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APPLICE.i ION FOR CONSTRL�:TION <br /> PERMIY <br /> the Everyreen <br /> CITY OF �������� <br /> �� � everett e <br /> BUILDING DEPARTMENT <br /> p � 259•8870 TO BE COMPLETED IN INK—PLEASE PRINT ryV ��� ��� L��� � I 3 7 7 <br /> �'�' y y � pyyryEq MARaODRESS CItY ZR PNONC <br /> r- <br /> f,�a� �Y[3,e: �?7� L-.2r��sT.G'�i�G 5.., ,L/�/ �-7/�t7� 2J�9— �2� � _ <br /> F] H TEN�NT MAIL�DUNE55 ��—/ 6�1Y ZIP PMONE <br /> K n <br /> H 7tl <br /> �M� ANLMREGfOROE5IGNER MAILRDDRESS CIIY 2�P PHONE <br /> CA H <br /> y z � GENEF0.GO11LR/.LtOR MAILPD�RE55 GiiY ZIP PIIONE LICENSE• <br /> c �G Gfi�//��.n s � /a//�7� .3E���-�BDo <br /> OM MECM�NIGALGl9SR�riOR MA�L���RE55 pTY ZIP PHONE LICENSE• <br /> ��� PWMBINGLONLP�CiOR MAIL�ODPE55 GITY 21P �NON[ UCENS[• <br /> �y� �L��/�e.� i��� �G'� Q��S�9 .r1s�v.-✓su�//.� 9,�'���_G-�.�3:,2/Go ���C'N PL 157n18 <br /> CL�SSOFWORY � <br /> yy ❑ NEW�.ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPL INSEFT ❑ BUILOINGREIOCATION <br /> g �y T[NRNtiMPNOVEMENtOFINtERIONPEMO�ELONIY CONIFLTFEPSONRNOPNONENO <br /> ��� <br /> CONiPGQ FRILE Of WONK <br /> � DESCRIBEWONNPNp50VAREFOOIAG[INVOLVED <br /> y�y PPOPOSEOl15EOFBl11L�IN0 <br /> I HEREBV CERTIFY'HAT I HAVE READ AND E%AMINED THIS APPLICATION AND <br /> ��Y7J��j��f�I�.�J KNOWTNESAMETOB[TAUEANDCOFR`CT.ALLPROVISIONSOFIAWSAND <br /> LW�L�E� SGqipiiprvoFVRO ERivISnOwNBEIOwOAa AGNrouaGOPiE51 ORDINANLESGWERNINGTHISTVPEJF\NORKWILLBECOMPLETEDW�TH <br /> WHETIiER SPEGFIEDHEREINOR NOT.THEGRANTINGOFAPERId1T DOESNOT <br /> PRESUIdE TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> loT B�oCK OF ANVOTNERSTATEORLOCALLAWREGULA?INGCONSTRULTIONCRTNEPER� <br /> FORMANCL OF CONSTRUCTION.TMAT 1 FM AUTHOPIZED BY THE OK'NEii OF <br /> THIS PROPERTY TO PERFORM TH[\NORK FON W HICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONiRACTORS LAW 1827 RCW AND <br /> 296 200 WAG. <br /> �IGNFIUP CONiRACiORO�.PUIHONIZC�4GCNi DAtE <br /> X <br /> ����-�--- <br /> PROJECi/.00NE55 � APPIiC iSCIIYBlI51NE5��UClNSLIIO 06U iNE55NAME <br /> O ' ��a c F ' ,._ <br /> PLUMBING MECMANICAL <br /> '�1 NO. 1YPEOFFIXNi7EOflITEM FEE — NO. TY7EOFEOUIVMENT FEE — <br /> WA�ERCLOSET�TOILET) _� A/C—A/HNDLGUNITS—M.P. <br /> BATHTU6 FORCEDAIRSYSTEMS—B.T.0 MEA <br /> 1�� LAVATORY�WASHBASIN� � UNITHEATERS—�.T.0 M <br /> '�1 SHOWER ___ CLOTHES DRYERS — <br /> KITCHEN SINK 6 DISP. VEN71LATION FAN <br /> '_' DISMW/SMER RANGE HOOD <br /> LAUNDRVTPAV � \VATERHEATER _�J S� <br /> CLO?MES WASHER �'dOOD STOV[ _ <br /> 1 URINAL __5 _ METALRFEPLACEBCHIMNEV _ <br /> ' DRINKING FOUNTAiN FIREPLACE INSERT <br /> FLOOH DRAIN HEAT PU69P _ <br /> � BACNFLOW PREVENTERS GAS PIPING <br /> i�' ROOFDRAINS—�AINLEpDERS _ ��J' _ E%MAUSTFAN = <br /> _ 51NK(SERVICG—BAR,ETC 1 <br /> '_' — — <br /> SUB TOTAL 5 SUB TOTAL 5 � <br /> '! PERMIT S PERMIT S _ � QQ_ <br /> ' TOTALF[E S TOTAIFEE 5 <br /> fRONT5LT9�GN RE�RSETBAGK SiDE5ET9ALH PIARCMECNNUMBEN fEE PECEIVfNO. <br /> usez0ee �oineEe VPtANT51TE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> BUILOING <br /> 1VPEOFCAHST. OCCU^�NCTOPOUP NOOFOWELLINOUNiiS -- <br /> PLLOW�BLE/�GTUAL PLUMBING ' � <br /> SIZEOFBIDG MOAGSIORIES esMr. occiono MECHANICAL � <br /> UN <br /> NE�GHTLIMITATION OTHER <br /> rine5rait+kleasnEowaeo nve3 ❑�+o STATEBUILDINGSURCHARGE <br /> STATE ENERGV SURCNARGE <br /> APPL'LAiIONPCLBY PUNSAPPH.BY PUBLILWORY.$ <br /> v`y�1 rora� �I �J <br />