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� y <br />C�H <br />9HN <br />�o�� <br />'ilHb <br />N <br />yx <br />��o <br />��g <br />�Y (] <br />t"y� <br />HH <br />g �' <br />n �� <br />�O� <br />,.,� ,--.. <br />p�PLICE'.t10N FOR CONSTRI..: TION <br />PERMIT <br />Ihe Evergreon �'°< «�� <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />, 259�8870 TO BE COMPLETED IN INK— PLEASE PRINT <br />� MAILAODRE55 CItY LIP PNONE <br />OWNER u�,,� PO Qox �/9� ��ere�" 9Bzo� �S�-s%Y� <br />1,�11� �-le� fl��o� <br />LENANL A�FILAOORE55 GL ZV FNONE <br />❑ NEW AOUITION ❑ A��ERATION ❑ REPAIR ❑ OEMOLITION LJ WOOI75TOVElFRPLINSERT U B111L01N�NtLO[:Piiun <br />iENNNTIMP EMENTORINLERIORPEMO�ELON�Y CON—IA{C-tPER50NANOP110NLN0 <br />�j no .JC� V.1'ni�I�C `ZS`�—.5-/�/�_ <br />CONLRAf,TPFICE0F190RK GOf� �OOO <br />DESLP�BE WORN ANO SO WA[ G001PGE �NVO W[b <br />rl � I / /1 I I •J � _ , L1�nR .�,i. . <br />q/ Q <br />LOT ✓ 9LOLN • � � OF <br />(�, /� � � �` l �. <br />r <br />PLUMBING <br />N� <br />LAVATORY (K'ASH B <br />SHOWEF <br />KITCHEN SINK 8 DI <br />DISHWASHER <br />LAUNDRY7RAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTP <br />ROOF ORAINS — R4irv�tni <br />SINK ISERVICE — BAR. ETG <br />� <br />I MEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNO�N'HE SAM11E TO BE TRUE AND CORRECT. ALL PFOVISIONS OF LAWS AND <br />OR�INANCES GOVEFNING THIS TVPE OF WORK 141LL BE COMPLETED WITH <br />WNETHERSPECIFIED HEREINOR NOT.THEGFA��TINGOFAPERMITDOES NOT <br />PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE PROVISIOtJS OF <br />ANY OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH E PER� <br />fORMANCE OF CONSTqUCTION. THAT I AM AUTHOP.IZCD RV THE OWNER OF <br />THIS PROPERTV TO PERFORM THE WORK FOR V�'11CH APPL�:'ATION IS MADE <br />AND I COt.1PLV WI74 THE STATE CONTR4J'.ORS LA\N 18.7�7 FC AND <br />296200 WAC. L <br />vcr+nro�corca+i�ar.iona�aunioa¢cnac[r�r Onr[ 8�'�� g� <br />Xl IoJ!/I��O,•//%.� /�//..;�/�., ,f�,,..,/,,,z.... <br />MELHANICAL — <br />ITEM F E NO. TYPE OF E�UIPMENT <br />-- WC—A/HNDLGUNITS—H.P. <br />— FORC[DAIFSYSTEAIS—flT.U. MEA <br />�' UNITHEATERS—B.T.U. M <br />_) �IOTHESDRYERS <br />— � VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER _ <br />SUBTOTAL 5 — <br />PERMI7 5 <br />TOTALFEE 5 <br />'RONi5ET6PCN REAFSETBACK SI�ESEIBPLN <br />z o' <br />JSEZONE LOLPREN � � VAGANT It <br />❑ YES NO <br />� 000 <br />IYPEOFCANST. �.� OC PAM�� AOUP •� NOAFOWEILINOUNITS <br />1LLOWAOLE/ACiUAL <br />52EOFBL�G. NOAFSiORIES 65Mi. OCGLONOA <br />gZ �( ����� • � u N HEIGNiLIM� ILAl10�N l <br />i av � <br />LIR[SPR�NNIERSRE001RE0 CYES NO <br />HEAT <br />SUBTOTAL 5 � <br />PERMIT 5 <br />TOTALFEE 5 � <br />111MBEP FEE ^- PECEIPTNO. <br />ZZ 79 �� � � <br />_��.. vei unnnrJ FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUIL�ING SURCHARGE <br />STATE EN ERGY SIIRCHARGE <br />PUBLIC WORKS <br />TOTAL <br />� <br />