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. . � . , . . . . .. . ' . .... . - .., ' . . . . . ., . � .. ... . .. ... . . . . . .. . . r1:t.,,._:6Y�4'1G: �^: <br />�" r-. <br />APPLIC�.�ION FOR CONSTR�..:TION <br />PERMIT <br />fhs Evsryreen everett <br />CITY OF � <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />�pEp MALLAOOHESS CIIY ZIP PIIONE <br />RN i N-S�h��F- /.}�,2.1-n r. �I?7'[( l�t� Sn„h -ri,P�--3'��/-uY/'7 <br />M�ILAODRE55 CITY 21P PIIONE <br />ARCHITECTORDESIGNER M�ILr10DRE5S CITV EIP PMONE <br />6ENERALC�ALTOfl M�ILA�OflF55 CITY 21P PIIONE LICENSE � <br />1�ei...0 C�ti..,l�c�,i-,ct ISI,.�I•uK 9IL'�C ��(� SNoh• _ 1.���/4 .33</•0,�17 Sch� 3;�bJ- <br />VLUMBINOGONTR�GTOfl MAII�D�RE55 CITY 21P PIION[ LICENSE� <br />..�.._� ?_v_.r 7�,�_.,�.. /�i]il-�'�.�,.4,�.ii/., Sl`dhnl..<.cl__`L�JQ.2 �.�-7�J7 SBJG�I,�? 180M�� <br />Q�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPL INSEtiT ❑ 6UILOINO RELOCFTION <br />fENANTIMPROVEMENTORINTERIORRE/M�ODELONLY/ ?. CONTACTPERSONANDPHONENO <br />LONTRACTPRICEOFWORIC �Wy^� ✓ �S / S�J ^ <br />� .�,......_.,_.... .._.,. . __. _.... ,_ _ <br />� LOT� BIOGK OF <br />PLUMBIN6 <br />NO. 7 <br />WATER CU <br />� BATMTUB <br />'�. LAVATORY <br />� SHOWER <br />1 KITCHEN: <br />I DISHWASk <br />LAUNDRY <br />CLOTHES <br />URINAL <br />DRINKING <br />FLOOR DF <br />BACKFLO� <br />ROOF DRI <br />FIXTURE OR <br />DISP. <br />�i <br />e <br />SUBTOTAL 5 <br />PERMIT S <br />TOTALFEE S <br />PE�HSEf9ACN SIC <br />�o � Z� � <br />LOT�REA �a� <br />� <br />OCCUPANGYGHOIIP NO <br />,� r� � •-3 <br />NO.OFSTORIES OSMf. OC <br />❑Y <br />� CiV N <br />—9 NE <br />REOUIRED ❑ YES PMO <br />BY PLANSAPPP.OY <br />` � <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED 7HIS APPLICAT�ON AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GP.ANTING OFA PCRMIT DOES NO � <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OI� <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERN TO PERFORAI THE WORK FOR WHICH APPLICATION IS MADE <br />ANO 1 COMPLY WITH THE STATE CONTRACTORS LAW B27 RCW AND <br />296200 WAC. V <br />SiGN�NflEOFLONiRAG10RONP111110RREDAGENI D�TE �� � o <br />APPLIGI�NiSC � �INE�ICENSEII D905iNE55N�ME <br />MECHIINICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C — AIHNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS— B.T.U. A7 EA <br />UNITHEATERS-6T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />I RANGEHOO� <br />_ �_ WATER NEATER <br />WOOD STOVE <br />_{_ METACFi�erc'+.ec' HIMNEY <br />fIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />. <br />L] NO <br />SUBTOTAL <br />PERh11T <br />TOTALFEE <br />JMBEN FEE <br />z � 3 �G �-F�-. <br />FEES VALUAT <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WOflNS <br />TOTAL <br />a <br />S <br />rec <br />FEE. <br />