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APPLI��ION FOR CONSTRI.�TION I <br /> PER!'�AIT <br /> tbe Everpraen cvrrelt <br /> CITY OF <br /> everett '� <br /> BUILDING DEPARTMENT � I <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAILADORE55 GITY ZIP PMON[ 'i, <br /> !r1/�RY r� ��/J��B�t,� 9�'n ivirl�',�i��No�P-��in��n1s� . 9'8'�9y �8"`j-90/� ', <br /> TENANT MAILADORE55 CITV ZIP � PMONE - ' <br /> I <br /> , PRLNITECTONDES:GNER MFILROOFE55 CITY ZIP PMONE I <br /> GENERALCONTR�CTOR M0.1LR�ORESS LRY ZiP PIIONE UCENS[+ I�� <br /> �u�ti�,� <br /> ' MELHANICALCONTRACTOR MPILA�ORESS CITY ZIP FHONE LICENSE+ j <br /> � �f �c'r��emi.rJE,o <br /> PLUMBINGCONTR�LTOP MAILADORE55 CITY ZIP PMONE 4GENSE• � <br /> %D ti3F ��TC-,�emiH�� ! <br /> Cl�SS 0F WORK <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ D'_MOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � TENANT IMPRO�E�NTi�URIOR REMODEL ONLY M CONTNLT PERSON qND PMONE NO. ; <br /> � � <br /> V�i C�A ,Arir- � L _ 38�y- 9O/S �: �� <br />', ,' CANTRACTPpICEOi�VIOPK � <br />�� � Ol°:RIBEWORN�NDSOURREFp�T��EM LVED . <br />�� <br /> ' � C L b'p�U , , �'lC�� <br />` va vosEouS FBWLDINO IHEREBYCERLFYTHHTIHAVEREADANDEXAMWED'41SAPPLICATIONAND <br /> I �� L�SI�Y�yGyL= CSi.r��,cr ,��y L KNOWTHESAMETOBETAUEANDCORFECT.ALLPROVISIONSOFLAWSAND <br /> � �ece DESCRIPTIONOF PROPERiY�SNOWN BELOW ORATTACM FOUR COPI[5� ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETE�WITH <br />� �a n '7 /'� I WHETHERSPECIFIEDHEREINORNOT.THECaFiANTINGOFAPERMITDOESNOT i <br /> �oT �'`� B�ocK� or ����� r T � T qNYO7NER9ATEORLOOALLAW{7EGULATNGCO STRUCTIONGRTIHEPERf <br /> FORMANCE OF CONSTRUCTION.THAi I AM AUTHORIZED BVTHE OWNER OF <br /> THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATIt�N IS MADE <br /> AND I COMPLY W1T4 TF.E STATE CONTRACiORS LAW 18.27 RCW AND <br /> 296200 WAC. <br /> SGNPTUREOfCONtRRLTOROHAUl110RIZE0FGENt DATE <br /> � <br /> X G,�Q.1, �f, -Q.occ -C'�� <br /> ' PROJECTADOPESS APPIILRNTSCIiYBU i ESSLICENSENOAM1DBO51 SSNAME <br /> /.J/0 /YI e f J` <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSETITOILEn NC-A/HNOLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-6T.U. M EA <br /> LAVATORY�WASHBASIN) UNITHEATERS-B.T.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. Z VENTILATION FAN <br /> DISHWASHER r ' RANGE HOOD <br /> LAUtrDRI'TRAY I WATER HEATER <br /> CLOTHES WASHER V �OD STOVE <br /> URIN.4L 1.�ETAL FIREPLACE 8 CHIMNEI' CSL <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVE'.TERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK ISERVICE-BAR,ETC.) � <br /> SUBTOTAL 5 SUBTOTAL 5 Z <br /> PERMIT 5 -- - PERMIT S <br /> TOTALFEE 5 TOTALFEG 5 <br /> iHONTS[TBAGN , REAqSETOC; SIOESETBAyK PIANCNE NUMQBEP ���) FEE� l'1G� AECtI J�I�� <br /> / /Y� ll rY"l I-� <br /> d S x� C:� `� � <br /> usezorvE ^ IOTRFER vn nr�rsire FEES VALUATION FEE <br /> Y� ,�..��[ � YES ❑ NO <br /> NPEOFCONSL occu��vc'ouv NOAF�1VElI.INGUNIiS BUILDING<<Qai 'r" �� � a� � 3 a � . <br /> AILOWABLE/�GTUAI/' , I / _— <br /> �(� PLUMBING p <br /> SIZEOFB�OG. NO.OFSTORIES &SMi. OCCLORD <br /> �a�� � Z ❑N N�, MECHAN�:AL �Z (J <br /> � HEIGNiLIMIiATION OTHER:. � �� <br /> r��G � `' �_. . <br /> FIpE SPPI4NlEi15 REOUIPED ❑YES y�rvo Z STATE BUILDING SURCHARGE <br /> ^'T <br /> STATE ENERGY SURCHARGE <br /> �PPLICRTIONACC.BY PLRNSAPPR.BY <br /> —, ' � PUBLIC WORKS ZQ <br /> �7/i <br /> �--�X� / TOTAI <br /> �� _ <br />