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Ihe Everprasn <br />GTY OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />APPLIC�I�'�'!ON FOR CONSTRt,i:T10N <br />PERMIT � <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />cve�ett <br />e <br />uwnen �.�..�.,.�,,...�,... p _... . . . .._.._ n <br />�4m �oN��ino cr�� 3 S�`i I�'c� An..�� C_...,...i� l�h 7 f�/ .�-Sy�•`�� � r <br />TEN�NT M�II�DORESS GiIY ZiP P��ONE <br />��%"„�. <br />MCNIfEGTONDES�GNER MM�ADDRE55 CIiY Z�� �NONE <br />�/i-�f{ <br />OENERdCONTRACiOR MNL��OOE53 CIIY ZIP P�IDNE p UCENSE• <br />Sg �� b (fN..a 'j3 �uZJ <br />EIEGHAN�G�LCONLMCTOR M�LLADDRE55 G11V t�P PHONE UCENSE• <br />PLUM&NOCANTP�CIOR M�IL�DUfiE59 CIIY liP PIIONE UCEN9E• <br />❑ �DDITION ❑ ALTERATION ❑ RC��IR ❑ DEMOLITION ❑ N'OODSTOVFJFRPL INS[RT ❑ BUILDING RELOCATION <br />LOi BLOCK OF <br />PLUMlINO <br />VO. TYPE Oi <br />WATER CLOSET f <br />I BATHTUB <br />I UVATORY(WASH <br />3HOWER <br />1 KITCHENSINK6 <br />� DI3HWASHER <br />LAUNORYTRAV <br />;s,� <br />��-� . �.,.< < <br />rtnivp ��� <br />UFINAI <br />DRINKING FOUNTAIN <br />FL(10R DRAIN <br />BACKFLOW PREVCNTEHS <br />ROOF DRAINS — Rf.' V LEA <br />SINK (SERVICE — 9AR ETI <br />F110NT SEIBACY. <br />ZQ' <br />USE ZyWy� 1 <br />T�— \ <br />ITEM I PEE <br />SUB TO7AL S _� <br />PERMIT E <br />TOTAL FEE S <br />ISEi� G� SIOES�A� <br />(J�� <br />�q� V,A�ANt511L <br />�`YES u �+o <br />p�N-YGROUP NOOFOWEIIII <br />2 / <br />IC�� 1 � _I � <br />� <br />FIqESPRINNLER3PE0UIRED ❑YE9 �0 <br />) <br />�PPLIC�ilOY�CGBY PLAN�� <br />M`►�` <br />� <br />vd <br />I HEREBY CERTIFY 7HAT � HAVE READ AND El(AMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUEl.�ID GOARECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING iH15 NPE OF WORK WIIL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTINGOFA PERMIT DOES NOT <br />PRESUME TO GIVE AUiHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCE OF CONSIRUCTION. THAT I AM AUTHORIZED BV THE OWNER O� <br />THIS PROPERiY TO PERFORM 1 �IE WORK FOR WHICH APPLICATION IS MADE <br />AND 1 COMPLY WITH THE STAtE CONTRACTORS LAW iB27 RCW AND <br />296.200 WAC. r, b <br />SIONANPEOFCONfR�C10RO0AU1110RRE0�GENT DAIE ��^ Iy� JC.� <br />X �� <br />�PPLIC�NTSpiYBU9 ESSLIGENSEN0.4ND9USIIIESSN�ME <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />— A/HNDLG UNITS — H.P. <br />ICED AIR SVSTEMS — flT.U. M <br />THEATERS-9T.U. M <br />ITHES DRYERS _ <br />ITILATION fAN <br />IGE HOOD <br />ER HEA7ER <br />CHIMNEY <br />FIRE{ <br />HEAT <br />GASf <br />1MBER <br />�l Z3 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />O7HEfi r <br />`� <br />STATE BUILDING SURCHARGE <br />SiATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />Zc(�p.f {I /y3 73 <br />VALUATION I FEE <br />