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�e�..: �. � r� /'� ' <br /> � APPLIC:+�ION FOR CONSTRI.�TION ' <br /> PERMIT <br /> me everoreen <br /> GTV OF everett <br /> ��� everett e <br /> p � BUILDING DEPARTMENT <br /> "• 259-e8t0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> ��� . �qyN � M41L�ODRE55 CIIY IIP PHONE <br /> �4 rt .�. �R r .cr y Z I U� �w� .�r �r^ �r/ `��LG� 2 `��.--/,v''b,$ <br /> R�� IEN�Ni M�IL� ORES � GLY ZIP PIONE I <br /> •PGHITEGTOPDESIGNER M�IL�DUNE55 ptY ZIP FMUNE <br /> ��� OEHEWICONiRACfOH MAI��ODRESS CIiY 21P FMONE IILENSE• <br /> �}� MECMANICALLONiR�GTOR MML�DDBE55 LIiY ZIP FMONE LICENSE� <br /> f�l P9 <br /> Qr <br /> RUM&NOGONTMLTOR MML�DOPE55 CITY 21P WONE UCEHSE• <br /> y wu�t « w��YS 9006 ��7,�;��� 5���, ���9� !��—��5' !,�/A7'E/Zw <br /> � �-�aK P 2 ia ��4 <br /> FFF...111� ❑ NEW ❑ ADDITION IS�AUERATION ❑ REPAIR ❑ UEMOLITION ❑ WOOOSTOVE/FRPLINSERT ❑ BUILOINGFELOCATION ., <br /> y TENMITIMPPOVEMENiOPINTERIORREMODELONLY CONTPLTFERSONANDPHONENO '�. <br /> 6� wr�m�c.vniceorwonK� I <br /> OESCRIBE WOHR�N�SOVANE FOpTAGE INW WEO <br /> k � <br /> arocoseous or i wa IHEREBVCERTIFYTHATIHAVEREADANDEKAMINEDTHISAPPUCATIONAND <br /> � ^/�. „_ ,_ KNOWTHESAMETOBETRl1EANOCORRECT.AILPROVISI0N50FLAWSAND � <br /> `^ ORDINANCES GOVERNING THIS NPE OF WJRK WILL BE COMPLETED WITH <br /> - te �oeseni ior+ ERTY�SNOWNBELOWOF�R�LNfOURGO%E51 yyHETHERSPECIFIEDHEREINORNOLTHEG9AN71NGOFAPF.RMITDOESNOT <br /> PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ior eiocK or ANVOTHERSTATEORLOCALLAWRE6ULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCE OF CANSTRUCTION.TH�T 1 AM AUTHORIZEO BV THE OWNER OF <br /> THIS PROPERTV TO PERFORM THE WORK FOR W HICM APPLICATION IS M�DE <br /> AND I COMPLV WITH THE STATE CONTRACTORS LAW 1827 RCW AND � <br /> 296200 WAG , <br /> 51GNAiUREOGCONTR�GIOROFAUt110FRE0�GENT DAIE <br /> PHOJEGi�DORE55 �'�.�����''�1'•� �I <br /> � MP ANi5C1iVBU51NE55LItEN5GN0ANpBU51HE55 <br /> � / <br /> i , <br /> PLUMlIN6 MECMANICAL <br /> '� NO. TYPEOFflI(TUREORITEM fEE NO. 7YVEOFEWIPMENT FEE <br /> 1 ' WATEF CLOSET ITOILEi) NC—NMNDLG UNI7S—H.P. <br /> � BATHTUB FORCED AIR SVSTEMS—6T.U. M EA <br /> LAVATORY�WASHBASIN) UNITHEATERS—BT.U. M <br /> f�1 SHOWER CLOTHESDRYERS <br /> 1 ' : KITCHENSINKBDISP. — VENTILATIONFAN <br /> � DISHWASHER FANGE HOOD <br /> LAUNDRYTMV � � WATERMEATER <br /> 1 CLOTMES WASHER WOOG STOVE <br /> ' URINAL METAL FIREPI.ACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR ORAIN HEAT PUMP <br /> '—' BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DPAINS—RAINLEADERS E%HAUST FAN <br /> ' � � SINN�SERVICE—BARETC.) � — <br /> ' -- — <br /> 1 <br /> �'_ SUBTOTAL S SUBTOTAL S <br /> PERMIT 5 1 ^ PERMIT 5 <br /> 1� TOTAL FEE S ' TO7AL FEE S <br /> — FRONTSEIB�Ge HEARSETBI�CIt S��ESEtO�CM PIANCHECNMIIMBER IEE 11LCEIRNO. <br /> uSexoN¢ ior�eee VAC�Ni&�E FEES VIILUATION FEE i <br /> ❑VES ❑NO <br /> IYPEOFCANST. OCCUP�NGYGFJUP NOOfDWELUNGUNIiS BUILDING I <br /> ♦LLow�BteuCTu�� PLUMBING — <br /> S�IE OF BI�G NO OF STORIES BSMf. OC4 LOG� <br /> ❑♦ MECHANICAL <br /> ❑N <br /> NEIGHfLIMITAbON OTHER i <br /> F�RESFHINNLEPSREWIPE� ❑YES ❑NO STATEBUILDINGSURCHARGE <br /> STATE ENERGV SURCHARGE <br /> V%IC�TIONPCC.BY PlANS�PMi.BY <br /> PUBLIC WORKS <br /> TOTAL /' � <br />