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� < . _ . <br />'�`'`' - . �� .�APPLICA�ION FOR CONSTR ���1 TION <br />i�` � �'' PERMIT <br />, � - <br />I� .. �m• Ewron•n <br />� CITYOF <br />everett <br />BUILDINO DEPARTMENT <br />everett <br />e <br />2�eSto TO BE�OMPLE ED IN INK— PLEASE PRINT <br />�4r LU�r��s ai6i� �s .av� .�t. �oTNELL 98os� �al-4S'�'i� <br />q MI1ILA�ORE59 GTY 21P PMONE � <br />� <br />h�T MAlll1UDRESS CITY ZIP PMONE . , <br />MECHANIC�LCONTMCTOR AUIl�00RE5S CITY 21P PHONE LICEN9E• <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFFPL INSERT ❑ BUILDINO RELOCATION <br />TENNlTIMPROVEMENTORINTERIORREMOOEtONLY _ � CONT�CTPERSON�NDPI/ONENO. ' <br />� <br />i /IqP08EDU9EOFBVILDINO I/ <br />,.,�;j�S.niatc tAn�icv hb�f <br />��'�L[G�LOEBCRIVTIONp� PROPE �SHOWNBELOWORATU�CMFOL <br />� OF (et3'! I� �I <br />i ."'LOT� BLOCK� OF �"'� <br />I <br />:� %�i 1� ��� � <br />PLUMBINO <br />e�n�rue <br />ROOF DRAINS — <br />ciuK iaFwvir.F — <br />�� <br />/ 22 <br />. <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />q�qg�g/��; SIOE9ETBI�CK <br />tj � � t <br />LOTAREA V� NTSILE <br />7200 E9 �NI <br />OCCUP�NGYl3ROUP NOAFOWELL <br />,�- 3 / <br />NO.OF9TORIES B9MT. (`CGLO�D <br />/ �r � <br />N <br />HEIOHTIIMITA <br />❑ YES O �� / <br />PWIS APPR BY <br />� <br />,��,�,sz �i..►.n r,r.r ��¢ - 6Gay <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISION80F LA1N3 AND <br />ORDINANCES OOVERNINO THIS NPE OF WORK W�IL BE COMPLEiEO WfTFI <br />WMEfHER SPECIFIED HEREIN OR NOT.THE GRANTINQ OFA PERMRDOES NOT <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVI310N3 OF <br />ANY OTHER STATE OR LOCAL LAW REOULATING CONSTRUCTION ORTME PER• <br />FORMANCE OF CONSTRUf,T�ON. THAT 1 AM AUTHORI2E0 BY THE OWNER OF <br />THIS PROPEHNTO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE <br />AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />298200 WAG <br />91pN�TVREOFCONTRACTORO W� NORRED�OENT D�TE `/S� A� <br />� � <br />X � <br />PPLI A T CI BUS�NE C � 1. 1 0 BVSINE54 N�ME <br />MECHANICIIL <br />NO. TYPEOFEOUIPMENT FEE <br />A/C—A/HNDlO UNITS— H.P. <br />FOFCEDAIRSYSTEMS—flT.U. MEA <br />UNIT HEATERS— 9T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN � <br />PERMIT <br />TOTAL FEE <br />BUILDING R�,Y �- <br />PLUMB�NO <br />MECHANICAL <br />OTHER <br />STATE BUILDINCa SURCHARGE <br />STATEENERQYSURCHARGE <br />PUBLIC WORNS <br />TOTAL <br />