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�-. <br /> APPLIC�.r10N FOR CONSTRI .:TION <br /> PEPMIT <br /> the Ever9reen evr�cll <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> M>IlA00RL55 GIIY 21P PMONE � ��� <br /> ow�� �r�huNs ?,.��� uJcusrwp�(' �nnu� R�o • <br /> T[NnNi MAIL�DORESS GIY ZIP PIIONE <br /> ��k�Ns �ia � C��-V�eu� 2rc�c,.e �v�r�tt R�s _�� <br /> ARG�PECLORDES16NER MAIL�D�PC55 CIIY 21P PHONE <br /> GCNCRFLCOMMCTOF MAILAODRESS CI1Y ZiP P��ONE IILENS[• <br /> au cosS.�41LE <br /> MCCIIANIGAL CONtR�G10R MPIL AOU0055 C t Z P F O C LICEY$[� <br /> RBLIABLE HOLD_-IN_G--S•� INC./dba 11435 120th Ave. N.E. #Bqg�3_ g20-1051 <br /> _ARCL1_ TNSTnT.L•Lil ill➢��-� TMp�nnoon[SS K1i1F�dLld cirv zm vno�+E ucEHse• <br /> ^i UMBiNG LONiNAG10N ��y <br /> O'1 r�'� ��j `�VGi�• . <br /> 4 1 <br /> GLA55OF WORN <br /> ❑ NEW ❑ ADDITION �ALTEFATION ❑ REPPIq CI DEMOLITION COOFCWOODONO�D/1 ONE OSERi ❑ OUILDING RELOCATION <br /> iENPNTIMPROVEMEHTORINIElIIOqPEMODELONLY �� � `._�.,^ , �r�^-�/�CI <br /> CONiRALT PRILE Of V. .IIG <br /> ���.� c�c.-�•E.r (�_. N� _ <br /> �ESGRIBEWOPN�NDSOU�ACf00iRGEINVOLVED �. <br /> Q�,,,�-�'p�,�qS 'ir� <br /> FROPOSEO USE Of OViLDING I HEREBV CEfiTIPV THAT I HAVE READ AND EaA1dINE�TNIS APPLICATION AND <br /> � KNOW'HE S�ME TO BE TRUE HND CORRECT.ALL PROVISIONS OF LAWS AND <br /> ORDINANCES GOVERNING THIS TVPE OF WORN WILL PE COMPLETED WITH <br /> LEWL�ESCRIP110NOFPROP[PIYISIIOWNOELOWORNTAGNlOURCOPIE51 WHETHERSPECIFIEDHFFEINORNCT.THEGRANTINGOFAPERMITDOESNOT <br /> PRESUME TO G�VE AUTHOPITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ��i B�aK_- or _ ppqp�1ANCE OF CONSTRUCTION THAT I AM AUiHORIZED BVI�THE OWNER OF <br /> THIS PROPERTY TO PERFORM THE WORK FOR W HICH APPLICATION IS MA�E <br /> AND I COMPLY WITH THE STATE CONTRACiORS LAW 1827 RCW AND <br /> 296200 WNC. <br /> $IGtlntU�EOFGONiRAC1080GAUiHORR[DRGENT DALE <br /> � `�l� ��f <br /> fM;C,6iAUUH6lw� A� 1'CI YNIISINESSUC i5E PNO US�N[SSNAME <br /> 3� p � �p�J�t �Z. AA-007321 AR NSTALLATICNS, LTD. <br /> PLUM8�N0 MECNANICAL <br /> NO. 7YPE OF FIXTURE OR ITEM FEE NO. TYPE OF EDUIPMENT <br /> FEE <br /> WATER CLOSET(TOILE� A/C-A/HNDLG UNI7S-H.P. <br /> BFTHTUB FORCEDAIRSVSTEN^-B.T.LL��OMEA _ <br /> �AVATORV�WASHBASIN) UNITHEA7ER5-BT,U. M _ <br /> -- CLOiHES DRYERS — <br /> SNOWER — <br /> KITCHEN SINK 8 DISP. VENTILATION FAN — <br /> OISHWASHER _ RANGE H00� _ — <br /> �AUNORVTRAY WNTER HEATER _ <br /> CLOTHES WASHER _ WOOD STOVE — <br /> METAL FIREPLACE 8 CHIMNEY <br /> URINAI _ — -- - <br /> DRINKINC FOUNTAW ��FIREPLACE INSERT _ <br /> FLOOR ORAIN HEAT PUMP — <br /> BACKFLOW PREVENTERS GAS PIPING — <br /> ROOF DRAINS-RA�NLEADERS E%HAUST FAN — <br /> SR:K(SER\'ICE-BAR.ETC� <br /> SUBTOiAL 5 SU�TOiAL $ _ <br /> PEPMIT $ __ PERMIT $ �� <br /> iOTALFEE S TOTALFEE $ <br /> fRUNiSEIBPGN nF.�F5Ei0ACN <br /> $ID[SElOACN PUNCNECRNUMBEH iEE FECEIFfNO. <br /> SCo� <br /> usczorve to�n�aen vr�ca�+tsire FEES VALUATION FEE <br /> ❑VES ❑��D <br /> BUILDING —_ <br /> tYPEOFGOHSi. OCGUPANLYGROUP NOAFDWELLINGUNIiS — <br /> RLLOW�BLVNCiU�I PLUMBING <br /> 5'lGOFBIDG. NO.O�STORIE9 BSMi. OCCLOAO MECH�NICAL <br /> ❑Y — <br /> ❑N <br /> -- IIEIGMtIIMITAiION OTHER — <br /> nnesreinrc�ens aeowaeo n res ❑rvo STATE BUILDING SURCHARGE _ <br /> STATE ENhHGY SURCNARGE <br /> pp�q.IqiIONFGG9Y �LPNSAPPRBY PUBLIL'WORKS <br /> TOTAL <br />