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� � <br />APPLICATION FOR CONSTRliCT10N <br />PERMIT <br />Ihe Everyreen <br />CITY OF <br />evcrett <br />everett e <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNER M�ILADORE55 qIY ZI^ PNONE <br />�lR�%�.IUf�-�,5� �$r�0 BI�T= s;-�f- E=uc=�f'� ao•� n�z- � 2�_ui_cu <br />•RGMITECTOROESIONER MAlL�00PE55 nt � . —_ <br />FlUMBiNOCONTR�CTOR MAiLA0DPE55 GIIV ZI� PNONE LI�ENSE• <br />NEW ❑ ADDITION ❑ ALTERqTION ❑ REPAIH C DEMOLITION _� WOODSTOVE/FRPL INSERT ❑ BUILDIN(i qEIOCATION <br />CANTR�LT PR::E OF WOqIE <br />/V <br />LOT� BLOLN� OF <br />.fYr�t���nc� N <br />PLUMBIN6 <br />�O. TYPEOF <br />WATER CLOSET (TC <br />BATHTUB <br />LAVATORY(WASH B <br />SHOWER <br />KITCH EN SINK 6 DI <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTA <br />FLOOR DRAIN <br />BACKFLOW PREVEI <br />FOOF DRAINS— RI <br />SINKISERVICE— B, <br />SUBTO <br />PERMIT <br />a <br />�, I �' 1 <br />115E ZO� �pT AqEA <br />2- �skiso' <br />7YPE OF fANSI. OCGUPANCY OROUP <br />�u�avnei���N k- .� <br />�_ <br />SIZEOFBLD(i. NO.OFSTOHIES OSM <br />�!(ov 2 av <br />N <br />FIRE SPRINKLERS REOUIRED ❑ YES f1Gi0 <br />i <br />� <br />o r+o <br />1 HEFiEBV CERTIFV THAT i HAVE READ AND E%AMINED THIS APPLICqT10N AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS AN� <br />ORDINANCES GOVERNING iHIS 7YPE OF WORK WILL BE COMPLETED WIiH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR iHE PER- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RGW AND <br />296200 WAC. // H <br />SIGN�TUREOFCONtR�CTOIiOfiAUfHORIZE0A0ENi pATE ry_,'/�� <br />•vPL i1N1 1 n�in��/yENS'� BUSI�ME , <br />/ <br />MECHANICAL <br />A/C — /VHNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — flT.U. <br />UNIT HEATERS— dT.U. M <br />CLO7HESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CNIMNEv <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />�euincur+ns BUILDINb <br />Z PLUMBING <br />1 <br />� MECNANICAL <br />urt�non OTHER � � <br />STATE BU DING SURCHARGE <br />STATE ENERGV SURCHARGE <br />PUBLIC WOIiNS <br />TOTAL <br />FEE <br />SUBTO7.1L S <br />PERMIT y <br />TOTAL FEE S <br />FEE RECEIPTNO. <br />6g <br />VALUATION FEE <br />A <br />