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. .._.: �:. <br />. <br />� <br />PLICATlt,N FOR CONSYRIJCI rON PERMIT <br />� <br />rne e�,roree� <br />cirv oF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK—PLEASE PAINT <br />❑ DEMOLITION I I COMBINATION I I BUILDING �MECHANICAL I I PL'JMBING <br />.�OWNEF i FUtIADDqESS CIT'! . ZIP PIIDNE ./1 <br />.- //)(nl'>-. L/HI/ l� I'-' <br />—J�.l �Vi� 3CJ <br />Pfi ITECT OR DESIGNEt1 MAII AO�RE55 CITY IIP PIIONE <br />AIECNANICALCONiRACTOR MA!LA�DRFSS <br />21P 'HONE <br />1 <br />r <br />everett <br />e <br />I .1 SIGN <br />LICENSE � � <br />L <br />PWMBINGGONTR�CTOR MAILA��RESS GITY 21P PHONE LICENS[t <br />CL�55 OF \VORN <br />Ll NEW 17 ADDITION .. EiiATION I�� I REPAIR f I DEMOLITION I I WOUDSTOVE/fRPL INSERT I I BUILDING RELOCATION <br />TENANT IMPROVEMENT OP INTRFIIpR REAIODEL qyy� GONiAf,T PEf150N RKd PHONE N0. <br />wi <br />PROPERtt �SHOIYN BEIOW OR RiR.CH FOUfi COPIES� <br />BLOCH __ __ OF <br />KITCHcN SINK 8 DISP <br />OISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIN(' FOUNTAIN <br />FLOOR Ur1AIN <br />FRONTSETOAGH I RE4pLETCACK � SI�GSET�AGK <br />USE20NE I IOTAFU <br />1VPk OfCONSi.RLLOW�BLE I iYPEOFCON51.AC1UAL <br />SIZE OF BLDG <br />OCCIIPANCY 10�D <br />REASONFORSPRINKLERS <br />NO, OF STORIES <br />FlRE SPflN6�EP5 PEG � <br />I I YES CI NO <br />nPPLICFTIONACC.OV I PIANSAPPliOVEOBV <br />I HERE3Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TI1E SAME TO BE TRUE AND CORRECT. ALL <br />PROV,SIONS OF LAWS AND ORDINANCES GOVERtJING THIS TYPE OF <br />WOFrC WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NO'. THE GR�NTING OF A PERMIT DUES NOT PRESUME TO GIVE <br />At�.iHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />C(HER STATE OR LOCqL LAW REGULATIN�i CONSTRUCTION OR THE <br />''ERFORMANGE OF CONSTRUCTION. TI1AT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PER�ORM THE IVORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RGW AND 296200 WAC. <br />SI4NATUBEOFCONTRACTONORAUiHORIZEDAGENT OAIE <br />X---1 � <br />: . �,� � i�J� c_ ��t -i3 -Y'� <br />APPIICANTSCITYBU INESSUGENSE ANDBOSMESSNAAIE <br />N0. TYPE OF EOUIPMENT _ FEE <br />A/C—AMNDLG UNITS—H.P. <br />� FORCED AIR SYSTEMS—B.T. . M E.A. <br />UNIT HEAT[RS—F..T.U. M <br />CLOTHES �RVf RS <br />VENTILATIpN FAN <br />IIEATER <br />EXHAUST FAtJ <br />� SUBTOTAL $ �i/`�� — <br />PERMIT S �-j — <br />TOTAL FEE $ � �.� <br />PLANCIIECHNU610Efl FEE NEC[IPiNO. <br />VRCAN7 511E FEES <br />I I YES I I NO yi�iLDwG <br />JCLIInANCY NOdq111-�Nu11N'�IS <br />LP)VP <br />PLUh1�ING <br />OASE6IBNT IACCHANICAL <br />I I YES I I VO <br />HE.GMTIIMIiAiION OTHER <br />__ STATE OU!LI)ING SURCHARGE <br />STATE ENI RGV SUliC11ARGE <br />CITY OF EVER[TT PUBLIC WGF cS <br />LOCAL SALES <br />TAX COUE 15 3105 TOTAL <br />vnwanoN <br />i <br />i <br />0 <br />