEW ❑ ADDITION ❑ ALTEflATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ Bl11LDING HELOCATION <br />TENANTIMPFOVEMENTOflINtEPI OnEM�O�7ELONLY CONGCIVERSO�NjA/N}O,PMONENO./� <br />CONiPAGTPqIGEOFWORK �L I�OI L�UL./ ��A'�/I�// / // I/II 1��� �/ / <br />«�a a�o�K� oF <br />PLUMBING <br />�i <br />e <br />SU9 TOTAL <br />PERMIT <br />TOTAL FEE <br />:RGNISEIBACK qEAPSETBACN <br />�0 � � . <br />USE E LOiARE� <br />I - S / z, voU <br />IYPEOFCONST. pLGU�+ ^.yGFOUP <br />1LLOWApLE/�GTU <br />'�'-N �- I <br />512EOFBlW. NOOFSTORIES 0.5N <br />5724 -L hrn <br />FI�ESPRINNLERSpE0U1PE0 ❑YE9 �NO <br />aPPUCqiON�CCBY PLANS�PPRBY <br />l'� <br />, ,_j, �.J <br />8 <br />S <br />S� <br />VACAIlT 50'E <br />I] YES ❑ NO <br />�y'_`_' � -r._"—_�IL '. <br />� . .�i'S` �3 �38 - ' <br />IHEREBYCERTIFV"fHATI AVEREAaANDEXA INEDTHISAPPLICATIONAND <br />KNOWTHESAMETOBcTRUEANDCORRECT.ALIPROVI510NSOFLAWSAND <br />ORDINANCE� GOVERNING THIS iYPE OF WOHK WILL BE COMPLETED WITN <br />WHETHERSPECIFIEOHEREINORNOT.THF.GRANTINGOFAPERMITDOESNOT i. <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF '+ <br />ANY O1HER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />fORMANCEOFCONSTRUCTION.THATIAMAUTHORIZEDBYTHEOWNEROF ;^j <br />7HISPROPERNTOPERFORMTHEWORKFORWHICHAPFLICATIONISMADE ,� <br />AND I COMPLY WITH 7HE STATE CONTRACTORS LAW 1827 qGW AND <br />29E200 WAC. <br />SIGNAil1fP FLONTRACTOPOHAUi110fl12E0A ENT DRE <br />I' <br />X i, <br />RP ICR SINE55 , l3EN . IlESSNAIAE : <br />MECHANICAL �� <br />�+� TYPEOFEOUIPMENT cFF �•� <br />A/C — A/NM�LG U�IITS — H.F. <br />FORCED AIR SYSTEMS— B.T.U. M EA <br />UNITMEhTERS—B.T.U. h1 <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD:70VE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />n <br />PERMIT S <br />TOfALFEE S <br />FEE flECE1PTN0. <br />�� � �� ( �� ��9. <br />VALUFT!ON FEE <br />�_ PLUMBING <br />AD <br />2 � MECHANICAL <br />IIMITAiION OTHER <br />� STATE BUILDING SURCHARCaE <br />STATE ENERGV SURCHARGE <br />PUBLIC WOFKS <br />rora� <br />.'1 <br />