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A,PPLICA�,ION FOR CONSTRU.s�T10N <br /> PERMIT <br /> Ihe Everp�een evciell <br /> CITY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•BB10 TO BE CJMNLETED IN INK- PLEASE PRINT <br /> OWHER P MML�ODNE55 y,I C�IY 11 /�� Z�P GMONE <br /> N � `P 1 U �DD E55 P�O '� 1�LJ�GIiIMV U\ I l0 Z'� ��y��l <br /> NNIT / <br /> � � MAILADDNE55 CIiY 21P PNONE <br /> ANGNITECT RDESIGNER <br /> OENER�LI.V��Lr�p MAIL��DRESS CIIV ZIP 1'l1ONE LIGEN�Es <br /> M CMAti y�NiPACTOF MML�ODRESS GITY ZIV PNONE LICENSE♦ <br /> PLUMBiMOpONTP�GIOR M�II�DDNESS CIIY ZIP �NONE UGENSE� <br /> N/� <br /> CLAS90F WORK <br /> ❑ NEW ❑ ADOITION ❑ AL7ERAilON ❑ REPAIR � DEMOLITION ❑ WOUDSTOVE/FRPLINSERi ❑ BUILDINGFELOCAT�ON <br /> tENANT IMPROVEMENf OF INTENIOA AEMO�EL ONIY CAHi�GT i'E�SON�ND PI�ONE NO. <br /> CONTNACT PpICE Oi WOPK <br /> pEg�q�pEWORN�NO50U�REFOOT�GEIHVOIVED /���(1n � <br /> X . . C ��l1�lJ ----- <br /> O SEDUSEOFBUiLDINO IIIEHEBYCERTIFVTHATIHPVEFEADANDEXAMINEDTHISAPPLICATIONAND <br /> KNOW THE SAME TO BE TAUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> lE(ULOESCNiP1iOIlOFPROPEFIVISNOWN9ELOWONATT�GNfOURCOP1Ei ORDINANCESGOVERNINGTHIS7VPEOFWORKWILLBECOMPLETEDWITH <br /> W HETHER SPECIFIE�HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> PRESUME TO GIVE AUiHORIN TO VIOLATE OR CANCEL THE PPO�ISIONS OF <br /> �or BLOGN___ OF ANVOTIIERSTATEORLOCALLAWREGULATINOCONSTRUCTIONORTMEPER� <br /> FORMANCE OF CONSTPUCTION.THAT I AM AUTMORIZED BV THE OWNER OF <br /> THIS PROPERN 10 PEFFORM THE WORK FOR WHICH APPLICATION IS MRDE <br /> AND 1 COMPLY WI7H iHE STA7E CONTRACTORS LAW 1B27 RCW AND <br /> 2B6.200 WAC. <br /> SIGN�tU8E0FCON � ORAU1110RIZF.D�OENf 0�i`� /�� <br /> / <br /> X � <br /> 3�a� P�,�S� . � <br /> PROJECTADDHESS �PPt �N Y U9 E iC � HO.�NOBUS !%N�ME <br /> . � <br /> PLUMBINO MECHANICAL <br /> NO. TYPEOFF�%TUNEORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET�TOIIET) A/C—AIMNDLG UNIiS—H.P. <br /> BATHNB FORCED AIR SYSTEMS—B.T.U. M EA <br /> LAVATORV(WASH BASIN) UNIT NEATERS—�.T.U. M <br /> SHOWER CIOTHES DA1'ERS <br /> KITCHEN SINK 6 DISP. VENTILATION FAN <br /> DISMWASHER RANGE HOOU <br /> LAUNDRVTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CNIMNEV <br /> DRINKINO FOUNTAIN FIREPLACEINSERT <br /> FLOOP ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RRINLEADERS E%HAUST FAN <br /> SINK�SERVICE—BAR,ETG) <br /> SUBTOTAL S SUBTOTAL E _ <br /> PERMIT S PERM�T E __ <br /> TOTAL FEE S TOTAL FEE 5 <br /> FRONi6ETB�CN REARSEiMCK SI�ESETBPGN PUNCMEGNNUM9ER FEE RECEIPfNO. <br /> uSEzone �ot�nE,� VAGANi51TE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> BUILDING <br /> TYPEOFCON9T. OCCUP�NGY6HOUP NOAFOWElLINOUNltB <br /> �uowee«i�Cru�t PLUMBING <br /> BREOFBL00. NO-0FSLORIES oSMr. occ�o�D MECHANICAL <br /> ❑Y <br /> I1 N <br /> H[IONILIMII�iION OTHER <br /> FIRE SPPINKLEFSiiEOUIREO ❑rEs o r+o STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCliARGE <br /> �PPLILAiION�CGBY PLRN9APPR.BV PUBLICWORKS <br /> TOTAL <br />