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APPLICATI� FOR CONSTRUCT.JN PERMIT <br />Ihe Evergrcen <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />CITY OF <br />everett � <br />BUILDING DEPARTMENT <br />259-8810 <br />i.l DEMOLITION I_I COMBINATION <br />OWJN—ER �j y/ �)� �M��ILAODOE55 �/ <br />f_"U� f-F�/i h�CL/S�JC/ �L.(TIf. <br />lEN NT M�ILA00 E55 <br />HEATING SYSTEM: ❑ GAS U ELECTRIC ❑ <br />I I BUILDING <br />arv <br />/ �lor F <br />LIfY <br />everett <br />e <br />Ir'�AECHANICAL LIPWMBING !] SIGN <br />zir PIIONE <br />�,� j��r i� z��� z.s� gzaZ <br />zm rr+oNe <br />�fiC111iEC10R�E51GNEB M�IL�DUf1E5S CI1Y 21P PIIONE <br />GENEN/LGOHTO�Ci00 MNL�DDiiESS CIfY 21P PIIONE LICENSEI <br />MECNANIC�LCONTRACiOR MRILADDR[55 CI7V ZIP PIIONE LICENSE� �� <br />����: � F�L(r.t<dl�✓S %�U ��� �� l7 �� .s%L"C%r.GiS lL�.L/`%.%z53 .`3.3�1�3c�y 3?� =5�z3�'CL <br />PLUMflINGCOIIIRACTOR MML DDRESS CIfY ZIP PIIONE LICENSE� <br />CLASS OF W0f1N <br />I I NEW I I AD�ITION I I ALTBRATION I I FEPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I. i BUILDING RELOCATION <br />GONiAC�PEfi50NANDPHONENO. � <br />CONTRAGTPRICEOFWOPK �/ ���� � � <br />DESCRIBE WORK AND SOUAPE fOOTAGE INVOLVED <br />�7� S '� i PI n.L1 <br />rnoroseo use <br />LEG�LDESCRIPIION OF PROPERTY <br />LOT OLOCN _ <br />I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br />APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CO ,�iECT. ALL <br />�owon nrT�c��rouncoPies� PROVISIONS OF LAWS AND ORDINANCES GOVERNING TMIIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�F NOT. THE GflANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL U1W flEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOiiK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGNATUREOFCONTiUCIDf10R�UTH0012EDAGENT DATE <br />iP1ECT ADUItE55 <br />� Z�� ✓�U.+�lj��-' <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITE� <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP _ <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEIJTERS <br />RC�F DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR, LTC.) <br />FEE <br />PERMIT E <br />TUTALFEE $ <br />FOR OFFICE USE ONLY: <br />Ff10Nf SETB�CN BEM SETOACK <br />US@ ZONE <br />IYI'E Of CU11I5. �LIOWAPIF I �YPE Of CONSf. AC10AL <br />sizr: <br />INIANE 9Y <br />e�o or sromes <br />SPfiNKLERS f1E00 <br />rinr:s errnoveo or <br />VACnNt SItE <br />�NO <br />NO. TYPE OF EOUIPMENT <br />A/C—AIFiNDLG UNIT S—H.P. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />METAL FIREP4ACE 8 CHIMNEY <br />FIREPUCE INSERT <br />HEATPUMP <br />BUILDING <br />occur�rxr xn p VM�uxGNvns <br />tuwr pLUM01NG <br />BnSEMeNr MLCHANICAL <br />HflIG11i LIIAIINIOt! ADDI710N�L PLA�! CII[CH <br />OTHER <br />SiATE DUIL�ING SURCLIAf1GE <br />CITY OF EVERETT PUBL�CNt!9K5 <br />LOCAL SALES <br />TAX CODEIS 3105 TOT�� <br />FEE <br />�9 <br />SUB TOTAL $ <br />PERMIT 3 <br />FECEIPT NO. <br />� <br />0 <br />