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I APPLIC�ri'ION FAR CONSTRI. �TION <br />' PERMIT <br />fhs Everyr�en <br />CITY OF <br />; ev�rett <br />i BUILDING DEPARTMENT <br />; 269•8810 <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />CVefr.11 <br />� <br />� p�yN v.�a eoon�ss . ... ..._.._ <br />��/CG�i=/sG .�"���•s'o.�=�,�" fvFR��T���a.f- ��a-�39� <br />� MCMITECTORDESIONER MMLTD�RE55 G�tv 21P P��ONE <br />OENERQyCO�NI�R�C�TOR MAIL�UDPE55 CIiY ZIP FNONE LICENSE• �I <br />� MECNANIG�LGOMin�ZTOR MA�LADDBE55 CIIY ZiP PNONE UGENSF• <br />RUMBIN�CONiR�G10R MML��OPE55 CIIV 21P PHONE IICENSE� I <br />CUl4SOF WORR�q <br />❑ NEW Ip ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/fRPL.INSER� ❑ BUILDING I7ELOCATION � <br />TEN�H7IMPPWEMEHT OR INLERIOA AEMO�EL ONLY /� CDN��GI P[I15JY RNO �IION2 NO j <br />CONTR�CT PRiCE OF WO�K � �_ / z� �~ , � <br />DE� I)E ORK��IOSOU�PEFOOt�6E VOLVE�' � <br />,�f?�i i�Qi 3.sU� � .�ti - - I <br />vROPo ouSEOFBUnoiHp ��j IHEREBYCERTIFYTHATIHAVEREADANDE%AMINEDTH13APPLICATIONAND � <br />�,'Y/�Nq ��DoH/ (��� KNOW7HESAME70BETRUEANDCORRECT.ALLPROVIcI0N50FLAW5nND <br />LEWl�ESCPiPi NOFPPOPEHfVISNpWNBEIOWOR�RAGNFOURCOFIE51 ORDINANCESGOV[RNINGTHISTVPEOFWORKWILLBECOMPLETEDWITH I <br />1/� WHETHERSPECIFIEDHEREINORNOt.THECRAN71N60FAPERMITDOESNOT <br />LOT�+7•�• BLOCNl%u�•�'�BF Sw'�f6� Idil'Q,O��� P�ESUME70GIVEAUTHOA�n'TOVIOIATEORCANCELTHEPROVI510N50F I <br />ANY OTH ER STATE OR LOCnL LPW REGULATING CONSTRUCTION OR THE PER• <br />FORMANCE OF CONSTRUCTION THAT I AM AUTHOFIZE� BYTHE OWNEfi OF � <br />�� THISPROPERTVTOPEtiFORMTHEWORKFORWHICHAPPLICATIONISMADE I <br />ANO I COMPLV WITH TI1E STATE CONTRACTORS LAW 1027 RCW AND <br />� 298200 WAC. I <br />saruwn[orcornnncionai�numomztonoeN� o�r� <br />�� �7�i pf �- � V OZ ��j(1 ✓� X���ti� A�l._Q e n �/' /0 '� j' II <br />� FROJEGT�ODRE55 �PpLIC�NiSGIIY0U51NE55LICEN5EN0�NDBU51NE55N�ME <br />PLUMBINO <br />No. T- <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DRINY.ING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — PAi NLEADERS <br />SINK ISERVICE — BAR, E'C I <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FPONi5Ei6AGlt PE�RSEIBeCK <br />zo zo <br />' USEZON LOiApER <br />�'Z oi000 <br />„�.�.,, �=. � .3 <br />SIZEOF BlDO. NO OF STORI[5 BS <br />30� /J�„� ( ° <br />FIPESPfiINNLER5RE0UIPED ❑VES �NO <br />APVLIC�iION CG BV PL�NS APPR. BY <br />�W <br />.. .. r,v+s ; . . . . . . . . <br />MECHANICAL <br />FEE NO. TYPEOFEOUIPMENT <br />A/C— NMNOLG UNIiS— H.P. <br />FORCED AIP. SVSTEMS— B.T.U. <br />UNIT HEATERS— �.T.U. M <br />CLOTHES DRYERS <br />METAL FIREPIACE 8 <br />FIREPLf.CE INSER7 <br />HEAT PUMP <br />GAS PiPING <br />S <br />E <br />S+ �� a� � <br />WCANi SITE FEES <br />❑ YE9 �O � <br />Noorow[uurvaUr+n9 BUILDING J � � r <br />r PLUMBING <br />occ w�o <br />MECHANICAL <br />��c�cNruMiTarioH OTHER (3,(OD "�S.i� <br />SiATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />.. �. r .,. �. _ . . � . . . � � - <br />FEE <br />VALUATION <br />E <br />5 <br />S <br />l:i� <br />