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APPLIC.+TION FOR CONSTR�CTION <br /> PERMIT <br /> the Everpreen <br /> pTY OF Cveretl <br /> everett e <br /> BUILDING OEPARTMENT <br /> 259-8810 TO BE CQMPLETED IN fNK— PLEASE PRINT <br /> MNIL>ODRE55 GiY ZIP pNONE <br /> �;�� ���so�r/ �G/f&� L/i�✓C'���/!i' �i�e�l� .�',�'3 _ 3vz8 <br /> lE �NT MRILRDORESS Crtv ZiP PHOrvE <br /> RRGHITECTORDESIGNER M�ILADORE55 OLV 21P PHONE <br /> GENERA ONTR�CTO M�ILADDRESS CILY 21P PHONE UCENS[� <br /> � p/ll�'ou,t.L' ,�.1 /�Y� oI'o,✓�y�,�'� �i�h-ty1d.�l� - ��-z.riz- <br /> MECNANILALGONTPAGTOR MAIL��DRE55 / CrtY ZIP f�MONE LICCNSE� <br /> PLl1MBINGGONTR�GTOR MPILAOORE55 CpY 21P PMONE UCENSE• <br /> \♦��� <br /> CLASSOF WORN <br /> ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEA�OLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> IEN�NT IMPRW EMENi OR INTERIOF PEMODEL ONLY GONiAGT PFRSON ANO PNONE NO. <br /> CONTR�GiPRIGEOFWORK ��QO� �J�� -��� <br /> DESCRIBE/y/�p/RJNf.NO50U�REi00TRGEINVOWEO <br /> t"Q � 'n/ � �IO O �/� <br /> PPOGOSEO USE OF BUILDINO I HEREBV CEFTIFV THAT I HAVE FEAD AND EXAMIN ED THIS APPLICATION AND <br /> KNOW THE SAME TO BE TRUE AND COFRECT.ALL PROVISIONS OF LAW S AND <br /> LEG�L OESCRIPTIONO�YROPERTVISNOWN BELOW OR�T1ACH GOURGOPIE51 ORDINANGES GOVERNING THIS TYPE OF WORK WILL BE COMPLETEO WITH <br /> W HETHER SPECIFIED HERF.IN OR NOT.THE GFANTING OFAPERMIT DOES NOT <br /> Q ,� PRESUME TO G WE AUTHORIN TO VIOLATE OR CANCEL TNE PROVISIONS OF <br /> �oT_.S� e�ocK�9O or < < �� ANYOTHERS7ATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> J/�G� � � FORMANCE OF CGNSTRUCTION.THAT I AM AUTHORIZED BV THE ONNER OF <br /> � THIS PROPERN TO PEf7FORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLV WITH THE STATE CON7RACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> �� �J �ODD� o03 -(c3op.� s.�r+AruaEorcor+Tnacto�or,nun�oaizeonc�Hi onrE <br /> �6/8 l�i�u/ �i�P�`/�-c� ��t l� X ���C�- 9 /S�jY <br /> PROJEGinODNE55 AP U NTSCITYBUSINESSLICENSENO.PND INESSNAM[ <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEi) W C—A/HN DLG UNI7S—H.P. <br /> BATHTUB FORCEDAIRSVS7EM5—BT.U. MEA _ <br /> IAVATOFY�WASH0A51N) UNITHEATERS—B.TU. M <br /> SHOWER CLOTHES DRVERS _ <br /> KITCHEN SINK 5 DISP. VENTILATION FAN _ <br /> DISHWASHER RANGE HO00 <br /> LAUNDRY 7qAV N'ATER HEATER <br /> CLOTHES WASHER WOOD STOVE _ _ <br /> UFINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF ORAINS—RAINLEADERS E%HAUS7 FAN <br /> SINK�SERVICE--BAR.ETC) - <br /> SUBTOTAL 5 SUBTO7AL 5 <br /> PERMIT S PERMIT 5 _ <br /> 70TAL FEE S TO7ALFEE S <br /> FRONT SEIBnLN AE�R SETBnCN / SIDE SETP4LN VUN CNECR NU BEN FEE /� PECEIPT NO <br /> �iS�J 7iS' '• ,� � ' `�-'�n S c�` 0/�L i D��3 <br /> usezone �� IOTPRE� vncnNTsrte FEES �A�UATION FEE <br /> ❑YES u NO /J �J <br /> BUILDING ��j31 G �� ^` <br /> TYPEOFCONST. OCCUP�NLYGFOUP NOAF�WRIWQUNITS — <br /> ALLOWABIE/NGTWL _� PLUMBING <br /> SrzEOFBoc. NooFSToniES es� occtoao MECHANICAI / <br /> � A J — — <br /> MEIGHiLIMIlAT10N, OTHER <br /> Fine svaiNrcieasneomeeo ❑YES �+o �� STATE BUILOING St1RCNARGE � <br /> STATE ENERGV SU(iCHARGE <br /> nrvuc�noNncc.av r��nsevva.ev PUBLICWORKS <br /> Jr 3� � �,2 <br /> Cj � TOTAL �- _ <br /> � /Z,CcS'.G'tf�lt-( <br />