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L'i.��........Y� � �.��.. ..... . . . . . . ..•._ ... .. _ ...�. .... . �.. . . <br />. . . . .. \ . . _ �t�Y�"1\�. W <br />APPLIC.wT10N FOR CONSTR�WCTION <br />PERMIT <br />Ihe Everqreen everett <br />CITY GF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />, OWNER MNRADORE55 CITY ZIV PNON[ <br />v�,��►�r I-InLman 66oa �Gck.¢�Qi,I,�Y�V.c Sdc3 353 �5"��� <br />APCNITEGTORUE51(3NER AI�R�D�RESS Ci1Y 21P PHONE ' <br />Q (A% �i <br />OENER�LCONTRACiOR MAIL��DF[55 CITY 21P PHONE LICENSE• <br />�Lran � bU - 2y3GG`lUG � p� w �rrwh�S 9$oa0 sy�y�� cCol can,da�2lGRF, <br />..cr-u�umu cnuia�CTOR M�IL�OORE55 GIiY ZIP PMONE LIGENSE <br />u'n ��"I�"'� CITY ZIP VIIONE UGENSE� �. <br />PLUMBIN�CONTRAGTOR M�ILAO�RE55 . <br />f <br />c� N���,h 6� <br />YJ NEW � A�DITION ❑ A�TERATION ❑ REPA�P ❑ DEMOLITION ❑ WOOOSTOVE/FRPL INSERT C Bl11lDIN(3 RELOCATION <br />TEN�NTIMPROVEMENTORINTERIOR�P$�f�O�DELO-N_LY^ COIIiAGiPER50NRNOP110NEN0. <br />CpNTPAGTPPIGEOf WORK '/( � ' � �Z/ '3,� uL � <br />OE9CRIBE WOPNA�O SOUARE FOOTAGE INY VEU � <br />Hobu ShOp P Yc <br />LEWLD RIPTIONO PflOPERttI5110V <br />� <br />�p7� BLOGK� OF <br />Nor�hh i.�n�- lay,9� <br />��1-1,�%u Lo.;�7 <br />pROJECT�DOAE55 � <br />5Go2 l4oeke.�e <br />PLUMBINO <br />NO. T'PE OF FI%T <br />WATER CLOSET ITOILET <br />BATHiUB <br />LAVATORVIWASH BA51� <br />SHOWER <br />KITCHEN SINKB DISP. <br />DISHWASHER <br />LAUNDRYTflAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTE <br />ROOF DRAINS— RAINL <br />P�( C0.V I�h <br />� BELOW OR ATTACH F011i;l <br />J�,ur.cL � .��� <br />Sou.�'h ` <br />♦ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN ED THIS APPLICATION AND <br />HNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />OROINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />PpESUMETOEGIVEA�UTHORI7Y OV�IOLA EGORCAINCELTHEPROVSIOONSOF <br />ANY OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br />FORMANGE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />ANIDPRC�OMP YTWITHRiHEMSTATE CONTRACTrORSHLAWL7B27 RCW AND <br />296200 WAG <br />SIGNAIU OFCONIpACTOROHAUT110RREDRGENT D�TE <br />X��� u_ y^„/� //,�/� � � J1 iJ l7 O <br />u i r�cr�.• -�-r � <br />•PPU�ANiS GITV BUSINES�I CENSE NO �ND UUS W E55 N�ML <br />MECHANICAL <br />OR ITEM FEE NO. TVPE OF EOl <br />A/C— A/HNDLG UNITS— <br />FORCEO AIR SYSTEMS-- <br />UNIT HEATERS— &T.U. <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE S <br />g qE�P5ET8ACN SIOESET��CN� <br />. o� � <br />��I <br />TYPE OF fANST. <br />�ILOWACIFJALTUAL'� N <br />saeoreioc. ��0� <br />'- . .. � � � f, � ❑ YES '�'(NO <br />Q <br />OGCUP�NGYONOUP NOOFD1YELlIN <br />r2� <br />M _ f 'L7 <br />NO OF STORIES BSMT. OCG LOPD <br />/ ° N Nf� <br />NEIGHT LIMITATI� <br />❑ YES NO <br />i5' <br />P1.ANSAPPR.BY <br />� <br />8 <br />HEAT PUA1P <br />GAS PIPING <br />EXHAUSTFAN <br />M EA <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />:I(NUMOER FEE <br />� (0�0 <br />,'����.7ir� ��� <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUOLIC WORKS __ <br />TOTAL <br />1. <br />�S <br />� <br />