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,; <br /> ew�a /�h I <br /> APPLICA� ION FOR CONSTRU�.TION <br /> PERMIT <br /> iha Evergreen evciell � <br /> GTY OF � I <br /> everett ' , <br /> BUILDING DEPARTMENT <br /> 259•88to TO BE COMPLETED IN INK— PLEASE PRINT j <br /> OW!!CP I.UILAppR[SS LIiY ZIP PMON[ I <br /> �rn�c! + �:1xcII�H .Q�sE �3ii Ua�r �dqe �'d `�U I$��D3 �V�-3839 <br /> IEN4N� IAAILADOR 55 GITY 2�P PHONE <br /> �qGNITECiONDE5IGNEF AI�ILAOORE55 CILY 21P PHONE <br /> GENEPALCONTRAGTOP AtAIL�D�BE55 CITY ZIP PMONC I�CENS[• <br /> m � <br /> ME M�NICALGONTR�L70R MAILAODPE55 CIiY ZIP PHONE IICENSE� <br /> � �I�� �1 L � `I l�"f' <br /> 1'LUMOINGGONiR�CiON M�ILAODRE55 GTY ZIP PMOHC LICENSE <br /> �,�( _, ._k� �I'1� ���llfl(/ �v <br /> Clfw'SOF RN � <br /> � NEW ❑ A�DITION ❑ AL7ERATION ❑ REPAIfl ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br /> TEN�NT IMPROVEMENI OR INiEPION REMO�EL ONLY � � �ANI�CT PERSON RNp PIIONE NO <br /> — — � \ <br /> LONIRALT PflICE OF WONK <br /> OESCHIBE WONN�ND SOl1�RE fOOTAGE INVO D - CL, <br /> � � a cce ����t l/l•(`` -- — <br /> r oroseouseorem�oma iHEREBVCERTIFVTHATIHAVEREADANDEKAMWEDTHISAPPLICATIONAND <br /> F1 � I Y SI �QI _( P KNOW'HESAME70BETFiUEANDCORRECT.HLLPROV1510NSOFLAWSAND <br /> �Ecuocs� � ���'�OPEPiY1S11OWN9ELOW0(i�R�QIF0U000MESI ORDINANCESGOVEFNINGTHISTYPEOFWORKWILLBECOMPLETEDWITH <br /> WHETHERSPECIFIED HEREIN OR NOT.iHEGRANTINGOFAPERMITDOES NO7 <br /> ��'YcYIJI791��l Cc'�� PRESUME 70 GIVE AU7HORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> i��� e�ocK. oF — ANYO7HERSTATEORLOCALLAWREGULATINGCONSTRUCTIONOR7HEPER� <br /> 1 FORMANCE OF CONS7RUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> T�lt' L�(S'� L ��' � —L�+�.3 �iClA'( [ TNISPROPEfiTYTOPERFORMTHEWORKFOR\VHICHAPPLICFTIONISMAOE <br /> AND I COMPIY WITH TFIE STATE CONTRACTORS lPW 1827 RCW AND <br /> ��� 296200 W.4C. <br /> �U�S���;��'1 j'1'� �� QS ' �� 7GU1it�e�JY�_ scr+atuneorcor+rnncronoianumomzeoncervt o.r; <br /> 1L�u��iL r,_n__�f 1LI�:-�j�9 ' 7 3c: "�c_ rd�a X ��'..l '�� � +<<<�Lr � -?"._1`_L— <br /> PRO.IECTAODRE55 1 J7. �O� �I,SI'� APPUUNiSCITYQUSME55 CENSCNO�NOBUSINFSSNFAIE <br /> 7 �a U �r 2�dc e. �' <br /> PLUMBING �MECHANICAL <br /> NO. TYPE OF FIXNRE OH ITEM FEE NO. 7YPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILEp A/C—A/HNDIGUNITS—H.P. __ _ <br /> � BATHTUB _ _ FORCED AIR SYSTEMS—B.T.U. M EA ___ <br /> �. LAVATORY(WASH BASIN) UNIT HEATERS—B,T.U. M _ _ <br /> _� SHOWER � __ _L CLOTHES DRYEfiS ___ <br /> � KITCHENSINK8015P. _ L _VENTILATIONFAN _ <br /> I DISHWASHER ; _�_ F�FNGE MOOD _ <br /> LAUNDRYTRAY� '_ WATERHEATEf7 _ <br /> �---- _ — <br /> CLOTHES WASHE; �'� �_ �'�'000 S70V[ _ <br /> URINAL METAL FI(7EPLACE 8 CHIMNFY _ __ <br /> �� DFiNKING FOUNTAW _ FIREPIACEINSERi _____ <br /> \ �LOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING _— <br /> RpJF DRAINS—RAINLEADERS E%NAUST FAN _ <br /> SINK�SERVICE—�AR.ETC� _ —— <br /> — __. -- —— — �I� <br /> — —__ _ � <br /> —— I <br /> SU�TOTAL 5 __ SUB TOTAL S —'—'--_-_ �i <br /> PERMI7 q PERMIT g _ <br /> TOTAL FEE S TOTAL FEE 3 II <br /> FNOMSCTU�CH ' RCANS�� � ' SIpE5E1�GN P`NOI�E RNO/��N.�/ .� FEE/ / (..� �EC`PTNO.�(1�� <br /> !j 1 <br /> /J A � '1 (. � � '� <br /> !/� <br /> �iisE2or7� �oi�nen7 j wcnHtsrte FEES VALUATION FEE <br /> ���( I l �/S( S�F 11RES ❑HO <br /> T"PEOFCANST. OCCU�NGYGROIIP NO.OFOWEILINGUNIiS BUILDING _ 9�J _�!� �� <br /> ni.�ow�e�eieaue� —� PLUMBING <br /> �_� _ —_ --_ <br /> S.zEOFo�oc. NonFSToaiES osur. occ�o�o MECHANICAL <br /> I ❑Y —__ <br /> G.Go � — <br /> -- HeicrtuMiunorv OTHER <br /> vmesaau+niensaeowneo nres o ��/ STATEBUILOINGSURCHARGE � SQ <br /> — — _ — I <br /> STATE ENERGV SURCHARGE i <br /> �PPLIC�iiON ACC OY P�PNS�PPfl NY PUBUC WORKS -- ---��-- — � "—_ <br /> __L=,_ /�� <br /> �'�r�� �.'k�'�J TOTAL �V <br />