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,�., �,,• <br /> APPLIG�►TION FOR CONSTfiJCT10N <br /> PERMIT <br /> f�e Evergreen ����°�� <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•88�0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � n�.niinooness cirv ,r, =��ove <br /> owr:oa � � � /� <br /> ��]N�y1s�c_!�o—�'�'•: � �c�.-�U��l G._f'�tl�C_������_.3.�7_�J`_L <br /> iENANi A MAILP ORE55�— L Lllv I�f+ <br /> N/�'7 Giir zin —' P�oNc `Jl-j"'j2�U <br /> ApC1111E TO DES�GNER ' ,�' MA�LAUORE55 3 <br /> �' ��c� �a���(_2_ZzY�S�cifr�.cl�-��✓_�P,f�w�,„�f�Rc wlfl/`�9X1� <br /> `���..� G[NE L/;rvinnclo�� n�nit�DDRE55 r "^ <br /> �7 C�d� � .CY t�'1C'= An� ,oc�,a�' st✓o�N�'1 /jZ.�J��cAC�it/,�._�qr_��7'k�r�l+�B-�j-/1//1----�=��C' <br /> ,•�"nuZADDRE55 C�1V 1�P GnONE �lc:[q{CEN4E� <br /> p�� MECM�NILFLCONiR LIOR � �� <br /> ~ f.irv ZIP PMONE LiCCpcc• <br /> Syy FLUMBINGLONiR�LTOA M�ILIOOFE55 <br /> � CLnSSOF RN <br /> O Ct.O NEW ❑ ADDITION ❑ AITERATION ❑ REPAIH ❑ DEMOLITION ❑ WOOD570VE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � yH IEN�NIIMPROVEMENI0NINIERIONNEMOOELONLY �.. �.,�/� CONiA C�SONPNDP��ONENO � <br /> Ij r CON1RnCi�PICEOiWORK `�/_V_1_��—(–V-'"-�'\—��L-���J,� , —��� <br /> � 7+� OESCRIBEWURNANDSOWRE(OOiAGE1NVOWED � <br /> �ty /��G�.�; -� /�'/d� 3/�>2 -� �'� _ ------- — <br /> PPOPo5Eou5EOF oinf� ��-----� IHEREBYCERTIFY:H.ITIHAVEHEADANDEXAMWEDTNISAPPLICAtIONAND <br /> � �g �j) HNOW'hIESAMETOBETRUEANDCORRECT.ALIPROVI510NSOFLAWSAND <br /> �� n ORDINANCES GOVEFNING iH15 iYPE OF WORK WILL BE COM1IPL[TED WITH <br /> �..� LEGFLDESCR� norvo�raoac 1\'ISHOWNBELOWORATiACNfO11RCOP1[S y�HETHERSPELIFlEDHENEINORNOT.TNEGRANTINGOFAPERA11T00ESNOT <br /> �`�� �-f- �` ������p PRESU ME i0 GIVE AUTHORIN TO VIOLATE OR CANCEL T11E PROVISIONS OF <br /> � y �oi� BLOCK_.� OF J!�!�-l�L=�— ANYOTHER57ATEORLOCALLAWREGULAi1NGCON3TRUC7lONORTHEPER� <br /> N y (� {�nQ ,�/ FORAIANCE OF CONSTRUCiION.THAT I AM AUTHORIZED 6V THE OWNER OP <br /> � y (,[�Q�QL' �7OIO� ����D ��T"' C� THISPROPERTVTOPERFORMTHEWORKFOFWHICHAPPLICA�IONISMADE <br /> H AND I COMPC! V71TH TME STATE CGNiRACTORS lAW 1827 RCW AND <br /> � �y �1 // ?�J62oo wAC. <br /> � �r /'' � �./ ///¢� � / �//���� SiGN<iVP[OFC �>G10���.'�11110PiLE0AGENt f.AIE <br /> t r c� r.r `'itr � <br /> � �—r—� X y <br /> y o u, ��_ cC � �c��Q EvS�' �vh ' <br /> �,,��w�__---- <br /> PROJEGtA�OPE55 �/N� MPUGN GIiV�U51NE55LICENSfNOAN OUSIry[SSNANE <br /> 1 1 �T <br /> 1 _ <br /> MECMANICPL <br /> PLUMBING <br /> NO. <br /> TYPEOFFI%TUREOHITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATERCLOSET�TO�LEn _ A/C—NHNDLGUNITS—HP. _ _ <br /> FORCEDAIRSYSTE�dS—&TU. h1EA <br /> BATHTUB <br /> '� � _ UNITHEATERS—BT.U. M <br /> _ ' LAVATOR�IWASH BASIN� CLOTHES DRYERS — <br /> SHOWER <br /> VENTILATION FAN _ <br /> KITCHEN SINKB DISP. qqNGE HOOD <br /> f� � DISHWASHER _ <br /> I LAUNDRYTRAV WATER HEATER <br /> '�" � WOODSTOVE <br /> CIOTHES WASHER <br /> METAL FIREPLACE 8 CHIMNEY <br /> URINAL <br /> ; �f DRINKING FOUNTAIN _ FIPEPLACE INSERT _ <br /> �� FLOOR DRAIN _ HEATPUMP <br /> BACI:FLOW PREVENTEPS GAS PIPING — <br /> ROOF�RAINS—RAINLEADERS E%H4.ST FAN — <br /> �� <br /> ,�� I SINKISERVICE—BAR,ETG) <br /> t�" <br /> ��� — <br /> SUBTOTAL S SUBTOTAL 5 __ <br /> � --— PERMIT 5 <br /> � ' ' PERMIT g _ — — <br /> TO7ALFEE 5 TOTALFEE 5 <br /> � NECEIPINO. <br /> iR0'lISE1��CK ' R[ARS[IBACr� sm�sc�yACN VIANCN CNN�EP` FEE � ��� ^ - <br /> !�/y� <br /> , .. Zp o 5 �� �%"� �.�� <br /> usezov iornau vnc<Htsrte FEF.S VALUATION FEE <br /> '/'� —�Z� :1 YES Ll NO – <br /> L.� <br /> � �a e���o�N���� � � �v��"_`7�`—�=�_ <br /> NPEOFwNSi OCCU�ANGYGFOUP NOOFOWELLINGUNiiS <br /> nuow�o�v�au ^� !�7 � I � PLUMBING _ _ <br /> �<. <br /> siZE or etoa r+o or SioaiEs osn�r. occ tono MECHANICAL , <br /> 3252 S 2 NA <br /> rrtrorrtuMnenoH OTHER <br /> l , <br /> rine sNnrt+niensacoumEo n res '� ��� _— StA7E BUILDING SURCHaRGE _�� r _i <br /> STATE ENERGY SURCHAqGE _ <br /> qf'PLIG110NA� �UNSAPPRO� PUBLICWORKS <br /> / t `r <br /> TOTAL <br /> — ('ti i t��� ' �'�� "�__ ����', ���-r�,� .� .rY� u� -(r� (C-�,�" �..�r., �z'l l �l,�� ( tt C F <br /> � <br /> � <br /> 4 �lCeb� c' 1' S� C '� <br />