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APPLICATION FO^ CONSTaUCT10N <br /> PERMIT <br /> the Everpreen �����i�� <br /> CITV OF <br /> everett e <br /> � BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAILA�DR[5$ CIIY ZIP PIIONE <br /> ,:,e ._ I l-b��,7a1 l�tP�, LT�L i���3j_v1,x- E�.s:,,�:Ir -N�c--��c�Jl <br /> TENANT hIMLPODfiE55 GiY ZIP PIIONB <br /> br o vr��c�'a� ��w.�c (3:S('� L�.�i�klerC��Q,� �/�� �PiZI(.- <br /> CNRECI�TOROESIGNER M�I��ODRE55 CILY 21P PMONE <br /> G[NEP�LCONTNACTOR M41110�RE55 LiiY ZIP PIIONE LICENSE• <br /> MEGHANIC�LCONTR�CTON MML�Dbf1ES5 f.ilY 21P PIIONE IICENSE• <br /> Pll1��CONLfl�GTORs ���Gn M�IJnnRL59 G�YL�tI._���\._=�1f1. . .f.I1Y,�\y`��. _,��IC�,.���US __"_�'��"���n�_�-__f��nL.[td[NSE�VI�I <br /> C1�S50FNORK --� ------ _-�---.. <br /> ❑ NEW ADDITION ❑ ALIERATION ❑ REPAIR ❑ DFMOIITION ❑ WOODSIOVE/FRPL INS[RT ❑ BUILDING flEIOCATION <br /> TEN�NT iMPROVEMENT OR IN�tdER�IOR REMOOEL ONLV CONiAGi P[RSON ANp PI IONE NO <br /> CONTP�CTPRICEOFWOflN�.�-W�Oa�__• .' ____ "__ _�o�'1J� _ L�LAp�N!L _____�_`V�_�._4�� <br /> OESCRIBE WORN�NO SOl1AHE FOOt�GE MVOI.V6D <br /> ��n / (//9U ('�"���l�c�_�-��_l�l,���vrA4 _ . . ------- — -- ----------------- <br /> Pf1orJSED USE OF nuun�H� I I iflfiEBV CERI ll'Y T I IAT I 11AVE READ ANO EXAMINED TNIS APPUCFTION AN� <br /> IW O W!HE S�ME TO BE T RUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> LEQ�LOE9CRIPTIONOFPHOPERttIS11pWNpELOWOR�R�CHFOUfICOPiEF� ORDINAN.ESGOVEHNINGTIIISTYPEUFWORKWILLBECOMPLETEDWITH <br /> WH E7HER SPECIFIED H EREIN OR NOT.THE GI�.ANTING OFA PERMIT DOES NOT <br /> PFESUME TO GIVE AUTIIORIiY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � �oT e�ocK oF --- ANYOTHERSTAIEORIOCALLAWREGULATIN�CONSTFUCTIONORTHEPER• <br /> FOFMANCE OF CONSTRl1CTION.THAT I AM AUTHORI2ED BV THE OWNER OF <br /> TI115 PROPERN TO PE RFORM TNE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 HCW AND <br /> 296.200 WAC. <br /> SiGNAIURE OP CONIP4C1U11 ON AlIt110N�2E0 AGENI OAtE <br /> PPOJELT�ODRESS ! � I—LJ-�� <br /> q ICaNi$CIiYpU5NE5511GEN5[NOANOBUSINESSNAM[ <br /> � � � �I�u,- �ose �na . ,. � , <br /> PLUMBINO MECHANICAL <br /> NO. 7VPEOFFIXTUREORITEM FEE NO. TVPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILETI A/C—A/I IN01 G UNITS--H.P. _ __ _ <br /> _ __'___ . ._- . - . _-_._ . ___._ . _ __. _' .______. _____—__ — _— — — <br /> BATHTUB FORCED AIR SYSiEMS--B.T,U._ M EA ___ _ <br /> � LAVATORYIWASHBFSIN) _ � _ UNITHEATERS—BT.U. M _ _ <br /> SHOWER CIATHES DRYERS ___ __ _ <br /> ! KITCHEN SINKd DISP. _ VEMTILATION FAN__ _ <br /> � — _ _— . . .___—._'__. . <br /> OISHWASHER RANGEI100D <br /> — _ _ .. __. ____—__.___ — <br /> LAUNDRV"iRAY __ WATER HEATER __ _ <br /> CLOTHESWASHER _ _ WOODSTOVE _ <br /> URINAL METAI FIREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACEINSERT _ <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK�SERVICE—BAR,ETC) _� _. _�L].(L_L�<'� <br /> — —_�_��,__n��-r� E., �. <br /> — _ — —_ _R—��a�lls— — <br /> — -- -- = -�4�s7'�d,_tF.�Lsxw-t�— — <br /> SUBTOTAL S SUBTOTAL ___E � jjf///---���� — <br /> PEFMIT S� --- — � _ — '__ _ PERMIT _�—� g �— <br /> TOTAL FEE E TOTAL FEE S � <br /> FRONTSEfB�CN PERNSET��CN SID[SEIBACK PUNCHECNNUMBEN FEE AECEIPTNO. <br /> useior+e �orenee VAG�NTSITE FEES VALUATION FEE <br /> Ci YES O NO <br /> BUILDING <br /> ttPEOFCONST. OGCUPANCYGROUP NOOFOW[IIINGUNIiS — -- <br /> �ILOWABLE/�CTu�L PLUMBING <br /> S�EE OF B100 NO OF STOl11E5 BSMT. OGG LOAD <br /> ❑y MECHANICAL � _ <br /> n N <br /> H[IGIITLIAlITR11ON OTIIER <br /> FiRG9PqINKLERSREOWBE� fl YES Il NO __ __ STATE 9UILDING SURCHARGE <br /> � S1AiL GNLRGV SURCMARGE <br /> APPLICALION�CG 6Y PUNS APPR.OV <br /> PUBLIC WORKS <br /> � h TOTAL � � � � <br /> �e <br />