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APPLIC�,f10N FOR CONSTR4CTION <br /> PERMIT <br /> Me Everpreen rvr�cll <br /> CITY OF � <br /> everett <br /> BUIL�ING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER h1All Af10'11.55 f:I1Y tll' PII(1N1. <br /> _fEAY"IR9'T ,_H/IAIk •TKJS )I_' NIII'' = ' � /(c•t � _ (>_.JFL'Sf1�_ �-2.=�_ ?4'.�3----- <br /> T��S uan�no[LS_L:f_T.__. .. . �:.-_ cnvl'.Wi77 . zi� 6iwNi�: - <br /> IEN�NT <br /> UA —___"_'—_-_—f.IIY _"""'__ .. _.IIP —_-- PMONE <br /> �pCHREGT OR�ESIGNEF MAII POORE55 <br /> Mc P�RiDF Rdr7CS�Y��_--1-�L4_LS�K—%�-�_ _ ;21-L .-- - . ��li�--2—t��_-Zrz(_�tLc@ �c�uo8 <br /> GENER�IGONTR�GTOR M�IL�OORL55 CITY ZiP P��ONE IICENSE• <br /> _-___"_.-__—_ -- —_______"____."_-___" _ -'"__ <br /> MECM�NIC�LCONTRACTOR A1�R�DOPE55 CRY ZIV 1'HONE LICENSE• <br /> PLUAIBINGCONTRAGTOR M�ILAO�RE35 CIiV 21P PIIONE 4LENSE• <br /> CL�SSOFNOPK --_'-__—"__ __ ' _. _ ' _ ._ . _ '.. _._._._ . _-_.____"_- <br /> ❑ NEW ❑ AOUITION ❑ ALTERATION � FEPAIH ❑ DEMOLIIION ❑ WOOUSIOVE/PHPLJNSER7 _ ❑ dUILDING RELOCATION _ <br /> TEN�NT IMPPOVEMENT OP INTERIOR PEMODEI ONIY C011T/•GI PERSOH AIID PIIONE NO <br /> CANTR�GTPRICEOFWORK � 1 l ____ L.I'���Ll_..7 ._..�2f��rG_ Z�S��IZ./ _ <br /> OESLPoBEWONKANDSOUAREF TAGEI VOIVED <br /> rv QEr,oi�- ��Kr- �A,���:.�rsl�i�u;i�- --- ------ -- , <br /> iROPOSEO USE OF BUILOINO I I IEREBY CERTIFY T11AT I I IAVE READ AND E%AMINED TMIS APPLICATION AND <br /> KNOWTIIESAME70BETHl1EANDCORRECT.ALLPROVISIONSOFLAWSAND � � <br /> 7 FK ---�— OR�INANCES GOVENNING THIS NPE OF WORK WILL BE COMPLETED WITH <br /> LEWlOESLPIPTIONOFPNOPERttI5110WNBELOWON�Ti�LMFOIIRCOPIL51 WHETIIEHSPECIFlEDHEREINORNOT.THEGRANTINGOFAPEFMITDOESNOT <br /> `�� `� U___ VRESUMETOGIVEAUTIIORITYIOVIOLATEORCANCELTHEPROVI510NSOF <br /> �OT � E' B�OCn �3��� oF _ ��-�-C_L"KE.jT_.. .__._ qNYOTNGRSTAlEOH1.00ALLAWREGULATINGCONSTRUCTIONORTMEPER� <br /> FORMANCE OF CONSTRUCTION THAT I AM AUTHORREO BY THE OWNER OF <br /> DIU• IJ /ILLG.LPI�.14• rL_��G�I 7__�[([L'SLUF _��[,�, 11115PROFER7YT0PERFOHtATMEWOPKFORWHICMAPPLICATIONISM�DE <br /> AND 1 COMPLY WI711 1HE STATE CONTRACTORS LAW 1827 RCW AND <br /> -1 296.200 WAC. <br /> �u `k�L j �� r`{I-r�� � _L/S��CUK�_1_ SIGN�lUNE04GONINAqONO1�F11111JR1lk0AGENI UA1C <br /> 5Nolf� .�u�s N Cu. ------ ...-------- X��'�/z�� �1�<L��- ����` -- <br /> PNOJECI�DDPE55 RP nNf5CI1�OlI5R�[SSIIC[I ENO�NOBII ESS �ME <br /> r �E�5 c� - A✓r r= ��=e �=�;- sl=_ c:>�r's i�4 <br /> PLUMBINO MECHANICAL <br /> NO. TYPEOFFIXTUREORITEM FEE Nn. TVPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILEn __'___ _ _____ AiG-A/HN�I.G UNITS-H P. __ <br /> BATHTUB __ ___ __ _ FORGED Alfi SYSTLMS--B.T.U. _ M EA _ __ _ <br /> LAVATOFY(WASH BA81N) __ UNIT HEATERS�-BTL. M _ __ <br /> SHOWER _ . _ CI.OTHES ORYERS _ <br /> KITCHEN SINK 8 DISP. VENTILATION FAN_ <br /> DISHWASHER _ RANGE HOOD ____ <br /> LAUNDRVTRAY WATERIIEATER _ _ _ <br /> CLOTHES WASHER _ _ H'OOD STOVE <br /> URINAL METAL FIREPLACE 8 CIi1MNEY _ <br /> DRINNIN6 FOUNTAIN fIPEPI.ACEINSERT _ <br /> FLOOR DRAIN HEAT PUh1P __ <br /> BACKFLOW PREVENTERS GAS PIPING _ __ _ _ _ <br /> ROOFDRAINS-RAINLEADEFS _ EXNAUSTFAN _ _ _ _ <br /> SINK�SERVICE-BAR,ETCI -.___ _____-..- _ — — <br /> ____ _—____ -___.—_—__—_--_— _ — <br /> SUBTOTAL S ..._ ________ SUBTOTAL___.S __ _ <br /> PERM�T 5 — _ � __ PERMIT _$ ____ <br /> TOTAL FEE S -- - - TOTAL FEC- S <br /> fppNT5ET8ACK PCRRSETBACIf SIDESETBAGY. VUNCHECRNUM9EP FEE HECEIPTNO <br /> usE2oNe toreee� VALANTSIiE FEES VALUATION FEE <br /> CI Y[5 LI NO <br /> BWLDING <br /> ttPEOFCONST. OCGUP�NGYGROUP NO.OFOWEIIINGUN115 -�---------�- - -'--- -' -- <br /> ALIOWABLE/AG1UAl PLUMBING <br /> SREOFBLUG. NOOFS70RI[5 oSMr. xcioeo h�ECHANICAL <br /> ❑Y __ <br /> ❑N —__ _.—__ _--. — _ <br /> � IIGGIITUAIIIAIION OTIIER ________ ___'_ _ <br /> FIHESPNINNLERSREOUIRED ❑YES ❑ NO $7ATE BUILDING SURCHARGE <br /> SiAIE ENEF7GY SURCIIANGE <br /> . -_______ .—_----- <br /> /.PPLIG�TIONACC OY PL�NS�PPR OY PUBLIC WOFKS � <br /> Tora� <br /> b <br />