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� APPLIC�.f10N FOR CONSTFi1�t�:T10N <br />' PERMIT <br />Ihe Erorpreen <br />GTY OF evereU <br />everett e <br />� BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />. OWNER M�IlA0�BE55 GIIY ZIP PIIONE <br />MAT7'Cson) Conti%1..t,C�. /56�:1Jis,iade(.vpe C.��,+,+no 1� 9PZ92 339 �89g -- <br />, 1EN11HT MFILPpDPE55 CIiV ZIP PIIONE <br />� �RGNITECT090cESIGNEP MMLAD�NE55 G�iY 21P P��ONE <br />c�� �vw-�i M A TtECl'/ 73 C3 A <br />OENER�LGON1R�CiOH MMLPU09E55 Cilv LP PMONE UGENSE• <br />i <br />f <br />i <br />� <br />f <br />W' NEW ❑ ADDITION ❑ AIiEPATION ❑ REPAIe ❑ OEMOLIIION ❑ WOOOSTOVFJFRPL INSER7 ❑ UUILOING PELOCATION <br />WORK <br />LOT BLOCN OF <br />393 <br />v�ureiNa <br />SHOWER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />— RAINLEADERS <br />_ wna cTr.� <br />�LIOW�BIE/AGTWL <br />FIRESPRINNlERSREOU�pED UVES <br />ItEM <br />❑v <br />UN <br />a <br />n res ❑ No <br />FEE <br />I H EREBV CERTIFV 7HAT I HAVE READ AN� ERAMINED THIS APPLICATION ANO <br />KNOW'HESAMETOBE7RUEANDCORFE:T.ALLPROVISIONSOF�AWSAND <br />ORDINANCES GOVERNING 7HI5 TVPE OF WOFK WILL BE COMPL[TED WIiH <br />W HETl1ER SPECIFIED HEREIN OR NOT. THE GRANTING OFA PERMIT �OES NOT <br />PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCF CF CONSTRUCTIOY. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPEFN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND � COMPLV WITH TI1E STATE CONTRACTORS LAW IB.27 RCW AND <br />C. /� � � <br />SIGNnIUAEO CONIMCLORORAUINOR¢EDAGENi D�tE /14.w � <br />^ A� . _���r..1 <br />A/C - A/IiNDLG UNITS - H.P. <br />FORCED AIR SYSTEMS- 6T.U. M <br />UNITNEATERS—B.T.U. M <br />CLOTHES DRYEFiS <br />WATER I1EAIER <br />WOOD STOVE <br />GAS PIPING <br />EXHAUSTfAN <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANIC�L <br />otNen <br />SiATE BUILDING SURCHARGE <br />STATE ENERGY SURCI{�qGE <br />PUBI.IC WORKS <br />TOTAL <br />SUB TO7AL <br />PERMIi <br />IOTAL FEE <br />S <br />FEE <br />....- -:�-cr. ' . . . . . � � � ,. ., . � � . � . , . ' -- , ' . .' .. ...:..•.t.. <br />