925 PINE ST 2016-01-01 MF Import

t�e Everpreen CITY OF everett BUILDING DEPARTMENT 259•8810 �� � APPLIC�..f ION FOR CONSTR1ia:T10N PERMIT BE COMPLETED IN INK— PLEASE PRINT (::� � 7_ 2 s.� :S e?17TCC 95l- T everett e AflGNITECTONUE51aNER MAI�AOOPESS CITY 21P PIIONE OENEH�LCONTR�CfON MAI�AOUFlESS CITY 21P PNONE LICENSE• MEGHANIC�LGONTRIICTOR M�ILAD�RE55 CITY 21P PMONE IICENSE• DE7�N TrIV�o2 �vwN�Kl ��1> 99/z� _....._...........�.......... J uiu mnoacc CRY ZIP PNONE UCENSE• ❑ NEW ❑ ADOITION ❑ ALTERATION Iq REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSEPT ❑ BUILDING RELOCATION CONTMCTPRICEOF WORK DE9CRIBE WOFK AND SOU�RE FOOT�GE INVO WED wA71Tt CiuF ;a Q�� e�eAc�fJ IPROPOSED USE OF BUILDINO s �� LOT BLOGN Of i4 _9z,� Pbuc' St' �Ue�2l'"T'l- PLUMBIN6 Yil7� LAVATORVIWASH BASI SHOWER KITCHEN SINK6 DISP. URINAL DRINKINO FOUNTAIN FLOOR DRAIN BACKFLOW PREVENTERS ALIOWABLE/�GTUAL ❑Y ❑ N FIRE3PRINKLERSHEOUIHED ❑YES ❑NO S ❑ YES ❑ NO I HEREBY CERTIFY THAT t HAVE READ AND EXAMINED THIS APPLICATION ANU KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF WORK WILL BE COMPLETED WITM W HETHER SPECIF�ED HEREIN OR NOT. THE GRANTING OFA PERMITDOES NOT PRESUME TO GIVE AUTHOflITY TO VIOLATE OR CANCEL THE PROVISION$ OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERNTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW iB.27 RCW AND 296200 WAG SIGNAIUREOFGONiR�CtOROR�UTHORI2ED�GENT OAtf X�� g9 APPLIL�N—� TSdTYBT15NE55LCEN5 NO�NDBUSINE N�ME MECHANICAL FEE NO. TYPE OF EOUIPMENT NC — A/HN�LG UNITS — H.P. FORCEDAIRSVSTEMS—BT.U. M UNIT HEATERS— B.T.U. M CLOTHESDRVERS VENTILATION FAN RANGEHOOD WATER HEATER HEATPUMP GAS PIPING EXHAUSTFAN SUB TOTAL PERMIT TOTAL FEE BUILOING PLUMBING MECHANICAL OTHER STATE BUILDING SURCHARGE STATEENERGYSURCHARGE PUBLIC WORKS TOTAL rce �