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��e Everprsen <br />�IiY OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />� <br />r�{�5 6tF <br />APPLICATION FOR CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK — PLEASE PRINT <br />pryqEp M�IL�DpRE55 Cllv /IP I410NL <br />rti� T....�+�...�. rt. , wa, i.,..� ��«l„ R��. Yu�,� �it�4oz cso<ij s,c- ��so <br />0 <br />t�verclt <br />e <br />•HCNIIEGTORDESMNEN M�It�00f1E55 Glv ZII' f'110NE <br />�ow,ci AN�t��s des+�� 33� '(kiy i�'�_ ���..o„�.�—.--- 9�o?D 91��6 <br />GENER�LCONTN/�CtOR QM�IL�OOPES! Cilv t�l' PBONE UCENSE• <br />Gt F T���S�IMf�� I`Ot �il1 �INCQI� ���1.,�,___ 9_�02 ��q� Sli=lnt6- GFi�a� i�ic <br />u.�u.u�rurwro�cmn u�iuooac55 CIIY 21P PMONF 4LENSE� <br />PLUMBINOCONiRAGTON MAILADDRE55 Cilv (iP PIIpNG LICENSC• <br />(h�,,.1a,�. ��W P���4:�. GISiz• sZ�� sr �C� ,,}i _`i8P.o3 2s�-��s� � n,�„� � s <br />CL�SS OF NORR <br />❑ NEW ❑ ADDITON ❑ ALTERATION ❑ REPAIF G OEMOLITION ❑ WOODSTOVE/FRPL II15[�iT ❑ BUILDING RELOCATION <br />CONTMCT PRICE OF WONR� <br />�,� <br />LUT � BLOCK OF <br />PLUMBINO <br />KITCHEN SINKS DISP. <br />DISHWASMER <br />LAUNDRVTRAY <br />ROOF <br />r <br />IIA <br />il�E 9PRINMLERS NEOUIqEU <br />— RAINLEADEFS <br />—aaa Frr.i <br />'OTAL S : i � <br />IIT S — — <br />_ FEE S �� <br />CN SIpESE �G/K <br />, � P �' <br />V�WNT SITE <br />� � §�YES ❑ NO <br />/ <br />fGROUP NOAiDW[IUN�UN115 <br />-3 � <br />iIES BSMi. OCG LOAp <br />or <br />yyN <br />�� <br />� HEREBY CERTIFV ?HAT I HAVE READ AND E%AMIN ED 7HIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVIS�ONS OF LAwS AND <br />ORDINANCES GOVERNING THIS TYPE OF WOPK WILL BE COMPIEiEU WiTH <br />W H ETHER SPECIFIED HEf7EIN OF NOT. THE GRANTING OF A PERMIT DOES NOl <br />PFESUME TO GIVE AUThIORITV TO VIOLATE OR CANCEI THE PROVISIONS OF <br />ANY OTHER STATE OR IOCAI LAW REGULATING CONSTRUCTION OR THE �'FR� <br />fORMANCE OF CONS�RUCTION. THAT 1 AM AUTNORIZED BV 7HF OWNER OF <br />Th11S PROPEFTY TO PERfORM THE WORK FOR WHIG�� APPL�C�TION IS M�DC <br />ANO I COMPLY WITri T11E STA7E CONTRACTORS LnW 1827 RCW AND <br />296.200 WAC. <br />smH�iunEor[oetnec�w�rn�.�,uu�on¢cn�cEnt D�rE <br />�X�'�/^�/jLLy.��1'A,4'Ao �//j1//� 4- /S��sq <br />•PPLIG�N15GIlYOU�[SS1�C� SCNO�NOOOSINE55N�ME <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />A/C—lVHNDLG UNITS— H.P. <br />FORCED AtR SVSTEMS— 6T.U. M EA <br />UNITHEATERti--OT.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WAiER HEATER <br />WOOD STOVE <br />METAL FIREPLACE A CHIMNEY <br />FIREPIACEINSERi <br />HEAT NUMP <br />GAS PIPING � <br />FEES <br />OUILDING _ <br />PLUMBING <br />MECHANICAL ___ <br />OTHER <br />STAT[ BUILDING SURCHARGE <br />STATE ENERGY SUFiCHARGE <br />PUUUC WORKS <br />� Tora� <br />;�f��0��'�� ,� `(:' <br />� ����rtzly�� <br />FEE <br />.. _ __._._ _ _ r=)� <br />C' -- <br />_' —' �� <br />TOTAL 5 " : L_ <br />AIT E —�,� <br />L FEE S T�X — <br />E PECEIPTNO. <br />VALUATION FEE <br />s3 FI3 �/ % �i��(_ )� <br />._�_�.` __'".__ .� . <br />�� -�—i� <br />I,,i�/ f <br />�� <br />�, <br />`.>�� `•S% <br />����j � ° ! fi��P f'� � <br />