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tne Cverqrre� <br />C�TY Of <br />everett <br />BUILDING DEPARTMENT <br />259-80t0 <br />_ ,- <br />APPLIC.-.PION FOR CONSTRI..:T10N <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />iryp�p ) �1 i mnn �Oc>nls5 ,., Gir Lr r�noNE <br />JJ !,n /( ���-/�—.1�✓�! rYf�-{M_ % o� �� � I�/G�.t t..L_�� � uc C�/ � S� � J S''�— <br />LCN�Ni ./ // / NM1 D�PC--� �SS �— CiIY IIP PIIONE <br />V � �. <br />♦RCNIfECtORDESiGNEP MAIL�OORE55 G1Y i1P PMONE <br />f.CNER�LCANTN�C�OA MML�DDRE55 GI1Y ZIp PMONE LiCENSE� <br />�tuin�/-�— — — <br />M[CN�WCAILONTR�GTOR M�IL��ORE55 qTY ZIP PMONE LICCNSE <br />i'IUMB�NGWNIR�LTOR MM�AU�NE55 GIfV ZIP �NONE LIGCN9E• <br />CUSSOIMONh <br />❑ NEW ❑ ADDITION ❑ ALTERAiION ❑ HEPAIR ❑ DEMOIIT�ON ❑ WOO�STOVEJFRPL INS[RT ❑ BUILDING FELOCATION <br />CpNiR�Q <br />O/ <br />i01 B�OCn 0� <br />PLUMBING <br />NO. TYPE OF <br />SINKh <br />TRAV <br />GRINKING FOUNTAIN <br />FLOOA �RAIN <br />BACKFLOW PRCVENTERS <br />ROOF DRAINS— RFINLEADERS <br />SR�K ISEFVICE — BAR. ETC I <br />ALLOWABIE/�GTU�L <br />❑v <br />CN <br />�iRE SPRMKlERSREOUIRED [' YES ❑ NO <br />5 <br />S <br />S <br />❑ YES !: NO <br />I HEREBV CER71FV?HAT I NAVE R[AD AND E%AMMED TMIS APPLICATION AND <br />KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF lAW S AND <br />OR�INANCES GOVERNING THIS NPE OF WOF7K WiLL BE COMPLETEO WITH <br />W NETH ER SPECIFl E D HEREIN OR NOT. TH[ GRFNTI NG OF A PERMIT DOES NOT <br />PRESUME 70 GIVE AUTHORITV TO VI0I.ATE OR CANCEL THE PRGVISIONS OF <br />ANV OTH E R STATE OR LOCAL LAW REGULATING CONSTRUGTION OR THE PER� <br />FORMARCE OF CONSTRUCTION THAT I AM AUIHORIZED BV THE OWNER OF <br />THIS PROPERTV TO PERFORM TME WORK FOR Y�HICH APPIICATION IS MADE <br />AND I COMPLV WIT�i TNE STATE CONTRAGTO� : LAW 182i RCW AND <br />296200 WAC. <br />sicr�.rvaeorcor+,nncro��o�.nuu�narzroncevr nnri <br />X/�✓ <br />APPUf.�Hi3 pi� <br />r <br />MECHANICAL <br />-. _ , �� - -. - <br />�� <br />NO. 7VPE OF EOUIPME <br />A/C — A/HNDLG UNITS— H.P. <br />FORCED PIR SVSTEMS �- B.T U. <br />UNITHUTERS—B.TL M <br />FAN <br />METAL FIREPL/+CE 8 <br />FIREPLACEINSERT <br />HEAT PUA1P <br />GAS PIPING <br />EXHAUS7FAN <br />FEE <br />SUBTOTAL 5 _ _ <br />PEFMIT � _ <br />?OTALFEE S <br />fEE RECCIRNO. <br />VGIl1oT10N FEE <br />BUILDING _ __ <br />PLUIdBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />PUBUC WORKS <br />TOTAL <br />k� <br />