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. .. <br />..� , . ,.. ,:.,.. -_ . .. . . . � . .. . . :. .��." .i� .i:_.ja1CF:T <br />��� � <br /> APPLI�.ATION FOR CONSTkUCT10N ; <br /> " PERMIT <br /> fh�Ev�ryroen cverett <br /> CITY OF � ' <br /> everett ' <br /> BUILDING DEPARTMENT ' <br /> 2b9-8810 TO BE COMPLETED IN INK— PLEASE PRINT i <br /> t <br /> �1 1 ��� '���(1' �� Meil��s� �U/ Il.f/il� � 1 V �irv� t �r—,�;������� t <br /> C%\1.Y ��� I <br /> � <br /> ����^I D M�ILADORE 5 CITY ZIP PM NE � <br /> /N � <br /> MCHI ECfORUESIONEP MMLAO�RESS GITY 21P PHONE � <br /> 1 <br /> 1 <br /> NE CAN1H�Cf0 .!A�IL�O�NE55 f CfTY � IIP � PNONE LICENSE• j <br /> � ) ��� �: <br /> �C7( <br /> MECHANIGL TMCTOR M�IL�DURE55 CITY ZIP PHONE �� IICEN3E• � <br /> PIUMMNOGONfMCTOF MMLAODRE35 LITY ZIP PHONE CENSE� ^ <br /> L <br /> CIA&1 OFYqFN �; <br /> ❑ NEW ❑ ADDITION�TEMTION ❑ AEP::IR ❑ DEMOLIT�ON ❑ WOO�STOVE/FRPLINSEPT ❑ BUILGINORELOCATION �. <br /> TENANTIMPROVEMEMOPI RIORPEMOOELQ�` fANUGTPEN50N�NDPMONENO. (. <br /> ���.V/) `: <br /> �pNTUCT PRICE OFMqPK V � <br /> p[lCpllE RK�N U EfO0T�0EINVOWED � �' <br /> f' <br /> rno uaeoreuao a IHEREBYCER7iFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> YNC�WTHESAMETOBETRUEANDCORRECT.ALLPROVI910NSOFLAW9AND �. <br /> ORDINANCES 60VERNIN4 THIS NPE OF WORK WILL BE COMPLETED WITH <br /> � ` <br /> LEdLLDEWRIPfIONOFPf10PERTY1gNOWNBE WOR�TT�CNFOURGOAES} yyHETHERSPECIFIEDHEREINORNOLTHEORANTIN60FAPERMRDOESNOT I' <br /> PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCELTHE PROVISION80F G <br /> �or e�ocK oF ANYOTHERSTATEORL�:.ALLAWREOULATINOCONSTRUCTIONORTHEPEiF <br /> FORMANCE OF CANSTRUCTION.THAT I AM AUTHORI2ED BY THE OWNER OF �; <br /> TH�S PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND k <br /> 296200 WAG FF <br /> SION�TUREOFCONTR�CTOPORFOTHOPIZED�OENT O�TE � � � <br /> X �1 , <br /> PROJECT�DURE9S' �� �p �NiSCITYBU5IN LIL SENO.�NDBW�NESSN�ME � <br /> I•� <br /> rLUMlING MECMANICAL { <br /> �1p, TYPE OF fl%TUI1E OR ITEM FEE N0. TYPE OF EOUIPMENT F[E �� <br /> WATER CLOSET(TOILE7) AlC—A/HNDLG UNITS—H.P. � <br /> BATHNB FORCEDAIRSVSTEMS-6T.U. EA <br /> LAVATORVIWA9HB�SIM UNITHEATERS—&T.U. M j; <br /> 9HOWER CLOTHESDRYEFS 9 <br /> KITCHEN 81NK 8 DI3P. VENTILATION FAN � <br /> I <br /> DISNWABNER RANGEHOOD �, <br /> UUNDRY TMY WATER HEATER �, <br /> CLOTHE9 WASHER WOOD STOVE I� <br /> URINAL METAL FIREPLACE 6 CHIMNEY ' <br /> DRINKINO FOUNTAIN FIREPLACEINSEFT � <br /> f <br /> FLOORDRAIN HEATPUMP � i <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHFUST FAN <br /> SINKISERVICE—BAR,ETC.) � <br /> �. <br /> L <br /> SUBTOTAL S SUBTOTAL S % <br /> PERMIT S PERMIT S �c <br /> TOTAL FEE S TOTAL FEE S �• <br /> FRONT9ETB�GN RE�RSEf&�CK SIOESETBAGN PUNCNECKNUMlE11 FEE 11EC[IPfN . � <br /> U9E20NE LOTANEA v�ca+rsrte FEES VALUATION FEE 1.� <br /> O YES �NO �q <br /> BUILDING � <br /> 7YPEOFCON9T. OCCIIP�NCY0R0UP NOAFDWEllIN4UNIT5 <br /> u�ox'r�e�E/��Tu�� PLUMBING <br /> &ZEOFBLDO. NO.OFSTOFIES BSMr. occ�o�o MECHANICAL S �D <br /> ❑Y <br /> ❑ N � <br /> — IIEIGHTLIAIITAT10N OTHER � <br /> FlHESPRINNLERSREOUIRED O YES O NO STATE BUILOING SURCHARGE <br /> STATE ENERGY SURCHAR6E <br /> evMlunONecGev �+g�PPp-BY PUBLICWORKS <br /> TOTAL S✓ <br />