3601 RUCKER AVE 2016-01-01 MF Import

'�a Everpreen ;ITY OF everett BUILDING DEPARTMENT 259-8810 � -•� .-w APPLICATIt�N FOR CONSTRUC f10N PERMIT TO BE COMPLETED IN INK— PLEASE PRINT ARCNITECTOPUESIGNEH MAILAU�NESS GTV ZIP PNONE L cvciell e � PI.UMBMOCONTR�LTOR MAILA�OFE55 CIiY ZIP PNON[ UCENSE• ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIF ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERi ❑ BUILUING REL(�CATION TENANT IMPRWEMENT OR INTERIOR REMO�EL ONIY CONTAQ PERSON ANp PHOH[ N0. fANTB�CT PRICE OF WORK � � LE6�� UE5bnivTlON OF PROPERtt ISIIOWN BE�W OR AIAGM FOI�R GOPIE51�� ' :�c��p' � LOT �—� 9lOCN /�� OF � � 1 PROJECT�DDR[55 '3 O1 oR PLUMBINO N0. TrPE OF FIXTU WATER CLOSET (iOILET) BATHTUB LAVATORV (WASH BAS�N) SHOWER KITCHEN SINKB DISP. DISHWASHER LAU!JORYTRAV CLOTHES WASHER URINAL DRINKINCa FOUNTAtN FLOOR �RAIN fYi�.'.I SUB TOTAL PERMIT ❑Y ❑N FlRESPRINNIERSNEO111PED ❑ VES O NO N ❑ YES n I HEREBY CERTIFY THAT I HAVE READ AND EaAMINED THIS APPLICATION AND KNOW?HESAMETOBETRUEANDCORFECT.ALLFROVISIONSOFLAWSAND ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR NOT.THEGRANTING OFA PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL 7HE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� FORMANCE OF CONSTRUCTION.IHAT I AM AUTHORIZEO BV THF OWNER Of THIS PROPER7Y TO PERFORM THE WORK FOR WHICH APPL�CATION IS MADE AND I COMP�V WITH THE STATE CONTRACTORS LAW 1827 RCW AND 296200 WAC. SIGNAiUNEOFCONIRAC10POq�UTNORIZE��GENT �ATE AP ICAHiSGI BUSIN�SEN�SN�ME�/�/� MECHANICAL NO. Tao - METAL FIREPLACE 8 FIREPLACEINSERT EXHAUSTFAN - ,,.�. — B.T.U. M SUBTO' PERMIT BUILDING PLUMBING MECHANICAL OTHER STA7E BUILDING SURCHARGE STATE ENERGY SURCHARGE PUBLIC WORKS TOTAL M EA S S FEE