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xt�"y <br />m�x <br />(.�" H <br />9yN <br />H 9 �. <br />y zH <br />k n <br />H� <br />� H 'TJ <br />�/7 H <br />L'1 � � <br />Hq <br />O H <br />�/��g <br />y� V C] <br />ryz <br />t-+ H <br />� <br />H <br />f7 C7 � <br />� � Cs] <br />H O c�i� <br />� � <br />w � <br />fhe Ever9rean <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />T , <br />APPLICAr'ION FOR CONSTRU,..TION <br />P�RMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />rvi�ictt <br />� <br />GENEPALG^ON1T^PA�CiO'R� FIAILAppPE55 ��T� ZIP PNONE UGENSE• <br />�� 77 �eX <br />MECNANIC>LCONtPACiJP MAILPDDRE55 GTY $Ip pMONE IICENSEs <br />PLUMpINGCONTRAGTOR MAiLpOpRESS CIiY ZIP PHONE ln]ENSE• <br />❑ NE�V <br />�or <br />AD��iION ❑ ALTERATION ❑ REPAIR ❑ �EMOUTION ❑\1'DOOSTOVE/FRPL INSERT ❑ BUIL�ING RELGCATION <br />�r5,01N�:i;alq�El.IODE_jJy�Y � CONTAL�E�P�/����/ O <br />�v' J �rr�l:t� - 35�= , 3 <br />1,l.LF <br />PLUMBING <br />�O. <br />� WATER C <br />BATHTUB <br />IAVATOR <br />SHOWER <br />KITCHEN <br />G <br />I HEFEBV CERTIfV THAT I HAVe RE4D AND E%Ah11NED THI$ APPLICATION ANO <br />9 7 KNONTHE SA�dE TO BEIFUE AND COFRECT. ALL PROVISIONSOF LlSVSAND <br />�� ���V L�" ORDINANCES GOVERNING TNIS TYPE OF WOFiK \YILL BE COMPLETED W17H <br />�owrvBEiowon�neCHrouaco�iesi WHETMERSPECIFIEDMEREINORNOTTHLGRANTINGOFAPeFMITDOESNOT <br />PRESUME TO GNE AUTNORITV TO VIOLttE OR CANCEL TH[ PROVISIONS OF <br />�F ,���� ANVOTHERSTATEORLOf,A�LAWREGULATI.'1�CONSiRUCTIONORTHEPER� <br />�� FORMANCE OF CONSTRl1GTION THAT I AM AUiHOR12ED BV THE OWNER OF <br />�I TMIS FROPERTV TO PERFOF M THE WORK FGA WHICH AFPLICATION IS MADE <br />AND I COMPLV WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAC. Q[� �'Y <br />— 51G11FTpRE�1:y0NiqA��Of10FALiNOR12ED4GEKi pAiE I�Vl�2_��I�J�� <br />/ / <br />//] �// XR�fe r>C����.�� NDBUSINE�4�� <br />� � 1 �-� �. . — l V � — <br />MECHANICAL <br />TYPE OF FIXTURc OR ITEM FEE NO. TYPE OF EOUIPMENT <br />LOSET �TOILEA A/C — A�MNDI.G UNITS — H P. <br />_ ___ _ _ __ — __ PORCED AIR SYSTEtdS— flT.U. M EA <br />YIWASHBASINI N UNITHEATERS—B.T.U. M <br />— _. � '- __—____' <br />CLOTHES WASHER <br />URINAL <br />� � DRINKING FOUNTAIN <br />FLOOR DRAIN <br />'r � BACKFLOVJPREVENTERS <br />�O � ROOFDRAINS—RAINLEA <br />ciuv �eco�ncc _ wea cri <br />� i � <br />I'� �"` <br />a � <br />sue rorn� _ <br />PERh11T <br />TOTAL FEE <br />I SO UACK <br />=i / / � <br />��5 IONtp �Y`. i\ ��i.ri, <br />��S�C�i,�nMt •f 1 <br />rvaeorcoasr occurnn� <br />nuoweo�ei.cwm <br />size o� e�w. r+o oF sio <br />,�( �( �> L <br />�yZ� <br />fIRESPf➢NKLERSREOUIRED ❑Y[S �� <br />APPLICA➢ONFCCOY �LANSRPPI <br />� I \ <br />RANGENOOD <br />�VATER MEATER <br />W OOD STOVE <br />h1ETAL FIREPLACEB CNIMNEV <br />RREPLACEINSEflT <br />FEE <br />S } SUBTOT�L 5 <br />__'. _ -- __ __ _ _._— _ <br />5 — � PERh11T 5 <br />.,' _'—_ ___. --_ _— __— —_— <br />5 ,� ' TOTAL FEE 5 <br />in�sc�4c�c� vu� t7����C.-�� �1�� I� p��V`�SV <br />tv � <br />ec�r+*snc FEES VAWATION FEE <br />� � res �n <br />BUIL�ING ��/za+Xa�� <br />NO OF DW[LLING UNiiS <br />� / PLUh1BING <br />esM�. occ �uao <br />r: v MECHANICAL <br />;�N — 1/ <br />Hocrtunn�nriorv OTHER � <br />— `� STATE BUI DING SURCHARGE <br />STATEENERGYSURCHARGE <br />� .PUBUCWORKS <br />I I TOTAL <br />