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S"<T,::,.A`i'zi.:fndr•'i:.323ETi:}':. . . . . ..__. . . . .. . .._. . _ ..... ., .. _ .. . .... ...._.. . _. .. ., ,. . • <br /> � <br /> APPLICr.�ION FOR CONSTRVCTION <br /> PERMIT <br /> fM Ev�ryrs�n c�tY�tt � <br /> CITY OF <br /> everett <br /> BU�LDIN(3 DEPARTMENT <br /> 259 810 TO BE COMPLET D IN INK— PL ASE PRINT <br /> �� „ , 0..��- �yir .r/o��-�..� �`,,,.G� qv�.,� ��- 2a�/ <br /> E MAIL�UDRE CITY ZIP PNONE <br /> IEN�t1T MML�DDRE55 CITY LIP PHONE <br /> 11qOMIfECfOR�E510NER MALLAOORE54 CITV ZIP PHONE <br /> OEMEMLCONTIUCTOR MML��DRE55 CITY 21P PNONE IICENBE• <br /> MEp1ANICI�LfANiP�CTOR M�ILAUDRE55 r GTY ZIP PNONE LICENSE• ' <br /> 11 / - /l/, �,::.� �'fJ �o�c / GG Jj�-,�,a ya�47 /e�-cPsbo r��vA�4ti»wr <br /> �1a1qCONTp�C70 �--`MlULADORE59 GTY ZP PMONE LI(',EN'E• <br /> CW8 MIOR1c ` _ <br /> ❑ NEW ❑ ADDI710N ALTEMTION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPlINSERT ❑ BUILDINORELOCATION <br /> 7EIUN71MrppVEMENTORINTEN REMODELONLY CONT�CTFEN90N�NOiHONENO. <br /> �4. <br /> � pppIMCTPRICEOFWOIIK <br /> p[�C�I�E Wppl(/JID BOUME FOOTAOE INYDLVEO <br /> ; u�coreuadNo IHEREBVCERTI�'THATIH�VEREADANDEXAMINEDTHISAPPLtCAT10NAND <br /> KNOW TME SI�ME TO BE TRUE AND CORRECT.ALl PROV1610N60f LNN6 AND <br /> LEMLDElCNIPTIONOFPR PERtt(SHOYVNBEIOWOH�TT�GNFOIIRCOPIE9� ORDINANCE9OOVEHNINaTHISiVPEOFWORKWILIBECOMPLETEDWITM <br /> WMETHER SPECIflED HEREIN OR NOT.THE 6RAN�INOOFAPERMRDOEB NOT <br /> PRE9UME TO OIVE AUTHORITY TO VIOLIITE OR CANCEL THE PROVI&ON8 OF <br /> ' �oT s�ocK oF ANYOTMERSTATEOFLOCALLAWREOULATINQCANSTRUCTONORTNEPEIF <br /> ' FORMANCE OF CANSTRUCTION.iMAT 1 AM AUTHORI2ED BV THE OWNER OF <br /> TMIS PROPEH7Y TO PERFORM TME WORK FOR WHICH APPLICATION 18 MADE <br /> 'i AND I CAMPLV WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> � 288200 WAC. <br /> � &ON�TUREOFWNTH/�CTOROPAUINORRE0110ENT OATE <br /> i ^ �/�7Y�� li.✓f ___ <br /> � PIqR DRE89 � �PPLI—C�N�i GITYBU9ME9S�ENSENO.�HDBUSINE59N�ME <br /> � rLUM\INO MECNANIC�L <br /> Np, TYP[OR fllfTU11E OII ITEM FEE NO. TYPE OF EOUIVMENT �� <br /> ' WAiERCLOSETITOILETI NC—NHNDL�UNIT9—H.P. <br /> �. �m�B FORCED AIR SVSTEMS—B.T.U. M EA <br /> UVATORV(WA9HBASIM '— UNITHEATERS-9T.U. M <br /> ' sH�R CIOTHESORVER3 <br /> � KITCHEN SINK 8 DI8P. VENTILATION FAN <br /> � DISMWA9HER RAN6EHOOD <br /> UUNDRV TRAY WATER MEATER <br /> , CLOTHESWA9MFR WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> ! DRINKINOFOUNTAIN FIREPLACEINSERT <br /> � • FLOORDRAIN HEATPUMP <br /> BACKFLOW PREVENTER9 Q�9 PIPIN6 <br /> � p00fDRAIN9—RAINLEADER9 E%HAUSTFAN <br /> 91NK19ERVICE—BAR��) <br /> SUBTOTAL S � SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S � TOTAL FEE S � <br /> pONilETB/�CN REAPSETB�CI( 910ESEfBAGK R�NCXECRMUM�EI1 FEE �«��RNO• I <br /> usezowe LOT�REl1 V�WlTSITE FEEB VALUATION FEE ��i � <br /> ❑YE9 O NO <br /> BUILDING , <br /> TYPEOFCONlT. OCCUPANCYOROUP NO.OPOWELLIN6l1N1T5 <br /> w���a������ PLUMBINO �i <br /> �zewe�oo. NO.OFSTORIE9 BSMT. OCCL0�0 MECHANICAL rJ' I <br /> ❑Y — I <br /> ❑N <br /> HEIGNTIIMITATION OTHER , <br /> FlPElPNINNLEPSREWIPED O YES ❑NO STATE BUILDING SURCHARGE �' <br /> STATEENER6VSURCHAROE � <br /> ,APPIIC�TONAC4BY Pl�NS�PPR.BY PUBLICWORKS <br /> TOTAL <br /> �. <br /> ,Di � .. <br />