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�'b <br />q �q G <br />H Z H <br />IC ri <br />C :t O <br />b M �C <br />U1 H <br />6 H � <br />t9 <br />O Y <br />H � <br />Z y <br />� F+H <br />N <br />M <br />�� N <br />ttl <br />N <br />�� <br />«� �,��,s,�.,,., <br />CITY OF <br />everett <br />BUILDING DEPARTM11ENT <br />259�8810 <br />A4PPLIl..�►,TION FOR CONS7F..iCT10N <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />_ �_ i <br />,_>>�� S/� <br />pRGNiiECtOB0E51GNER MMLFODRE55 Cltt ZiP P��DNE <br />GENERALCONiRALiOF MAILAOORE55 CIIY ZIP PIONE LRENS[� <br />❑ NEW ❑ PDDITION r /ALiERAT10N ❑ �EPAIR ❑ �EM1tOLITiON ❑ �M1'OODSTOVE/FRPLINSERT ❑ OUILOINGRELOCATION <br />iENANiIIAPROVEHENiOR [Fi4/F/A�E vO�/D�E��LO GON�RLtiER50NANDP11pNEN0 <br />LONtR>CiPPICEOF\VOF�� �-l'C'V'� _ — — <br />BIOGN OF <br />PLUMBING <br />uoT— 7YPE <br />9ZE <br />� SINK <br />�WASH BASINI <br />iINK8DI5P. <br />1ER <br />TRAV <br />OR ITEM <br />SUB TOTA_ <br />PERMII <br />TOTAL FE[ <br />❑ res <br />FEE <br />5 <br />�-e C� _ <br />I HEREBY CEFTIFY THAT I HpVE REA� AN D E%AMINED THIS APPLICATION ANp <br />KNOWTNESAMETOBETRUEAWDCORRECT.ALLPROVISIONSOFLAWSAND <br />ORDIhAHCES GOVERNING THIS TVPE OF VJORK WILL BE COMPLET;_D \VITH <br />\l'METHERSPECIFIED HEREINOR NOT.THEGRANTINGOFP PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITV TO VIOLAT[ OR CAN�EL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAIV REGULATI NG CONSTRUCTION OR TNE PER� <br />FORMANCE OP CONSTRUCTIOtI. THAi 1 Ah1 AUTHORIZED BV TH[ OWNER OF <br />THIS PFOPERTV TO PEFFORM THE\VORK FOR WHICN APPLICATION IS AfADE <br />AND I COMPLY WITH THE STATE CONTFAGTORS LAW 1827 HCW ANO <br />296 200 WAC. <br />tiIGN4111PCOFCONiRPC1URCI1LlI1HOP4CDRGE\i OA1E <br />1 // <br />X �!_!�(i/.''�l.e_� / �//l��('�✓ /L.�/Y/ ��l — <br />qGFLI�/,N 6 CII V 2pSI1�E55 V L[N�L NO FN� NUSINE55 N�ME <br />MECHANICAL <br />NO. TYPEOFEOUIPMENT FEE <br />NC- NNN�LG UNITS- HP _ <br />FORCED Alq SVSTEn1S- B.T.U. M EA <br />UNITHEATERS�-BT.U. M <br />CLOTNESDRVERS __ <br />VENiIlAT10N FAN <br />RANGEHOOD <br />WATEP HEhTER <br />1YOOD STOVE <br />MEiAL FIREPLACE 8 CHIMNEY <br />FI(iEPLACE INSERT <br />MEATPUMP <br />� GAS PIPMG _ <br />F%HAIJST FA4 _. <br />SUBTOTAL 5 <br />PEFM1IIT 5 <br />TOTAI FflE 5 <br />t] YES ❑ NO <br />ouaoiN� <br />aooroweiur�au�+ns ---- <br />PLUhIBING <br />esMi occ �oeo MECHANICAL <br />❑Y <br />C N -- <br />HeicnturnrcnnOrv OTHER <br />- STATE BUILDING SURCNAR^E <br />STATE ENERGV SUR�:NARGE <br />—�I PUBLIC WORKS <br />TOTAL <br />FEE <br />_i � � � . <br />(': <br />n�1 <br />